Gems Medical Aid
Gems Medical Aid is a medical scheme for employees
of the South African government and that is what the initials GEMS stands for, namely Government Employees
The scheme have two purposes, the one is to create
an affordable medical aid scheme for government employees. The other purpose is to educate employees on healthcare
and issues related to health. Gems is in the place of all other medical aids and schemes that previously provided
medical and health cover for employees of the government.
Gems hasapproved certain service providers. These
service providers provide the health and medical services to all members of the Gems medical
All the medical aid schemes of Gem include the
Day-to-day cover including general practitioner visits, dentist,
Program for HIV/Aids management
Chronic medicine cover
Which government employees are eligible to apply for the
Gems medical scheme?
Organizational components listed in Public Service Act, Schedule
National Department employees listed in the Public Service Act, Schedule
National Prosecuting Authority
Provincial Administration employees listed in Public Service Act, Schedule
Provincial Department employees listed in Public Service Act, Schedule
If you belong to any of the 14 employer groups
listed in the Act, you are eligible to be a member of the Gems scheme:
Armaments Corporation of South Africa
Council on Higher Education
Council for Medical Schemes
Education Labour Relations Council
National Prosecuting Authority
National Youth Commission
Office of the Public Protector
Parliament of the Republic of South Africa
South African National Biodiversity institute.
South African Social Security Agency
Vhembe District Municipality
If Gems members who are Public Service Employees are transferred to a public
The benefits of the different plans are according
to the payment the member makes.
There are 5 medical aid plans:
Sapphire is an
annual hospital plan that covers hospital expenses of your family to the limit of R156 492 per year. Included in
the Sapphire, are unlimited visits to your general practitioner, provided your doctor is one of the approved
Beryl has a
hospital treatment cover of R782 475 per annum, for your family. Unlimited visits to your general practitioner are
covered if he is part of the network doctors.
Ruby has hospital cover that is unlimited for conditions that qualify as PMB, or
prescribed minimum benefit. For non-PMB hospital admittance, the amount per recipient is limited to R 12632. Visits
to general practitioners who are approved are unlimited.
unlimited cover for hospital for PMB conditions. Non-PMB hospital admittance is limited to R 12632 per recipient.
The yearly cover for day-to-day medical care per family is R6616.
· Onyx has unlimited cover for
hospital admittance for PMB conditions, and a yearly cover of R 12,632 per recipientfor non- PMB hospital
admittance. Day-to-day cover for your family per year is R 13,913.
aid, as the government medical aid in South Africa, would like to be seen as the example of how medical
aids should care for their members. © Medical Aid