Conflicting Charges and Coverage Issues with GEMS

Medical Aid Option Change Issues

I switched my medical aid option from Emerald to Ruby on January 24, 2025, with the change taking effect in February. However, I encountered issues with my daughter's chronic medication coverage, despite being assured it would continue. After she went without medication in February, I requested to revert to the Emerald option, effective March.

Conflicting Charges

In March, I was informed I owed R991.00, the difference between Emerald and Ruby fees, as my initial change was allegedly not accepted. Later, I received a statement showing an additional debt of R1,679.73 for "Clawback to savings" due to Ruby benefits used in February. This was confusing, as I had already paid the R991.00 and was scheduled to be back on Emerald in March, yet was being charged for Ruby benefits used before the change back took effect.