Medical aid price increase for government employees

South Africa’s largest restricted medical aid, the Government Employees Medical Scheme (GEMS) has announced price increases for 2020.

The GEMS is a medical scheme restricted to government employees, and with over 1.8 million beneficiaries is the largest closed scheme in the country, and the second largest medical scheme overall.

The scheme offers four levels of coverage plans for members (Sapphire, Beryl, Ruby and Emerald), with monthly contributions in 2019 ranging from R1,116 a month to R3,125 a month, for a single members (depending on salary band).

For 2020, the scheme has announced a weighted increase to contributions of 7.7%.

The scheme also announced a change in name of the Sapphire option which will now be called Tanzanite One.

“The Scheme endeavours to keep annual increases to a minimum without compromising members’ access to quality healthcare as we continue to prioritise the healthcare needs of over 720,000 principal members and over 1.8 million beneficiaries entrusted to us,” said Dr Stan Moloabi, GEMS chief operations officer.

These are the main changes to the scheme for 2020:

Tanzanite One

  • Sapphire renamed to Tanzanite One
  • Members will have access to a network of healthcare providers by nominating a general practitioner of their choice to coordinate their healthcare needs.
  • Members will have access to private hospitals, subject to utilising the GEMS private hospital network.

Emerald and Emerald Value Option (EVO)

  • Will have the lowest monthly contributions increase of all options
  • Both EVO and Emerald benefit options offer the same level of healthcare cover, however EVO is more affordable as members make use of a network of healthcare providers having nominated a general practitioner of their choice to coordinate their healthcare needs.
  • Members who switch to EVO can experience around R600’s worth of savings on their monthly contribution – equivalent to R7,200 money back in their pockets per annum.

GEMS said that members are encouraged to assess whether they are on the correct scheme that matches their healthcare needs, and to switch if necessary.

“The benefit option selection season will be open from 7 November 2019 until 7 December 2019. Should members wish to join a different option offered by the Scheme, they are encouraged to make the change during this period,” it said.


Read: Here are all your Discovery medical aid price hikes for 2020

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Medical aid price increase for government employees