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.
This means that crutches will be reimbursed at a maximum of R450 and wheelchairs at a maximum of R5 000 per request (subject to available benefits) from 1 August 2016. If the cost of crutches or a wheelchair on the claim is above the capped fee, GEMS will only pay up to the maximum limit (subject to available benefits and limits) and the shortfall will need to be paid by the member from their own pocket.
Please contact us on 0860 00 4367 or email enquiries@gems.gov.za if you have any questions.
At GEMS we believe that every one of our members matter. That is why we have prepared the member newsletter to focus on your specific needs.