MH
Monique H
1 reviews | Active since Oct 2018
23 Apr 2025, 13:38
Gems
So again I am having a problem with my medical aid. I am on maternity high risk careplan. Dr Siecker (19 April 2025) went off my day to day. Dr Foolchand (25 March 2025) went off my day to day. It needs to go off my maternity benefits. I am allowed 4 scans. The one for 25 March 2025 according to medical letter I am not suppose to pay which I did 800 and medical aid not giving me the money back. But according to medical aid I have 2 scans left. How if I have paid for the one? Which I am not even suppose to pay. My day to day and maternity benefits is not being sorted out. And now I am getting tired for Gems giving us maternity benefits but exhausting my medical aid and that I need to pay for scans that is given to me.
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Replies (4)MH
Monique H's updateReviewer Update
23 Apr 2025, 15:59I have phoned gems again 23 April 14:42 and still waiting for them to phone me back it is. 15:57. Now all of a sudden my ICD 10 code is incorrect for my high risk pregnancy but GEMS gave me the codes to use. I want my claim from day to day sorted out and my scan from the 25 March!!!!! My patience is now up!!! I already have a high risk pregnancy and now I need to fight with GEMS!!!!!
MH
Monique H's update23 Apr 2025, 15:59
Reviewer Update
I have phoned gems again 23 April 14:42 and still waiting for them to phone me back it is. 15:57. Now all of a sudden my ICD 10 code is incorrect for my high risk pregnancy but GEMS gave me the codes to use. I want my claim from day to day sorted out and my scan from the 25 March!!!!! My patience is now up!!! I already have a high risk pregnancy and now I need to fight with GEMS!!!!!
Gems (Government Employees Medical Scheme)'s replyOfficial
23 Apr 2025, 16:35Thank 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,
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
Gems (Government Employees Medical Scheme)'s reply23 Apr 2025, 16:35
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,
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
MH
Monique H's updateReviewer Update
23 Apr 2025, 18:13So now my ICD 10 codes is correct but my day to day and maternity benefits still not sorted out and my scan.
MH
Monique H's update23 Apr 2025, 18:13
Reviewer Update
So now my ICD 10 codes is correct but my day to day and maternity benefits still not sorted out and my scan.
MH
Monique H's updateReviewer Update
29 Apr 2025, 18:24I am really not happy with GEMS. They gave me the ICD 10 for z35.9 to use. Now all of a sudden the code is incorrect. I need to use the O range code. What O range code and why is it incorrect now. I am alreadt 25 weeks pregnant and not once did they tell me that when they fixed my claims from day to day to maternity? So what do I do now as the medical aid gave me incorrect information?
MH
Monique H's update29 Apr 2025, 18:24
Reviewer Update
I am really not happy with GEMS. They gave me the ICD 10 for z35.9 to use. Now all of a sudden the code is incorrect. I need to use the O range code. What O range code and why is it incorrect now. I am alreadt 25 weeks pregnant and not once did they tell me that when they fixed my claims from day to day to maternity? So what do I do now as the medical aid gave me incorrect information?