GEMS Approved My Treatment in Hospital – Now They Refuse to Pay and Don’t Care About My Health

I am extremely frustrated and disappointed with GEMS.

I was admitted to a psychiatric facility where, after proper diagnosis and evaluation, I was prescribed medication that finally worked for my condition. GEMS approved and paid for this medication while I was an in-patient, which clearly shows that it was recognised as necessary and effective.

However, immediately after my discharge, GEMS has now rejected the very same medication for continuation of treatment.

This makes absolutely no sense.

My treating doctor, Dr Matshoene, has already confirmed that:

* There is no suitable generic alternative for my condition * This medication is the one that works for me * The prescription is based on a thorough and correct diagnosis made during my hospital stay

Because of this rejection:

* I have been left without medication * The progress I made in hospital is being reversed * I am at risk of relapse and already feeling the effects

How can a medical aid approve a treatment in hospital, see that it works, and then refuse to cover it when a patient is discharged and needs to continue the same treatment?

This lack of continuity of care is not only unfair, it is harmful.

To make matters worse, GEMS continues to respond with generic template messages that do not address my case, which shows a lack of proper review and concern.

I am now struggling with anxiety, depression, and frustration because of this situation. GEMS has all my medical records and knows the seriousness of my condition, yet they are still denying me the treatment I need.

GEMS needs to:

* Ensure continuity of care for patients after discharge * Respect doctors’ medical decisions and motivations * Stop denying treatment that has already been proven to work * Provide proper, case-specific responses instead of generic replies

At this point, I feel completely unsupported by the very medical aid that is supposed to help me recover.

I urgently need this medication approved before my condition worsens further.