How do you claim from Gems medical aid?

How long does gems take to refund money?

Once processed, refunds to your bank account can take up to five business days to show on your account. We can process a refund for any amount if we have your bank account details on file, and we have used the bank account details more than 30 days ago.

Does GEMS pay for medication?

GEMS will pay for chronic medicine prescribed according to the Scheme’s clinical guidelines. This means that even if we cover a condition, we may NOT pay for all requested medicines from your chronic medicine benefit if the requested medicine is not in line with the clinical guidelines.

How long does Gems medical aid take to process?

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.

How do I get GEMS authorization?

Before you are admitted to hospital, or make an out-patient visit to a hospital, have a CT scan, MRI scan or Radio-Isotope study, you need to get a Pre-Authorization number (PAR) from GEMS by contacting 0860 00 4367.

Do GEMS cover pregnancy?

Benefits of joining the Maternity Programme

We will give you a GEMS pregnancy, birth and early parenting book when you register. We will send you a free maternity bag during your third trimester. This is a gift from us to you and your baby.

IT IS AMAZING:  What is the chemical name for diamond?

Does GEMS pay for Covid 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.

How do I check my application status for GEMS?

to registration)

Please contact GEMS on 0860 00 4367 to confirm membership status.

How do I get a refund for gems?

Call us on 0860 00 4367. When you have paid a healthcare service provider for a service, you may claim a refund from the Scheme. Whether we pay the claim, and how much we pay, will be determined by the Scheme Rules.

Does GEMS pay for ambulance?

GEMS has an Emergency Medical Services (EMS) provider network that provides unlimited emergency medical assistance to our members. How does it work? The EMS network is open to all EMS providers (ambulance services) that meet our criteria.