GEMS BENEFIT OPTIONS

Sapphire: This is the entry-level option. It provides unlimited out-of-hospital care such as visits to a general practitioner (GP), dentist and optometrist, maternity care at private facilities, and in-hospital cover at public facilities. As of 2019, members on this option will in addition to public hospitals have access to private hospitals for certain procedures, including childbirth, for example.

Beryl: This is an entry-level option where cover is provided through designated provider networks. This product offers members comprehensive in- and out-of-hospital benefits through a network of healthcare providers in both public and private hospitals.

Ruby: This option offers comprehensive in- and out-of-hospital benefits through a personal medical savings account (PMSA), a hospital benefit and a block benefit.

Emerald Value: Introduced with effect from January 1, 2017, this option is an efficiency discounted option, which mirrors the Emerald option. Members on this option pay discounted membership contributions for the same level of benefits, however they must agree to adhere to certain requirements. This includes nominating a GP to coordinate their healthcare, which includes specialist referral where required. Members on Emerald Value Option are also required to use the Scheme’s contracted hospital network.

Emerald: This option is designed to provide comprehensive cover that offers access to care at the member’s chosen provider, subject to benefits and Scheme rules.

Onyx: This is a top-of-the-range benefit option that offers extensive cover. On the Onyx option, the member has more extensive benefits for out-of-hospital expenses such as GP and specialist visits, from their day-to-day block benefit.