Unexpected illnesses can strike at any time, and whilst you are trying to concentrate on getting better, the last thing you need, is the worry about paying your medical bills at the end of the treatment. Medical bills can be costly, and if you require a lot of treatment, the costs can quickly add up into a tidy sum. You can offset the potential costs of medical treatment by signing up for a medical aid scheme.
There are many different medical aid companies in South Africa, and they all have various medical aid schemes available. These all offer a number of varying degrees of coverage as well as varying in how much you need to pay in monthly premiums. However, if you are an employee of the South African government, you can sign up for their medical aid scheme which has been especially tailored to meet the needs of government employees.
The Government Employee Medical Scheme (GEMS) was founded in 2005 and it was formed in order to provide quality healthcare coverage for the employees of the South African government. GEMS offer a wide range of different levels of healthcare, five in fact, and these are called: Emerald, Ruby, Onyx, Beryl and Sapphire.
Before the Government Employee Medical Scheme was launched, a large percentage of government employees found the costs of signing up to a healthcare scheme too expensive. It was with this problem in mind that the government decided to offer a closed medical scheme for its employees, so that they and their loved ones could receive the medical attention they require, whenever they need it, at a price they could afford.
The introduction of GEMS was seen by many as a necessary step in order to help public service employees to have access to medical treatment which is often too expensive. By setting up the GEMS medical aid scheme, the South African government was also showing private companies, that they could also commence a closed medical aid scheme for their staff.
People who sign up for one of the GEMS medical aid packages will have access to a wide range of healthcare providers such as dentists, doctors, optometrists and pharmacies. All of the healthcare providers who have signed up to provide medical assistance to GEMS members, have agreed to provide healthcare at an agreed price so that there is no extra cost to the patient. Members of the two most popular schemes, Beryl and Sapphire, will be able to spot the GEMS logo in the window of the healthcare providers, so it is easier for the patient to recognise them.
As you can see, as a government employee, it makes sense to sign up to the GEMS healthcare scheme, in order to make sure that you and your family receive the best medical treatment available.
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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.
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