Change in GEMS Network hospital for the Tanzanite One and Emerald Value (EVO) options.
The hospital network is restricted to only two benefit options namely Tanzanite One and EVO and from 01 January 2023.
Every three years a new network is established and all hospital groups compete on the basis of cost and quality to become network participants. The Netcare Hospital Group was unfortunately not successful in forming part of this network as an anchor group, meaning that not all Netcare Hospitals have been included in the new network. From 01 January 2023, Life Healthcare Group and Mediclinic will form part of the network main anchor groups. Joint Medical Holdings (JMH), Clinix Health Group and Lenmed Health will be the network support anchor groups. In areas where the above hospitals are not available; National Hospital Network (NHN) and Netcare hospitals have been identified as network fillers.
For a list of participating hospitals in each province, please click here.
Tanzanite One and EVO Members who consult with Specialists that have rooms in Netcare hospitals:
It is important to note that you and your dependants are free to continue consulting with those specialists as they mostly operate independent from the hospitals. Payment of those claims from these specialists will be assessed and paid as they have been historically. It is however recommended that they request these specialists to admit them to the network hospital when the need arises.
What can you do if there is no network hospital within 50 km of your residence?
If there is no network hospital within 50km of your residence or place of work, you can still access care at a non-network hospital without a co-payment.