/en/Healthcare-Programmes/Optometry-Management
Optometry Management Our optometry management programme gives you essential optometry benefits. Please note that GEMS will only cover essential optometry expenses related to your eyesight We don’t c
/en/Healthcare-Programmes/Chronic-Medicine-Management
Does GEMS pay for all chronic medicine prescribed by doctors? GEMS will pay for chronic medicine prescribed according to the Scheme's clinical guidelines. This means that even if we cover a condition,
/en/Healthcare-Programmes/Appliance-Management
External Medical and Surgical Appliance Management GEMS has designed its medical appliance benefit in such a way as to ensure that all beneficiaries have access to cost-effective, quality medica
/en/Healthcare-Programmes/Disease-Management
Asthma Cardio Care Bipolar Mood Disorder Diabetes Blood glucose Blood pressure Cholesterol Diet Exercise Smoking Disease Management GEMS offers its members disease management programmes
/en/Healthcare-Programmes/Dental-Management
Dentures Tanzanite One and Beryl options: GEMS covers fissure sealants, subject to managed care protocols. Dental fissure sealants are a simple and effective way to prevent tooth decay Only members an
/en/Healthcare-Programmes/Oncology-Management
Reasons for not funding treatment: When registering on the Oncology Management Programme, the clinical pre-authorisation team reviews the treatment proposed by your doctor and compares it to the stand
/en/Healthcare-Programmes/Wellness-Programme/How-to-book-a-GEMS-Wellness-Screening-event
/en/About-Gems/Our-Board-and-EXCO
The Board of Trustees is responsible for providing guidance on the scheme's strategic direction, overseeing the implementation of the strategic plan by the scheme’s management and managing the organ
/en/About-Gems/Careers
Are you our next GEM? Are you our next GEM? Click here to learn more about the GEMS Employee Value Proposition Life at GEMS At GEMS we value our employees and we continuously work towards crea
/en/About-Gems/Careers/MoreInformation
Positions available at GEMS 3 Month Fixed Contract - Executive Assistant Office of the Principal Officer OPO2303T The total remuneration package will be based on qualifications and experience. The pos
/en/About-Gems/Governance/Audit-Committee
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/CSI-Programmes
GEMS CSI OBJECTIVE To empower and uplift communities through initiatives that are in line with the Scheme's transitional objectives and promote wellbeing of communities that GEMS operates in. The Boar
/en/About-Gems/Governance
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/Governance/Ethics
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/Governance/Human-Resources-and-Remuneration-Committee
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/Governance/Benefit-Design-Committee
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/Governance/Clinical-Governance-and-Administration-Committee
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/Governance/Oversight-Committee-on-Special-Projects-and-Programmes
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/Governance/Finance-and-Investment-Committee
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/Governance/Risk-Social-and-Ethics-Committee
More GEMS commitees Benefit Design Committee (BDC) The role of the Benefit Design Committee (“the Committee” of “BDC”) is to develop recommended option changes (from amongst others, the scheme members
/en/About-Gems/News-and-Events
GEMS Media Release Media Statement GEMS Tribute to Dr Mini Media Statement 2020 Benefit enhancements and Contribution Media Statement GEMS Recognized with IRMSA Award GEMS News R4m bogus medical aid c
/en/About-Gems/Program
Our Mission To provide all members with equitable access to affordable and comprehensive healthcare; promoting member wellbeing. Our Vision An excellent, sustainable and effective medical scheme that
/en/Information/Trustees-election
2025 GEMS Trustee Elections The Government Employees Medical Scheme (GEMS) Board of Trustees has appointed The Elexions Agency (Pty) Ltd to administer the 2025 Board of Trustee elections. The proc
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Orthopaedic-Surgeons
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Otorhinolarynologists
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Plastic-,-a-,-Reconstructive-Surgeons
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Paediatric-Surgeons
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Urologists
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Population-Medicine-Programme-Provider-List
/en/Information/Scheme-Rules
2025 GEMS Rules Archives 2024 GEMS Rules 2023 GEMS Rules 2022 GEMS Rules 2021 GEMS Rules 2020 GEMS Rules Click here for more The GEMS rules contain important information that every member and prosp
/en/Healthcare-Programmes/Wellness-Programme
GEMS provides the following screening tests and services at Wellness events: Body Mass Index (BMI) Assessment; Random Blood Glucose Testing; Blood Pressure Testing; Total Cholesterol Testing; HIV Cou
/en/Healthcare-Programmes/Palliative-Care-Programme
How is GEMS Palliative Care Programme covered? If you are eligible and are registered on the GEMS Palliative Care Programme, it will be funded from your Alternative to Hospitalisation benefit and will
/en/Healthcare-Programmes/Population-Medicine-Programme
The focus of the programme is to manage the coordination of care of members who are nearer to where the MDT is located. This is important for beneficiaries with multiple comorbidities, or those with a
/en/Healthcare-Programmes/Prescribed-Minimum-Benefits
