What does GEMS medical aid cover?
You need to get pre-authorisation for all your hospital visits, out-patient visits to a hospital, MRI scans, CT scans or radio-isotope studies, in-hospital physiotherapy, ambulance transportation and specialised dentistry.
Does GEMS pay for Gynaecologist?
The Specialist Network provides you with access to Physicians, Paediatricians, Obstetricians and Gynaecologists at a set tariff for both in- and out-of-hospital ensuring that you will not be liable for a co-payment (subject to your option’s benefit limits).
What does GEMS Ruby cover?
The Ruby option includes a PMSA that consists of 20% of your contribution that is allocated to a savings account held in your name. This account will pay for your out-of-hospital or day-to-day medical expenses. Once you’ve depleted your PMSA, your out-of-hospital claims will be paid from the limited block benefit.
Does medical aid cover pap smear?
We cover various screening tests at our wellness providers, for example, blood glucose, cholesterol, HIV, Pap smear or HPV test for cervical screening, mammograms and/or ultrasounds and prostate screenings.
Does GEMS pay for Covid test?
Members should take solace in knowing that testing for COVID-19 will be covered, provided it is clinically appropriate. Ideally, beneficiaries should ensure they are screened first by a nurse/doctor who will then determine if a test is required. Once tests are done, both negative and positive tests will be paid as PMB.
Which is the cheapest GEMS option?
Tanzanite One is the most affordable of the scheme’s options for low-income earners. Members on the Tanzanite One option are provided full access to private and public facilities, awarding them much-needed dignity.
Does GEMS pay for frail care?
In a nutshell: frail care and medical aid
Long-term frail care, either in a facility or through home-based nursing or assisted living, is not covered. Short-term stays in registered step-down, acute or sub-acute care facilities are covered, provided they are related to a major medical event.
Does GEMS have a hospital plan?
GEMS has negotiated with numerous private hospitals to offer ALL our TANZANITE ONE members quality healthcare. If you use our network of hospitals you won’t have to make out-of-pocket payments, allowing you to save money! Click here to see the full list of GEMS network hospitals.
Does GEMS cover a dentist?
GEMS has designed the dental benefit to ensure that members have access to cost-effective, quality dental healthcare. It is important for you to have regular dental check-ups. What if I need dental treatment under general anaesthetic?
What is the difference between ruby and emerald GEMS?
A stone is a ruby when it is colored a certain number of ways ‘“ ranging from pure red to a bluish shade inherent in the stone. Emerald on the other hand is a variety of the mineral beryl and gets its green color from trace amounts of chromium and vanadium.
Does GEMS pay for baby immunization?
From 1 January 2021 an additional benefit for vaccinations has been made available on all GEMS Options. A limit of R750 per beneficiary per year applies and funding is allowed for Practice types 14, 15, 60, 61, 63, 110 and Specialists.
Is GEMS for government employees only?
As GEMS is a restricted scheme for Government employees, only those employed within public service can become members.
What diseases can be screened for?
Some conditions that doctors commonly screen for include:
- Breast cancer and cervical cancer in women.
- Colorectal cancer.
- High blood pressure.
- High cholesterol.
- Overweight and obesity.
- Prostate cancer in men.
Does momentum cover mammogram?
Dental consultation, general physical examination, DEXA bone density scan, cholesterol test (pathologist), blood sugar test (pathologist), glaucoma test, HIV test (pathologist), pap smear, mammogram, and prostate-specific antigen (pathologist).
Does Keycare plus cover mammograms?
We also cover a mammogram every two years, a Pap smear once every three years, a PSA test (prostate screening) each year and bowel cancer screening tests every two years for members between 45 and 75 years. These tests are paid from the Screening and Prevention Benefit.