One of the up and coming medical aid schemes at the moment is Gems Medical Aid which can offer plans that are a little different to those offered by the more well known plans such as Discovery and Bonitas. Gem medical aid is primarily aimed at providing healthcare to suit government employees. The scheme has five affordable plans which have been created with members’ needs in mind.
Gems medical aid aims to provide members with access to an extensive range of benefits while still maintaining affordable monthly premiums. Gems provides access to quality healthcare to public service employees and low income families. Gems medical aid members can also receive medical care at private clinics, access disease management programs and get emergency care as required. Let’s take a closer look at the plans on offer to Gems medical aid members.
The Sapphire Plan
The Sapphire Plan from Gems medical aid offers members access to a large network of health care providers including pharmacists, dentists and GPs among other services. Plan members do not need to pay any additional fees for treatment and consultations received within this network.
The Beryl Plan
Beryl offers all of the same benefits of the Sapphire plan, but members also have access to some additional benefits including out-of-hospital over, chronic mediation cover, maternity programs, dental cover, HIV/AIDS management, Oncology cover and optometry care.
The Ruby Plan
The Ruby Plan allows Gems medical aid members with an additional level of care. Not only do they get access to care programs for chronic diseases which will provide both them and their families with the necessary support and medical care they need, but the plan also includes a savings account.
The Emerald Plan
With the Emerald option plan members still have to make use of the approved GEM network of health care providers if they are to avoid out of pocket expenses, but using them is not required. It is necessary to seek re-authorisation for hospital visits including out patient visits, physiotherapy and ambulance transport.
The Onyx Plan
The upper level plan offered by Gems medical aid is the Onyx plan which offers members very specialist care programmes to help manage a range of chronic diseases. This includes education about a number of conditions including asthma, diabetes and mental health. There is no requirement for Onyx members to use the GEM network of providers, but doing so will remove the potential for out of pocket expenses.
Pre-Authorisation For Gems Medical Aid Plans
The various plans do require pre-authorisation when it comes to specialist dentistry, physiotherapy, out-patient hospital treatments, MRI scans and CT scans. Ambulance transportation is also a requirement for re-authorisation.
In conclusion, Gem medical aid presents the ideal solution for government employees and low income employees who are looking for quality healthcare at affordable rates while also gaining access to great benefits.