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When you think of gems, you think of something of quality that is worth something of value. That is an extremely fitting way of thinking when it comes to GEMS medical aid. GEMS medical was created with the needs of public service employees and their dependants in mind. Taking care of the health and well-being in government employees and their families became a priority. As before the creation of GEMS, there were many things that these employees and their families were lacking with regards to medical health benefits.
What problems did these employees face prior to GEMS?
Prior to the creation of this medical aid many public service and government employees were faced with, most importantly, the inability to afford any type of medical aid covers for themselves and their families. Obtaining medical aid was difficult because the costs of most medical aid schemes were getting increasingly more expensive. There was also the fact that those with medical aid schemes were not getting their monies worth. Another key point is that most medical schemes did not take into consideration the unique health benefits that some individuals need. With the creation of GEMS medical aid, things changed for government employees and their families by way of finally having access to quality affordable medical cover.
GEMS medical aid consists of five different medical aid schemes for government employees. These different benefit plans are sapphire, beryl, ruby, emerald, and onyx. Each of these different plans provides a variety of different services and benefits to the plan holders and their families. The different benefits offered by these programs include a variety of different programmes and management services. Some of these different programmes include chronic medicine and maternity, while simultaneously offering out-of-hospital benefits and assistance with both acute medicine and chronic medicine formulary. There is also dental, hospital, oncology, optometry, and hospital management in place for the benefit of GEMS plan members.
With a GEMS medical aid plan, government employees and their eligible family members can enjoy a host of benefits. One of the leading benefits to opting to go with GEMS is the affordable rates at which cover is provided. When it is necessary to make a claims payment, they are made promptly every fortnight. Various programs are in place that helps with different illnesses and diseases; this includes a disease management program and an HIV/Aids management program. Both of these programs are in place to help with a variety of factors, which include costs of on-going treatment, and management of treatment.
For government employees’ having affordable and comprehensive medical cover is now much easier thanks to the creation of the GEMS medical aid. Members can have all of the medical benefits their health requires while not paying excessive fees to get it.
No one wants to admit it, but there are times in everyone’s life where he or she is going to need some type of medical assistance. There are times where you or your family members may fall suddenly ill and require emergency assistance. There are also those rare occasions, where because of some sort of accident that there is a need for emergency medical care. In some of those cases that can lead to a need for hospitalization. Whether you or your family members come down with a simple cold, or there is a medical emergency, it is extremely important that you have some type of medical aid scheme to cover the costs of whatever is required to get your health back to where it should be. When it comes to providing the medical care that you need, for emergencies and preventative measures, Netcare medical aid offers a broad spectrum for their members and qualifying dependants.
When it comes to helping you take care of your health, and those that you love, Netcare medical aid offers a comprehensive range of services for your entire family. Since our staffs is aware that you and your family may need assistance with a host of different medical, dental and optometry issues, we have services ready. We want you to be aware that your health is our number one priority and because of that, if you have questions or concerns related to any issue, we are there with state of the art equipment, highly trained and skilled doctors, specialists for a variety of medical treatments and procedures. Your health is always our number one priority. The team at Netcare medical aid are also aware that besides the traditional forms of medical treatments and procedures, and preventative medicine that you need, there are times when other medical services are needed. It is for this reason we have information and offer assistance with transplants, renal care, and any other medical emergency that may arise.
Taking care of your health and the health of your family requires more than simply eating right and exercising. It also requires having regular visits to doctors, optometrists, and dentist to protect the well-being of your eyes, teeth, and entire body. Having quality preventative medical care in place can help either stave off, or diagnose diseases or medical problems early. Another important reason to have a quality medical aid scheme like that offered from Netcare medical aid is the security of knowing that if an emergency happens and you are in an accident you will have the coverage you need. Do not be left in a position where you are without the help you or your family needs, get a quality medical aid scheme today.
