GEMS

GEMS is a restricted, not-for-profit medical aid scheme that provides healthcare cover for South African public service employees and their dependants.

Key capabilities include:

• Multiple benefit options with published starting contributions, including Tanzanite One (from R1698 pm), Beryl (from R1915 pm), Ruby (from R3960 pm), Emerald Value (from R3705 pm), Emerald (from R4425 pm), and Onyx (from R7673 pm), plus an online option comparison tool.
• Network-based care and coordinated access through network hospital lists, designated service providers (DSPs), and, on certain options, family practitioner (GP) nomination and specialist rules.
• Self-service portals and support tools via a member portal (member.gems.gov.za), healthcare provider portal (hcp.gems.gov.za), and an employer portal (admin.medscheme.co.za), alongside resources such as forms, member guides, formulary lists, ICD10 codes, and tariff files.
• Healthcare programmes covering areas such as wellness, disease management, preventative screening, and annual flu vaccination information.

Available on Web, Android, and iOS (GEMS Member App also supports digital member services such as access to an e-card and updating personal details).

Target users are South African public service employees and their families who need medical scheme cover and digital tools to manage membership, eligibility, and healthcare provider networks.

Notable in the South African market because it is restricted to public servants, operates as a not-for-profit scheme that reinvests surpluses into benefits and affordability, is an authorised Financial Services Provider (FSP No 52861), and notes that qualifying public service employees can receive up to 100% employer subsidy on certain salary levels. It also states it does not offer gap cover.