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mattheo.burger mattheo.burger

1 reviews | Active since May 2017

17 May 2017, 11:50

Benefit Date provided 1 May and won't cover

<p>Moving over to Gems and received the card. Benefit start dateof the dependent states 01/05/2017. Main member benefit date 01/08/2017. Dependent was covered for medication at the pharmacy by Gems but when the dependent had to be admitted to hospital for an emergency Gems said no the benefits are only starting 01/08/2017. Phoned Gems and they say that the dependent benefits cannot start before the main memeber and it was a capture error on their side. The dependent had to be moved to government hospital due to this. Error on Gems side created the impression that the dependent was covered and now saying no after they already paid for medication 8 days earlier. I phoned twice on a previous occasion to understand why the benefit date is 01/08/2017. When the card was received and said dependent benefit date 01/05/2017. If known that both was only 01/08/2017 different arrangements could have been made. Gems made the mistake not me. I was told that speaking to a manager will not resolve my problem as thisis how it works, benefit date is 01/08/2017 eventhough the card states benefit date 01/05/2017. I was told that I will be phoned back. 2 hours later and I still have no feedback and the dependent is still in the government hospital. Gems comapyny valuesare Excellence,Innovative,Value for money,Integrity,Member-centricity. Clearly there is NO Integrity. Dates states 01/05/2017 oh sorry its an error made on our side sorry and NO we won't help you. And I can't speak to someone who can help. Member-Centrisity... Yeah that's not the experience here. Ref: MH ********** 8</p> <p>Please can you sort this out.</p>

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Replies (5)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply17 May 2017, 16:18
Official

Good day

Thank you for giving us the opportunity to respond to your concerns.

We are looking into this and will provide feedback.

Kind regards

The GEMS online team

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mattheo.burger mattheo.burger's update18 May 2017, 09:53
Reviewer Update

I have sent an email to your complaints department and I cannot wait for 48 hours before getting a response. PLEASE this is a matter of URGENCY!!!!

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mattheo.burger mattheo.burger's update23 May 2017, 11:14
Reviewer Update

Still ZERO feedback from GEMS. Not via the complaints department or The GEMS online team. Will report it to the Medical Scheme Board then. I will keep taking it higher and escalating.

Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply26 Jun 2017, 17:02
Official

Good day

Thank you for bringing your concerns pertaining to your membership to our attention.

We understand that you have filed this complaint to the Council for Medical Schemes (CMS) and wish to inform that an official response will be sent to CMS by GEMS.

Kind regards

The GEMS online team

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mattheo.burger mattheo.burger's update27 Jun 2017, 09:28
Reviewer Update

Yes I did because calling your call centre, sending a complaint to your complaints email address and even Hello Peter has gotten us nowhere. It has been a month since I complained and brought the situation to your attention. Nothing has been done. CMS was the logical next step. You have no pride in service. So yes please communicate with the CMS