ET
Elelwani T

1 reviews | Active since Feb 2014

09 Apr 2025, 20:37

Assistance with GEMS and POLMED Medical Aid Issue

I hope this letter finds you well. I am reaching out to request your assistance regarding an ongoing issue my husband is experiencing with GEMS and the transition to POLMED. As background, my husband was a main member of GEMS until he was offered a new position, which required him to switch from GEMS to POLMED. His new position became effective on 1 December 2024. In December, we contacted GEMS to inquire about the process of moving from their medical scheme to POLMED, and the lady assisting us over the phone advised us to wait until everything had been processed from his old position to his new one before starting the switch. We continued using GEMS until February 2025. In mid- to late February, the organization officially moved my husband from his old title to his new one, which prompted us to reach out to GEMS again to begin the switch to POLMED. At this point, GEMS requested a new appointment letter, which my husband promptly sent to them. In return, GEMS provided him with a medical certificate and a termination date. To our surprise, the termination date listed was 30 November 2024, which was incorrect. The correct date should have been February 2025. We were told that my husband owed GEMS approximately R9,000 for the months of December, January, and February, and that this amount would be deducted from his salary. However, my husband was not comfortable with this, but he was more focused on starting the process with POLMED, as it had been long overdue. Fast forward to yesterday, when I received a letter from POLMED stating that due to the termination date of 30 November 2024, my husband had forfeited the 90-day period to move to POLMED and would have to wait for 3 months before his coverage could be activated. We immediately called GEMS to correct the termination date, but they informed my husband that he should have come to them right after receiving his appointment letter, which he had already done. Unfortunately, POLMED has stated that there is nothing they can do unless GEMS rectifies the termination date to reflect February 2025 instead of November 2024. Given that the error was not my husband's fault, I am kindly requesting your assistance in working with GEMS to correct the termination date, as this situation is causing unnecessary delays and financial confusion for us. Your help in resolving this matter would be greatly appreciated. Please let me know if any further information is needed.

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Replies (5)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply10 Apr 2025, 10:10
Official
Thank you for engaging with us. We are attending to your message and feedback will be provided. If you have an urgent query, please contact us on: ***(members) & ***(providers).
 
 Call Centre Hours: Monday - Friday: 8h00 - 17h00 & Saturday: 8h00 - 12h00. Emergency number: ***(available 24 hours)
 
 If you wish to submit a compliment, please email us on at ***. We look forward to receiving your positive feedback. 
 
Regards,

GEMS
ET
Elelwani T's update25 Apr 2025, 19:52
Reviewer Update
You had assured us that you would get back to us within seven days; however, we have yet to receive any response from you.

We would appreciate your response at your earliest convenience, so that we may resolve the matter without further delay
ET
Elelwani T's update01 May 2025, 19:33
Reviewer Update


You continue to take the money and keep sending messages to my husband. I feel like nothing is being done about my husband's complaint.

On the 28th of April 2025, you sent a message to my husband about the R8115. 09. Then on the 30th, an amount of R8115. 09 was debited. However, today, on the 1st of May 2025, he received yet another message from you.

Why are we being charged such a large amount when this issue is not our fault? We logged a complaint, and it is clear to us that nothing is being done to resolve it.

We have been with GEMS for over eight years and have never experienced any problems until now. The way this matter is being handled is deeply concerning and disappointing.

Please provide us with the correct date of termination so that POLMED can proceed accordingly. As it stands, we do not have any active medical aid because GEMS has not resolved our issue.


ET
Elelwani T's update18 May 2025, 21:19
Reviewer Update
Urgent Follow-Up on Outstanding Complaint and Medical Aid Access

I am writing to express our deep concern and frustration regarding the lack of progress on the complaint we lodged with GEMS. To date, we have not received any meaningful response or resolution.

In the meantime, we are facing serious difficulties. We currently have no access to medical cover, and our son has fallen ill. This is now the second time he is seeing a doctor, and we are paying for these consultations out of our own pocket. My husband also had to cover medical expenses last week, which has placed us under significant financial strain.

Despite our efforts to communicate the urgency of this matter, the only calls we receive are regarding the outstanding balance we allegedly owe. Each time we explain that there is a complaint pending, the representatives seem unaware of it, and we are left with no answers or support.

We are truly struggling and cannot continue to wait indefinitely. We kindly request urgent feedback on the status of our complaint and a clear explanation of the way forward.

We would greatly appreciate your immediate attention to this matter.

ET
Elelwani T's update20 May 2025, 18:34
Reviewer Update
Request for Detailed Update on Complaint Escalation

I hope this message finds you well.

We refer to our ongoing complaint, which has been repeatedly met with the response: “Please note we have escalated to the relevant department.”While we appreciate the acknowledgment, this response has remained unchanged since April, and we have yet to receive any meaningful update regarding the progress or resolution.

We kindly request a detailed update on the status of our complaint, including:

* Which department it has been escalated to?
* What stage of the resolution process it is currently in
* Expected timelines for resolution
* Any action required from our side, if applicable

Your continued assistance and transparency in this matter would be greatly appreciated. We look forward to your response with the requested details.