What is a funding guideline (protocol)? GEMS carefully manages the PMB benefit to ensure that beneficiaries are provided with good quality, appropriate healthcare that is cost-effective, affordable, a
/en/Healthcare-Providers
Formulary GEMS official list with details of prescribable medicines. Medical Appliances View the latest Medical and Surgical Appliance List Tariff files The GEMS Tariff file contains the Scheme rates
/en/Healthcare-Providers/Formularies-List
Claims for the items listed on the formulary can be submitted without any supporting documents and motivations. Submit your claim directly to GEMS via enquiries@gems.gov.za or fax to 0861 004 367. P
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Chronic-Back-and-Neck-list
/en/Healthcare-Providers/Medical-Appliance-List-search-functionality
Claims for the items listed on the forms can be submitted without any supporting documents. You can submit your claim directly to GEMS via email: enquiries@gems.gov.za or fax to 0861 004 367. Plea
/en/Healthcare-Providers/Preventative-screening
If you have any further queries regarding this, kindly contact us on 0800 00 4367, fax us on 0861 00 4367 or send an email to enquiries@gems.gov.za Preventative care and screening benefit Prev
/en/Information/Claims-guide
Who can claim? In terms of the Medical Schemes Act, a medical scheme shall, in the case where an account has been rendered, subject to the provisions of this Act and the rules of the medical scheme
/en/Information/Dispute-Resolution
The Dispute Committee is an independent committee which ensures that disputes between the scheme and a complainant are resolved. The decision by the Dispute Committee is final and binding on the schem
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Maxillo-Facial
/en/Information/Copy-of-Annual-General-Meeting
At the Annual General Meeting Attendance at the AGM is limited to members, officers of the Scheme and individuals or organisations who are invited by the Scheme to attend. It is important to remember
/en/Healthcare-Programmes/Alternative-to-Hospitalisation
4. Palliative end-of-life care, such as pain management, is available for terminally ill members and this can be provided in a hospice or at home. There is also a separate value-based GEMS Palliative
/en/About-Gems/Overview
Our Mission To provide all members with equitable access to affordable and comprehensive healthcare; promoting member wellbeing. Our Vision An excellent, sustainable and effective medical scheme that
/en/Compare
Emerald Emerald provides comprehensive cover and gives our members access to a healthcare provider of their choice, subject to benefits and Scheme rules. Comprehensive in-and-out-of-hospital cover Hea
/en/Healthcare-Programmes
Asthma Cardio Care Bipolar Mood Disorder Diabetes Blood glucose Blood pressure Cholesterol Diet Exercise Smoking Disease Management GEMS offers its members disease management programmes
/en/Healthcare-Programmes/Chronic-Back-and-Neck
What benefits will be used? The dedicated Chronic Back and Neck Rehabilitation Programme benefit will be used for members receiving treatment at the centres. This is paid from risk benefit and not aff
/en/Healthcare-Programmes/Emergency-Services
Emergency medical services include: Help given over the phone if there is an emergency while you wait for an ambulance Dispatching emergency medical response (ambulance and emergency personnel) by r
/en/Healthcare-Programmes/Managing-HIV-AIDS
How do I register on the HIV/AIDS DMP? Step 1:Beneficiaries who do not know their HIV status can ask their doctor or clinic to test them. GEMS will pay for this test from the preventative screening be
/en/Healthcare-Programmes/Maternity-Programme
Registering on the programme To access your maternity benefits, pregnant members or dependants must register on the programme as soon as their pregnancy is confirmed. You need to complete an enrolment
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Hospital-Network-List
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Primary-Network/Dental/REO-Dental
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Primary-Network/Dental/T1B-Dental
/en/Information/Fact-Sheet
Product offering GEMS offers six excellent healthcare benefit options, namely Tanzanite One, Beryl, Ruby, Emerald Value, Emerald and Onyx. Our goal is to help public service employees and their famili
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Primary-Network/Family-Practitioners
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Primary-Network/Family-Practitioners/REO-Family-Practitioners
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Primary-Network/Family-Practitioners/T1B-Family-Practitioners
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Primary-Network/Renal-Dialisis
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Anaesthetists-List
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Obstetricians-and-gynaecologists-list
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Paediatricians
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Physicians
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Psychiatrists
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Cardiothoracic-Surgeons
/en/Information/Prescribed-Minimum-Benefits
What is a funding guideline (protocol)? GEMS carefully manages the PMB benefit to ensure that beneficiaries are provided with good quality, appropriate healthcare that is cost-effective, affordable, a
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/General-Surgeons
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Neuro-Surgeons
/en/Healthcare-Providers/GEMS-Network-of-Healthcare-Providers/Specialist-Network/Surgeons-multi/Ophthalmologists
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.