South African teachers are grappling with significant medical aid increases from GEMS, prompting them to seek alternative options before the January 24 cut-off date. Picture: Courtney Africa / Independent Newspapers
Some South African teachers are trying to figure out which Government Employees Medical Scheme (GEMS) options will be suitable for downgrading ahead of the January 24 cut-off for option changes.
Teachers have been complaining about the price hike, saying they will not afford the fees of their current options.
One teacher said GEMS will kill them. “My medical aid increased by exactly R1 000!”
Other teachers shared their figures, which included increases of R2 532, R1 700, R1 460, and R1 300, among others.
Another teacher said their medical aid went from R1 300 to R2 550.
These increases made teachers ask if there were other medical aid schemes they could use instead of GEMS.
“What are other medical aid options that we can use except GEMS? Are we even allowed to use other options? I feel like GEMS wants to prevent our financial development, it brings us down! I don’t want to live without having a medical aid plan but I want to get rid of GEMS. If we are not allowed to join other schemes - how can we deal with this financial burden??” one teacher asked.
Some teachers were afraid of leaving GEMS because of the subsidy.
Other teachers looked to downgrading their options and asked their colleagues for advice.
Teacher 1 said: “... I need your advice regarding GEMS. I want to change from Emerald to any plan due to affordability. I have a child who is on chronic medication, which option is better between Ruby and Emerald Value?”
Teacher 2 said: “People on Beryl please tell us the pros and cons because Hau nkosiyami! R1 300 to R2 500 is just too much.”
Teacher 3 said: “Which medical scheme are you using? I’m trying to move from GEMS and have just called Dis-Chem, yes it is affordable but I would like to know more from those who know better. I’m currently on the Ruby option, and the increase is going to be R1 300.”
Teacher 4 said: “Can I get reviews on all GEMS options besides Emerald and Onyx, please fellow colleagues.”
GEMS had announced that member contributions for 2025 would only increase by an estimated average of R438, subject to the average family size across its benefit options. The adjustment was necessary to ensure the scheme’s long-term sustainability.
Speaking to Newzroom Afrika in December, GEMS principal officer Dr Stan Moloabi, said there are variations to what each member’s increase will be for 2025.
GEMS wrote to all their members, calculated their individual increase and while it aggregates around 13.4%, there will be members who will have a slightly higher than 13.4% increase. There will be those who will be right around 13.4%. There will be those who will experience lower, depending on several factors such as the number of beneficiaries on a medical scheme option.
“At 13.4%, when you look at that percentage, it is high, but it is pushed on by the fact that our members have had a very high utilisation ratio for this past year. Based on that, we have to make sure there’s provision for their health-care needs,” Moloabi said.
“While we are also doing things to try and stem this trend of a high increase... one of the biggest contributors is fraud, waste, and abuse.”
thobeka.ngema@inl.co.za