Avoid co-payments on medicine claims

Ensure you get cost effective medicine and avoid out-of-pocket (co-payment) expenses on your medicine claims.
To avoid co-payments, follow these simple guidelines:

• Use in-formulary medicine: a formulary is a list of cost effective medicine which GEMS pays in full according to Scheme Rules. If your doctor or pharmacist prescribes medicine which is not on the GEMS formulary (medicine list), you will have to pay the difference of what the medicine costs and what GEMS pays.
  
• Use a designated service provider (DSP): Use the GEMS DSP for chronic medicine. If you receive chronic medicine from any other pharmacy, you will have a 30% co-payment, even if the medicine you are claiming for is on the formulary.
  
• Use generic medicine: Where possible please ask your doctor or pharmacist for generic medicine. Generic medicine contains the same active ingredients as branded medicine and achieves the same therapeutic results, at a cost effective rate.