GEMS medical aid 2015

im not with Gems.

but regarding your question for gynie visits. a gynie wants to see you every 4 weeks, and from 32 weeks every 2nd week.
but i don't think its necessary, they just check baba's growth.
if your medical aid cover 2 gynie visits, go on 12 weeks and on 20 weeks - for checkup on the major milestones.
it will be more than sufficient to see a GP or even just a sonographer

Just a quick side note... I'm not on Gems, but all medical aids maternity benefits are "per pregnancy" so you can't spread it over 2 years unfortunately.

I am on Resolution and don't have ANY cover for gynae visits, only 12 GP visits, so I pay for my gynae visits out of pocket. It's really up to you if you want to pay out of pocket or just visit your GP for your monthly check-ups. Personally I would rather pay the R600 out of pocket and see a specialist.

It's always good to have a GAP cover as medical aids mostly pay 100% medical aid rates and some specialists can charge up to 400% medical aid rates. My GAP cover pays up to 500% medical aid rates, plus emergency room consults (which Resolution doesn't cover), co-payments, etc. And I only pay R190 per month for the GAP for both myself and my husband.

On the Gems site they have a list of Gyneas (3 in Durban) who charge ma rates. And since you in durban dont be afraid to use Primecure facilities for scan etc as they charge a fraction for a gp + scan to make the most of your medical aid.

I dont think you need to see your gynea so many times unless its a high risk pregnancy. They dont do much really they do the same as a gp sometimes less. If possible skip visits and save those for the more frequent ones during the last weeks of pregnancy

Hi Sadhs
I am on Gems but this year downgraded to Beryl (was on Emaryld) last 7yrs). I would suggest paying cash for each visit and claiming it directly from GEMS(PLEASE DO CLAIMS DIRECTLY AT THEIR OFFICES NOT VIA EMAIL OR FAX OR YOU MIGHT NOT GET YOUR MONEY). I SAY THIS BECAUSE Dr's claim a diff amount on medical aid which ends up finishig your benefits faster.

Hi is there anyone on Gems medical aid...has it served you well.

I am planning to conceive (if it takes, fingers x'd) in April.

Originally planning for Jan 2015.

Gems maternity offers
• 6 gp visits
• 2 gyne visits
• 2x 2d scans at
10-14weeks
20-24weeks
• 4 blood tests

I read that you may need 15 gyne visits (can anyone confirm that)

If so, that means i need 13 more gyne visits, which will come out of a day to day block benefit which is really not enough.

So i devised a plan to spread my pregnancy over two years which means two 2015 benefits and 2016 benefits (since nothing carries over, i forfeited funds from 2014)

Has anyone had a baby on GEMS, how did you do it..

--- Did you pay anything out of pocket?
--- Was your gyne within medical aid rates?
--- Did you have gap cover (is it needed)?