The Government Employees Medical Scheme (GEMS) has become a cornerstone of healthcare provision for public service employees in South Africa. Its development marked a significant moment in healthcare policy, as it was introduced with a firm commitment to equity and affordability, ensuring public sector employees have comprehensive healthcare coverage. Here’s an in-depth look at GEMS, its origins, mission, and what it offers.

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• Is GEMS for government employees only?
• How much is the government subsidy on GEMS medical Aid?
• Who is eligible for GEMS?
• Can any person join GEMS medical aid?
• How do I find out if I qualify for GEMS?
• Can I stay on GEMS if I resign?
• Does GEMS cover abortion?

GEMS was officially registered on January 1, 2005, but its story began in 2002 when the Cabinet approved a framework policy to create a restricted medical scheme. This framework, crafted by a collaboration of several government departments—including Public Service and Administration, National Treasury, Health, Education, Correctional Services, and SAPS—focused on three guiding principles: equity, efficiency, and differentiation.

1. Equity: All employees should have equal access to basic healthcare benefits under fair remuneration structures, tailored to be affordable.
2. Efficiency: Emphasis was placed on cost-effective delivery of healthcare benefits.
3. Differentiation: Employees seeking broader coverage can access enhanced benefits, based on their needs.

This scheme represents the government’s commitment to providing accessible, affordable healthcare, positioning itself as an employer that values the well-being of its workforce.

Who is GEMS?

GEMS is dedicated to meeting the healthcare needs of South Africa’s government employees. It offers six benefit options designed to cater to various healthcare needs and financial capabilities:

• Tanzanite One
• Beryl
• Ruby
• Emerald Value
• Emerald
• Onyx

The overarching goal of GEMS is to enable public service employees and their families to access quality healthcare at competitive rates. As of now, nearly two million beneficiaries are enrolled, showcasing the scheme’s success and impact on the healthcare landscape.

GEMS: Supporting Public Health

GEMS has had a significant influence on both public and private healthcare sectors. Its implementation has eased the burden on public healthcare facilities by enrolling members who would otherwise rely on state resources. By incorporating government employees into a medical scheme environment, GEMS not only reduces patient loads in public hospitals but also generates additional revenue streams for healthcare facilities through the Tanzanite One option. This initiative creates a synergy with ongoing efforts by the Department of Health, including National Health Insurance.

The expansion of medical scheme beneficiaries helps to:

• Decrease pressure on public healthcare resources.
• Drive revenue in the private healthcare sector.
• Promote partnerships that enhance overall healthcare delivery.

Mission and Vision

Mission

GEMS aims to provide all members with equitable access to affordable and comprehensive healthcare, prioritizing their well-being.

Vision

The scheme envisions being an excellent, sustainable, and transformative medical scheme, leading advancements in the healthcare industry and aligning with universal healthcare principles.

Core Values and Commitments

GEMS is driven by a set of core values, ensuring members receive reliable, high-quality service.

1. Collaboration

GEMS fosters a culture of collaboration, keeping members well-informed about activities and changes in services. The scheme communicates openly, particularly when addressing members’ healthcare needs.

2. Member Value

The organization values dependability, efficiency, and cost-effectiveness. It is committed to retaining members, adapting to their evolving needs, and maintaining active engagement.

3. Excellence

Aiming for high performance, GEMS consistently delivers on its goals and strives to exceed member expectations.

4. Innovation

The scheme encourages innovative thinking, cost-control strategies, and practical risk-taking to enhance service delivery. Continuous improvement remains a priority.

5. Integrity

Trustworthiness and professionalism define GEMS. It stands firmly against fraud and corruption, fosters transparency, and takes responsibility for its actions. The scheme also actively supports the communities it serves.

How to Contact GEMS

For any inquiries or support, GEMS provides various contact options:

• General Enquiries:
  • Call: 086 000 4367 (Mon-Fri: 08h00 – 17h00, Sat: 08h00 – 12h00)
  • Email: enquiries@gems.gov.za
  • Post: Private Bag X782, CPT, 8000
  • Fax: 086 100 4367
• Emergency Number: 080 044 4367 (24/7)
• Healthcare Provider Enquiries: 086 043 6777 (Mon-Fri: 09h00 – 16h00)
• Confidential Fraud Hotline: 080 021 2202
  • Email: gems@thehotline.co.za (Mon-Fri: 09h00 – 16h00)
• HIV/AIDS Support: 086 043 6736
  • Send a ‘please call me’ to 083 843 6764