Access and manage your benefits anywhere, anytime with these convenient self-help tools: Give us a call: Simply dial 0860 00 4367, press 3 (three) for members, then press 1 (one) for the self-service facility. Now listen to the voice prompts to get the information you need.
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GEMS is required by law to build reserves (funds) equal to 25% of annual contributions. The Medical Schemes Act requires these reserves to be held so that medical schemes can be protected from unexpected, negative circumstances (such as unexpectedly high claims).
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According to the Scheme Rules, claims must reach the Scheme within four months from the treatment date. If your claim is not received within this period, it is considered stale and GEMS will not pay for these late claims.
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The GEMS Medicine Provider Network (MPN), which dispenses both chronic and acute medicine, was activated in May 2013. This means that as a GEMS beneficiary you now have a choice in how you get your chronic medicine.
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All pregnant members and dependants can access the GEMS Maternity Programme. To access maternity benefits, pregnant mothers-to-be must register as soon as their pregnancy is confirmed.
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Member claims debt is also called the member's portion in the medical scheme industry. The member is responsible for the outstanding balance of this type of debt.
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