Hospitalisation for members on the Emerald Value Option

Important facts to remember about the Emerald Value Option

• You and your dependants MUST use one of the Scheme'snetwork hospitals in a case where admission to hospital is
  required.
• Not all hospital groups form part of the Emerald Value hospital network.
• Use of a non-network hospital will attract an out of pocket co-payment of up to R10 000.
• A list of network hospitals is available on the GEMS website at www.gems.gov.za, and through our call centre on
  0860 00 4367.
• Unauthorised admissions to a network facility will attract a co-payment of R1 000 (late penalty).

Co-payments will be waived in the case of a medical emergency (as defined in the scheme rules), but once the patient has been stabilised, the Scheme may require that the patient be transferred to a network hospital.

The co-payment is also waived if:

• You don't have reasonable access to a hospital within the network; or
•  You are travelling; or
• You require specialised care that is not available through the nominated healthcare providers

The co-payment applies to Prescribed Minimum Benefits (PMBs), except in cases of emergency