Know what to submit for member refunds

When a GEMS member pays for medical costs directly to the service provider and that member has benefits available, the member can claim for a refund, which will be paid according to the Scheme rate and applicable Scheme Rules.

To ensure that your claim is processed quickly and efficiently, here is quick checklist of information required for a refund:

• Has your doctor captured your details correctly? (these must be the same as the details on your membership card)
• Is there a practice stamp on your claim? (showing that you have paid the healthcare service provider)
• Is there a dated receipt indicating the practice details; and
• Have you signed the claim?

Lastly, ensure that your claims are sent to the correct address. Send all hospital claims to: PO Box 1101, Florida Glen, 1708; and paper claims to: GEMS, Private Bag X782, Cape Town 8000.