This entry was posted in Medical Aid and tagged Family, Health, Health care, Health insurance, Medical emergency, Medicine, Netcare, South Africa on by Jackson.721class="post-721 post type-post status-publish format-standard hentry category-medical-aid tag-chronic-medicine tag-health tag-health-care tag-health-insurance tag-medicine tag-preventive-medicine tag-south-africa tag-south-african-police-service"
Those that devote their time, energy, and lives to protect the well-being and safety of the rest of the populous need to know, should something happen to them, while on duty or off, that they are covered medically. The South African Police Service is an incredibly important group of people who need to have the assurance that their medical needs are covered. In order to ensure that they are taken care of, as well as their dependants, there is POLMED medical aid. This medical aid scheme is specifically for this group of individuals who spend their lives looking after others and enforcing the law. Unlike other medical aid schemes that are offered in South Africa, this is a closed medical aid scheme only for the employees of the South African Police Service (SAPS) and their families.
Designed to provide the absolute best services for employees of the South African Police Service and their dependants, POLMED medical aid offers a wide variety of different services. There are services set in place that are strictly there for preventative care purposes. If individuals are able to have regular check-ups and other care, such as access to dental care and optometrists, potential problems can be avoided, or damage can be reduced. POLMED also has in place coverage for those that plan to get, or are pregnant, along with treatment and care for chronic medical problems, as well as a Confidential HIV Risk Management Program.
Unlike other medical aid schemes available, POLMED medical aid has the POLMED 60+ club for its members. This Club was designed with one goal in mind, to educate the older generation on how they can approach aging. The club offers information that can help with empowering members on how it is possible to age in a healthy way. It helps them learn how to cope with the various illness and diseases they can suffer from as they age. Finally, it also teaches the older generation to enjoy this later stage in life and all of the opportunities that come with it, instead of approaching aging with a negative attitude.
In addition to the programs established for the elderly, and all of the preventative care programs in place, POLMED Medical aid also offers the security that individuals need on the occasion that the unexpected accident or medical problem arises. If there is a need for hospitalization or emergency treatment with POLMED, there is no need to worry about how you are going to get the treatment that you need or how those treatments are going to be paid for by you and your family. If you or a member of your family is with SAPS, POLMED is the ideal medical aid programme for you and your family that will afford you peace of mind.
Health and well-being are key to a happy life. Without good health, and the medications needed to take care of the chronic illnesses that you or one of your dependent family members may have, life can be much more difficult than it needs to be. One of the best ways to ensure that you and those that mean the most to you are taken care of, should an illness or accident strike, or if a chronic illness exists, is to have a quality medical aid scheme that will afford you with the ability to get the health and treatment when you need it. A quality medical aid scheme will also offer a number of preventative health services so that you can stay as healthy as possible and potentially avoid, a serious illness.
If you have not signed up for a medical aid scheme then now is the time to look into Transmed Medical Aid. They are dedicated to not only providing you and those you love with quality medical assistance should a medical emergency occur, but they also offer programs and services that will help you and those you love stay as healthy as possible for as long as possible. For they are aware that one of the best ways to stay healthy is not only living a healthy lifestyle which includes diet and a healthy diet, but it also includes normal and regular visits to your doctor for the purposes of preventative measures. It is because of this need to look after the health and well-being of all beneficiaries that Transmed Medical aid has created the Eldercare Programme.
Transmed created this programme for the benefit of those individuals that are over the age of 60. This programme serves a number of different purposes. The main goal of the program revolves around three different things. These three things are:
Providing information on healthy aging
Education that helps teach individuals how to deal with the illnesses and diseases that can the elderly may have
Encouragement for the elderly to enjoy the later stage of their life and all of the opportunities that comes with getting older.
In order to achieve these goals the Programme offers a few benefits to members and their dependant beneficiaries. These benefits include the following:
A regular newsletter that provides information on aging and healthy living
Opportunities to attend special events and health days
Easy access to medical information that can help you manage your health appropriately.
A webpage for communication with other members of the Eldercare programme as well as online activities
With Transmed medical aid, taking care of your family’s health and well-being doesn’t stop at medical treatment, it also includes programmes, such as the Eldercare programme, that offers that extra help for a great quality of life, even well into the older years.
