Your question: What is the waiting period for Gems medical aid?

How long is the waiting period for Gems medical aid?

There are two types of GEMS waiting periods: A general waiting period (GWP) of up to 3 months. A condition-specific waiting period (CSWP) of up to 12 months.

Does medical aid cover you immediately?

According to the Medical Schemes Act, medical aid schemes are entitled to impose a 3 months general waiting period and / or a 12 months condition specific waiting period(s) for any pre-existing medical condition(s). The Act makes specific provision for the imposition of waiting periods (and late joiner penalties).

How does Gems medical aid work?

GEMS Medical Aid is a government health plan for its workers. The government employee medical scheme is meant to be affordable and one that most, if not all government workers can opt for as opposed to private covers. The need for a reliable medical cover cannot be overemphasized.

Can anyone get Gems medical aid?

As GEMS is a restricted scheme for Government employees, only those employed within public service can become members.

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What is the difference between gems emerald and ruby?

The first difference which comes to mind is that ruby is red in color and a emerald is green. … Emerald on the other hand is a variety of the mineral beryl and gets its green color from trace amounts of chromium and vanadium.

How do I claim my gems back?

Please call GEMS on 0860 00 4367 if you’d like to know why your claim was rejected or partially paid.

You can submit your claims by:

  1. Post: GEMS, Private Bag X782, Cape Town, 8000.
  2. Fax: 0861 00 4367.
  3. Email:; or a.
  4. GEMS walk-in centre.

How long is the pre-existing condition waiting period?

The time period during which a health plan won’t pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.

What happens during waiting period?

What Is a Waiting Period? A waiting period is the amount of time an insured must wait before some or all of their coverage comes into effect. The insured may not receive benefits for claims filed during the waiting period. Waiting periods may also be known as elimination periods and qualifying periods.

What is a condition specific waiting period?

12-months Condition Specific Waiting Period – this is a period during which a member is not entitled to claim benefits in respect of a condition for which medical ad- vice, diagnosis, care or treatment was recommended or received within the 12 month period ending on the date on which an application for membership was …

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Does GEMS pay for Covid 19 test?

“GEMS members will be serviced and should not be requested to pay for COVID-19 testing upfront. The testing of members where guidelines are not met is not considered as PMB level of care as it is regarded as not clinically appropriate.

Does gems have a hospital plan?

GEMS Hospital Plan – Access to Affordable Health Care

Their aim is to provide all employees in the public service with access to affordable health care benefits.

How do I check my gems for medical aid?

To send an SMS request, you follow these easy steps: Step 1: Type in the keyword Benefit. Step 2: Next to the word Benefit, type in your GEMS member number. Step 3: Next to your member number, type in the benefit category you want to find out about.

When should I change GEMS for 2022?

If your option change form is received between 1 January and 10 January 2022, your benefits will be pro-rated, as the new option will be effective from 1 February 2022 and your contributions will be adjusted accordingly. This form must reach GEMS before or on 10 January 2022, or your option will remain the same.

Can I put my parents on my GEMS medical aid?

Can I put my parents on my scheme as dependants? A. Yes, you can. In fact, any member of your family can qualify as your dependant if you can prove that they are financially dependent on you and that you are liable for family care and support.

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