Does GEMS cover implants

Based on the GEMS Dental Provider Guide, GEMS has limited coverage for dental implants:

What’s Covered ✅

GEMS covers Phase 3 implant procedures only on the Ruby, Emerald Value, Emerald, and Onyx options. This includes:

• Implant supported crowns
• Implant supported bridges
• Implant supported dentures

These are paid from the shared dental sublimit and require pre-authorisation.

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What’s NOT Covered ❌

• Phase 1 procedures (surgical placement of implants)
• Phase 2 procedures (abutment placement)
• All implant-related clinical and laboratory fees for Phases 1 and 2

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Specific Covered Codes

The following implant denture codes are funded (with pre-authorisation):

• 8533 – Implant supported removable complete overdenture
• 8534 – Implant supported removable partial overdenture
• 8654 – Implant supported fixed-detachable complete overdenture
• 8655 – Implant supported fixed-detachable partial overdenture
• 8660 – Additional fee per implant for fixed-detachable dentures

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In summary: You would need to pay out-of-pocket for the actual implant surgery and placement, but GEMS can help cover the final crowns, bridges, or dentures that attach to those implants on certain options.

 

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Here are GEMS’s contact details:

GEMS Contact Centre

For Provider Queries:
📞 0860 436 777

For Member Queries:
📞 0860 004 367

Email:
📧 enquiries@gems.gov.za

Fax:
📠 0861 00 4367

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Operating Hours

• Monday – Friday: 08h00 – 17h00
• Saturday: 08h00 – 12h00
• Sundays and Public Holidays: Closed

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Online Access

• Website: www.gems.gov.za
• Provider Portal: hcp.gems.gov.za
• Mobile App: Download the GEMS Provider App from Google Play or the App Store

 

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