Every day we wake up, we have a number of responsibilities that we have to attend to not only for ourselves but also for our loved ones that depend on us. This includes taking care of the home, working, and the list goes on and on. One of the most important things that we need to take care of in order to make sure that our family is ok is our health. Living a healthy lifestyle is an incredible important part of anyone’s life. Living a healthy lifestyle for many individual means eating healthier, getting regular exercise, but it also involves having a medical aid scheme in place to help take care of our health in case a medical emergency of some sort happens.
Pharos medical aid is one company that prides itself on going that extra step to ensure that those beneficiaries of any of their plans are taken care of under any circumstances. Their plans are designed to take care of those individuals with chronic or pre-existing conditions, provide preventative care, and be there when the unfortunate accident or illness occurs at the worst possible moment. It is important, in a world of uncertainty, that you do not risk the health and well-being of your family by not having a quality medical aid scheme in place for not only the emergencies that can occur but also for the routine medical care that you need for preventative measures.
For those of you that are on a tight budget, that do not believe they have the ability to afford any type of medical aid scheme, this is false. Pharos medical aid has options in place for you to help you get the medical cover you need. They know that it can be difficult to get medical cover, which is why they offer a 50% reduction in rates, for those individuals that qualify, that earn less than R7500. The also offer significant discounts to those individuals under the age of 21.
Take the time to look into the different plans that Pharos Medical Aid offers individuals and families. There are three comprehensive plans, the Rainbow, Paladin, and Footprint, the Rainbow Plus with a savings plan, a traditional plan called Methcare, and two hospital plans, the Rainbow primary and the Footprint primary. Once you have determined which of these benefit plans best suits the needs of yourself and your family take the next step and sign up.
If you and your family do not have any type of medical cover, it is time that you look into finding an option that will serve what you need. Do not wait until you or one of your family members has a medical emergency to look for the medical cover you need. Do that today.
When choosing a medical aid scheme for your family, it is important to make sure that your kids are properly covered. As a parent, it is your duty to make sure that your offspring have the best possible chance of staying healthy, and with the new childhood vaccinations cover offered by Afrox medical aid you will be doing exactly that.
As of 2011, all Afrox medical aid members can take advantage of this benefit which is designed to help all babies and children to be fully immunized in line with guidelines from the Department of Health. This will go some way towards helping protect the younger generations from a long list of infectious, not to mention potentially life threatening, diseases.
Some of the vaccinations which are not only recommended, but are also fully covered by the Afrox medical aid scheme include:
Diphtheria
Tetanus
Rota Virus Vaccine
Pertussis
Polio
Haemophilus Influenzae Type B
Hepatitis A
Hepatitis B
Measles
Mumps
Rubella
Conjugated Pneumococcal
Varicella Vaccine (Chicken Pox)
Cover for these vaccines are only available to beneficiaries who are under the age of 7 years. However, all children who are beneficiaries of an Afrox medical aid plan are eligible for the same medical care that adult members are including medications and hospital care described in the schedule of benefits for the particular plan purchased.
Care That Starts From Before Birth
Of course, the best way to give your child a great start in life is with appropriate prenatal care. Afrox medical aid also offers great maternity benefits for members. All Afrox medical aid members can access the maternity program completely free of charge in order to receive support, care and education throughout the pregnancy and post-natal period.
Afrox medical aid members who enrol on the maternity program are allocated a case manager who will stay in contact throughout the pregnancy and following the birth. This case manager is fully qualified to advise on a number of important issues including diet, exercise, homeopathic remedies, birthing choices including home births and breastfeeding advice.
The aim is to teach you how to take care of yourself and your baby before, during and after the birth itself. You will get the help and support that you need along with information about appropriate doctors, midwives, hospitals and birthing units in your local area.
GEMS medical aid was established in January 2005 in order to help Government employees to satisfy their healthcare needs. Prior to the founding of GEMS medical aid many government employees were not able to afford any type of medical cover. Those who did have cover found that it was becoming more and more expensive over time and they were not getting value for money. In addition, the government did not have much of an opportunity to participate in the management of the medical scheme which their employees are enrolled with.
