How do you claim gems?

How do I check my gem benefits?

To send an SMS request, you follow these easy steps: Step 1: Type in the keyword Benefit. Step 2: Next to the word Benefit, type in your GEMS member number. Step 3: Next to your member number, type in the benefit category you want to find out about.

How long does gems take to refund?

Once processed, refunds to your bank account can take up to five business days to show on your account. We can process a refund for any amount if we have your bank account details on file, and we have used the bank account details more than 30 days ago.

Does gems have a waiting period?

There are two types of GEMS waiting periods: A general waiting period (GWP) of up to 3 months. A condition-specific waiting period (CSWP) of up to 12 months.

How does Gems medical aid work?

GEMS Medical Aid is a government health plan for its workers. The government employee medical scheme is meant to be affordable and one that most, if not all government workers can opt for as opposed to private covers. The need for a reliable medical cover cannot be overemphasized.

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How do I claim money back from GEMS medical aid?

Call us on 0860 00 4367. When you have paid a healthcare service provider for a service, you may claim a refund from the Scheme. Whether we pay the claim, and how much we pay, will be determined by the Scheme Rules.

How do I get GEMS authorization?

Before you are admitted to hospital, or make an out-patient visit to a hospital, have a CT scan, MRI scan or Radio-Isotope study, you need to get a Pre-Authorization number (PAR) from GEMS by contacting 0860 00 4367.

How do you nominate a doctor for GEMS?

Nominations can be made by contacting the GEMS call centre on 0860 00 4367. In order to avoid having to pre-authorise a specialist consult, and/or avoid a 30% co-payment, GEMS beneficiaries on the Tanzanite One and Emerald Value options require a referral from their nominated network FP.

Does GEMS pay for blood pressure machine?

**********: Apply for Authorization and Approval to buy a Blood Pressure M.T. Machine. … GEMS pre-approval and authorization is needed to buy this mentioned ITEM and that GEMS will undertake to pay the cost of it in full as promised by your officials.

How do I send proof of registration to GEMS?

documents, you can submit it for registration in any of the following ways:

  1. Fax: 0861 00 4367; or.
  2. Email: enquiries@gems.gov.za; or.
  3. Post: GEMS at Private Bag X782, Cape Town 8000; or.
  4. Walk-in Centres: drop it off at any of the following GEMS Walk-in Centres:
  5. Eastern Cape.
  6. Gauteng.
  7. KwaZulu-Natal.
  8. Limpopo.

Does GEMS pay for plastic surgery?

GEMS does not pay for)

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All costs for operations, medicines, treatments and procedures for cosmetic purposes (cosmetic refers to treatments or procedures that do not treat an illness), such as liposuction. Visits to specialists outside of the GEMS Network for Sapphire and Beryl beneficiaries.

How do you join GEMS?

For more information on how to join GEMS, please visit www.gems.gov.za, or call 0860 00 4367, or SMS “please call me” to 083 450 4367 and an agent will call you. Take Note: Adult dependant rates are payable for all eligible dependants who are 21 years of age or older.

Do gems cover bloodwork?

Pathology and radiology tests (blood tests and x-rays) must be referred by your nominated GP. These tests must be in line with the GEMS formulary (list of approved tests or services) for Beryl.

Does GEMS pay for Covid testing?

“GEMS members will be serviced and should not be requested to pay for COVID-19 testing upfront. The testing of members where guidelines are not met is not considered as PMB level of care as it is regarded as not clinically appropriate.

How do I register for gems maternity program?

Registering on the programme

You need to complete an enrolment form and fax, email or post the completed form to 0861 00 4367, enquiries@gems.gov.za or GEMS Maternity Programme, Private Bag X782, Cape Town, 8000.

What are the gems options?

We offer six excellent healthcare benefit options: Tanzanite One, Beryl, Ruby, Emerald Value, Emerald and Onyx.