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Healthcare
November 7, 2019

GEMS Enhances Benefits for 2020

<strong>By: GEMS</strong>

Public service employees and their families can look forward to receiving enhanced healthcare coverage in 2020 as the Government Employees Medical Scheme (GEMS) has reinvested close to a billion rand towards benefits enhancement. For the second year in a row, GEMS has kept its contribution increase one of the lowest in the industry.

The South Africa’s largest restricted medical Scheme has announced a weighted average contribution increase of 7.69% across all its benefit options. The Scheme also announced a change in name of the Sapphire option which will now be called <strong><em>Tanzanite One</em></strong> with bigger, better and richer benefits.

“The Scheme endeavors to keep annual increases to a minimum without compromising members’ access to quality healthcare as we continue to prioritize the healthcare needs of over 720 000 principal members and over 1.8 million beneficiaries entrusted to us, said Dr Stan Moloabi, GEMS Chief Operations Officer.

GEMS continues to make a significant contribution to providing access to quality healthcare to South Africans. As South Africa’s largest restricted Scheme, GEMS has the lowest non healthcare expenditure which means more benefits for members and their beneficiaries.

“The enhanced benefits on <strong><em>Tanzanite One</em></strong> symbolize an evolution towards the Basic Benefit Package and transformation which forms part of our business strategy that seeks to ensure more value for our members”, says Dr Moloabi.

<h2><strong>Summary of key benefit enhancements on specific benefit options for 2020</strong></h2>

<h3><strong>Tanzanite One:</strong></h3>

GEMS is excited to announce that the Sapphire option has been renamed Tanzanite One with better, bigger and richer benefits for our members who will now have access to a network of healthcare providers by nominating a general practitioner of their choice to coordinate their healthcare needs. From 2020, members on the <strong><em>Tanzanite One</em></strong> option will have access to private hospitals, subject to utilizing the GEMS private hospital network.

<h3><strong>Emerald and Emerald Value options:</strong></h3>

Members on the Emerald Value Option will experience the lowest monthly contributions increase of all our options, which makes sense for members on EVO to stay on this option. Both EVO and Emerald benefit options offer the same level of healthcare cover, however EVO is more affordable because members make use of a network of healthcare providers having nominated a general practitioner of their choice to coordinate their healthcare needs. Members on Emerald who switch to EVO can experience around

R600’s worth of savings on their monthly contribution that could be R7200 money back in their pockets per annum.

<strong>Benefits enhancement across all options</strong>

Each year medical scheme members are encouraged to review their healthcare needs and make the decision of whether they wish to remain on their current benefit option or choose to move to a different option. This year GEMS benefit option selection season will be open from <strong>7 November 2019 until 7 December 2019. Should members wish to join a different option offered by the Scheme, they are encouraged to make the change during this period. Members may contact GEMS using the following communication platforms for their 2020 option selection, GEMS Contact Centre, 0860 00 4367, Email: </strong><u><a href="mailto:enquiries@gems.gov.za">\enquiries@gems.gov.za</a></u><strong>, and Fax: 0861 00 4367.</strong>

“GEMS invites all members of the Scheme and prospective members of the public service who qualify to join GEMS to consider their family’s healthcare needs for the year ahead and choose the cover they are likely to need. More importantly, we would like to encourage public service employees on employment levels one to five to take advantage of the enhanced Tanzanite One benefit option as they may qualify for 100% subsidy which would cover their contributions,” concluded Dr Moloabi.

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