GEMS medical aid have a very clear mission statement in that they aim to ‘provide all public service employees with equitable access to affordable and comprehensive healthcare benefits’. They have very strong values including simplicity, flexibility, integrity, value for money and clear communication with members.
With 5 different products, GEMS medical aid has a plan to suit everybody. The plans are named after gemstones : Sapphire, Beryl, Ruby, Emerald and Onyx. The plans offer a range of benefits at different price ranges. In fact, GEMS medical aid claim that when compared to similar plans from other providers that they will come out between 10% and 25% cheaper. The Sapphire plan in particular is designed to be as affordable as possible by providing out of hospital care at private treatment centres and in-hospital care at designated public facilities. Meanwhile the Beryl plan will provide in-hospital care at public or private facilities.
The Beryl and Sapphire plans are the entry level choices offered to GEMS medical aid. Members who are subscribed to these plans are required to access medical care only from designated providers. There area number of service providers who are contracted to GEMS medical aid to provide a number of different services including:
Access Health – Maternity Programme;
Europ Assistance – Emergency Medical Evacuation Dispatch (EMED) contact centre;
Medipost Pharmacy – Chronic Medicine Courier Pharmacy;
Medscheme – Contributions and debt management services; Correspondence services;
Medscheme Health Risk Solutions (MHRS) – Managed care services;
Metropolitan Health – Membership and claims services;
Metropolitan Health Risk management – Clearing house services;
Opticlear – Optometry managed care services;
Pinnacle Health Solutions – Marketing and tele-marketing services;
Prime Cure – HIV/AIDS disease management services, Dental management services; and
Universal Healthcare Services – Chronic medicine management services; Strategic managed care services.
For the most comprehensive cover, members can opt for the top level Onyx plan from GEMS medical aid.
If you are expecting a child then it is only natural that you will start thinking about your baby’s health right from the moment of conception. It is also natural to be concerned about healthcare before, during and after the birth of your baby. These are the kind of healthcare needs you need to consider before signing up to a scheme like Hosmed medical aid or similar. If you know that at some time in the not to distant future you will be looking to start a family then you would be wise to ensure that your medical aid provider actually covers pregnancy and newborn health care.
Before The Birth
Prior to actually giving birth, you will need appropriate prenatal care including obstetrician visits, ultrasound scans and perhaps even prenatal vitamins. You will need to check with your medical aid provider to ensure that you are covered for these treatments as not all schemes will. If we take Hosmed medical aid as an example, members are limited to two ultrasound scans per pregnancy although they will cover all treatments and consultations up to the agreed cover limit. This applies to all three levels of cover offered by Hosmed medical aid, but other schemes may only offer cover on certain plans or may require an additional premium to be paid.
During The Birth
If your medical aid provider covers prenatal care then it is usually the case that they will also cover your hospital expenses and doctor’s fees during the birth itself. It is usually for even caesarean sections to be covered as long as they are not elective. It is important to be aware that you may need to choose a hospital from an approved list provided by your medical aid scheme and if your gynaecologist’s rates are above the usual tariff rates you will be liable to pay the excess.
After The Birth
You will need to register your new baby as an additional member/ dependent on your medical aid program. However, this is a hectic time for your family and the majority of medical aid schemes will cover newborns for up to 30 days following birth. Cover should include any necessary ICU treatments if the child is in difficulty. However, a prolonged hospital stay for the mother may not be covered.
It is fairly easy to add your new baby to your medical aid scheme providing that your name is on their birth certificate. The majority of schemes will offer a family plan for your convenience. In fact, with Hosmed medical aid you only have to pay for your first 3 children, so larger families can enjoy free cover for any additional children that they might have.
This entry was posted in Medical Aid and tagged Cover version, Health, Health care, Health insurance, Hosmed, Hospital, Medicine, Scheme on by Jackson.713class="post-713 post type-post status-publish format-standard hentry category-medical-aid tag-cover-version tag-health tag-health-care tag-health-insurance tag-hospital tag-netcare tag-parkinsons-disease tag-scheme"
When it comes to getting the best possible coverage at an affordable price from schemes such as Netcare medical aid there are a few important things that you need to keep in mind. The choice can be overwhelming if you do not know what exactly to look for, so we have put together this list of the key points to consider when choosing medical aid.
