In short, no—you cannot stay on GEMS if you resign from your public service job. Membership in GEMS is exclusive to active public service employees and participating employers, which means that when you resign, your membership is terminated immediately. Once your resignation is processed, you’re no longer eligible for GEMS benefits. Here’s what this means in practical terms:
- Membership Cancellation: Your GEMS membership ends as soon as your resignation is confirmed by your employer. You will lose access to GEMS benefits right away, and any medical claims after your last day of work will not be covered by the scheme.
- Avoiding Unauthorized Use: Using your GEMS membership card after resignation is strictly prohibited. If you or your healthcare provider attempts to claim for medical services after your resignation date, it could be considered fraud. Such actions could have legal consequences, so it’s essential to stop using your GEMS membership once you leave public service.
- Responsibility for Medical Costs: After your resignation, you’re responsible for all medical costs incurred. GEMS will no longer cover any healthcare services or prescriptions from the day your employment ends, so it’s essential to have a plan for medical coverage post-resignation.
What to Do About Outstanding GEMS Debt After Resignation
If you have any outstanding debts with GEMS upon resigning, these must be addressed. Outstanding medical scheme debt doesn’t disappear when your membership ends. Here’s what you need to know about managing any unpaid balances:
- Settling Debts Before Rejoining: If you leave GEMS with outstanding debt, you’ll need to settle the balance or agree on a payment plan with GEMS. Only after addressing this debt will you be able to apply for re-enrollment if you return to a public service position in the future.
- Payment Arrangement Options: For those who may find it difficult to clear their outstanding balance all at once, GEMS may offer payment arrangement options. Contacting GEMS customer service as soon as you resign can help clarify your options for paying off any debt and prevent issues if you want to rejoin in the future.
Tips for Transitioning from GEMS to Private Health Insurance
Since GEMS coverage is exclusively available to public service employees, resigning means you’ll need to look for other healthcare coverage options. Here are some tips to ensure a smooth transition:
- Evaluate Private Health Insurance Options: There are various private health insurance providers in South Africa. Compare coverage options, premiums, and benefits to find a plan that suits your needs and budget.
- Consider a Gap Period Solution: In some cases, there might be a waiting period before new health insurance becomes active. Some private insurers offer short-term solutions for individuals who are transitioning between healthcare plans. Exploring these options can help you avoid gaps in coverage.
- Budget for Medical Costs During the Transition: It’s possible that your new healthcare plan may have different benefits or require a waiting period for certain types of coverage. Budgeting for out-of-pocket medical expenses during this time is a wise move.