How to avoid co-payments

 Co-payments are portions of the cost of procedures or services provided by doctors that members will be responsible to pay. The co-payment can be a certain amount or a percentage of the total bill


Caesarean section benefit changes

From 1 September 2016, all in-hospital maternity caesarean sections for non-medical reasons (i.e. elective caesarean) are funded up to the cost of a normal vaginal delivery. A minimum shortfall of up to R10 000 may apply to the hospital cost, which the member/patient will be liable for


Introduction of capped fees on wheelchairs and crutches

One of the significant challenges faced by the healthcare industry today is the increasing impact of wasteful claims being submitted by members and healthcare service providers. That is why we have implemented a monetary limit (i.e. Capped fee) on crutches and wheelchairs


Physicians are now part of the GEMS Specialist Network

Because we know that you are always looking for smart ways to save, we have created the new, smart Emerald Value option. It gives you the same rich benefits as the existing Emerald option, but at a more affordable rate.


GEMS supports the Protection of Personal Information (POPI) Act

GEMS supports the Protection of Personal Information (POPI) Act. Complying with this Act will allow us to continue to provide you with improved coordination of care in a secure environment thereby granting us the ability to enhance your current quality of care


Introduction of waiting periods

 Stricter controls to protect our members and remain a sustainable medical scheme Since our launch in 2006, we have prided ourselves on being able to provide all public service employees with equitable access to affordable and comprehensive healthcare benefits.