Look At The Level Of Coverage
Every medical aid program offers slightly different levels of coverage. You may find that one scheme covers pregnancy while another doesn’t. Even between plans in the same scheme there can be large differences in cover. It is important to think about what sort of cover is important to you so that you can make sure it is included in your plan.
Look Into Payment Policies
When it comes to paying for your medical treatment procedures differ between schemes. For example, what Netcare medical aid does may not be what Liberty does. Some schemes will pay providers directly meaning that you only have to pay your agreed deductible or co-pay amount. However, with other schemes you may be expected to pay your own medical bills and then submit a claim to be reimbursed. Depending on your medical aid provider it could take as long as 30 days to receive your refund.
How Much Will It Cost
Perhaps the most important consideration when choosing your medical aid provider is the cost of cover. It is a good idea to work out how much your budget for health care is so that you can immediately eliminate those which are too expensive. It is never wise to sign up for medical aid you cannot afford as your cover will lapse if you are not up to date on payments. Always keep in mind that more expensive is not always better, it could be that you would be paying for services you will never use so make sure you are looking at which plan offers the best value for money.
Have You Considered Your Health
When choosing medical aid you need to take your own health and the health of any family members attached to the plan into consideration. If you have an existing condition then you need to make sure that your medical aid will cover your treatment. Some of the chronic illnesses covered by Netcare medical aid include: Asthma, Bipolar, COPD, Crohn’s Disease, Diabetes, Haemophilia, Parkinson’s Disease and Schizophrenia among others. However, this list will be different with other providers so take care to ensure your condition is on the list.
Does The Scheme Cover Hospital Care?
Not every medical scheme covers hospital care as standard. Often it is added as an additional premium for those requesting it. If you can afford to do so you should definitely opt for a plan which offers hospital care as you will never know when you might require treatment in a hospital or ER. As an example, the Netcare medical aid scheme does include hospital care provided you are admitted to an approved treatment facility within the Netcare group. Hospitalisation must also be pre-authorised under the rules of the Netcare medical aid scheme.
These are the top 5 things to take into consideration when choosing the right medical aid cover for you and your family, but you may have additional needs in which case you must thoroughly examine the terms and conditions of the program before making a commitment.
It is a rather common fact that most of people do not think about their health and the need for medical coverage until the unexpected accident or illness strikes. It is in that moment that we not only have to deal with the stress of having to deal with a medical problem, but we have to find a means to pay for the medical treatment and medications that we will need in order to recover properly. With so many different medical aid schemes available, it can be a daunting task trying to find the right policy that will work for you and your family. You may feel that because of your financial situation that you will not be able to afford to get a quality scheme. The reality of the situation is there are a wide variety of options that you can choose. LA Health medical aid has a variety of plans that offer a broad spectrum of benefits.
With each of the five different benefit options that you can choose from at LA Health, you are sure to find something that can fit into your budget as well as provide the benefits you need. The different plans offered are LA KeyPlus, LA Focus, LA Active, LA Core, and LA Comprehensive. Although each of these policies varies on what specific items they cover, they do cover a number of important medical needs and issues that can arise. Just some of the items that are covered include planned operations, oncology, and emergencies and casualties that require a hospital stay. Additional coverage takes care of the medicines that are required for chronic illnesses or other prescribed medicines.
Along with the cover for hospital stays and medicines, the right medical aid scheme can also offer coverage a number of additional items. This can include trips to your general practitioner, specialists, dentists, physiotherapists, and a host of other medical professionals. If you are planning to become pregnant, this is an additional medical benefit that is covered. The most important thing with LA Health medical aid is the overall health and well-being of those that use their various medical aid benefit plans. The goal is to help you live a life that is not only fulfilling, but one in which you are as healthy as you can be to have a quality life.
Your health and the health of your family is one of the most important things there is, because without it, life can be a struggle. Take care of your health, and those you love, by getting the proper medical aid scheme that will ensure that they are taken care of, in case an illness or emergency strikes that requires medical attention.
