AW
Aresh W

1 reviews | Active since Feb 2019

07 Nov 2025, 10:55

Delay in Approval of Prescribed Medication

My treating doctor recently adjusted my treatment plan by increasing the dosage of my existing medication by 1 mg and adding another 10 mg tablet. The updated prescription was submitted for approval on Monday, 3 November 2025, and I am still awaiting authorisation. I was informed that the delay is due to their medical review process, as the approval must be granted by their doctors. However, this prolonged waiting period is severely affecting my mental health and well-being. It is extremely distressing to feel that my treating psychiatrist’s professional judgment is being questioned or overridden by GEMS’ internal doctors — as though they are more qualified to make clinical decisions about my specific mental health needs. My condition is deteriorating, and I urgently require access to my prescribed medication to stabilise my mental health I am so disappointed at my medical aid that I question why Government employees are forced to use GEMS as a medical aid. A family member is on a sister medical with my mum as a dependant. My mum went through numerous changes in medication even some out of formulary and this medical aid has covered the cost.. Please be careful. GEMS doctors know more than your doctors, inform them before taking a script. Maybe, gems doctors should write out scripts.

0
Replies (1)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply07 Nov 2025, 12:11
Official
Good day,

Thank you for engaging with us.  We are following your message, and feedback will be provided. If you have an urgent query, please contact us on:  ***(members Toll-free number) & ***(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