GEMS DOESN'T HONOUR THEIR INSTRUCTIONS AND TREATS PATIENTS LIKE ANIMALS !!!

I have a growth on the left side of my upper gum which was diagnosed as a torus palatinus. I have full upper dentures which irritates the growth (lump) and causes excruciating pain and discomfort. I cannot eat properly and even my speech is being effected as I have to constantly remove my dentures due to the pain and discomfort.

I have contacted GEMS during September 2024 and specifically asked for a REGISTERED medical practitioner whom I could go and see in order to have this growth (lump) removed WITHOUT any co-payments. I was then referred to Dr S Dalakas in Krugersdorp. I also made sure whether a referral from a GP was necessary to see Dr Dalakas, to which I was told NO.

After the holidays, I eventually managed to get an appointment with Dr Dalakas. Dr Dalakas sent through a quotation to GEMS. GEMS then DECLINED all the codes relating to the removal of this growth (lump) : Rejected codes 8991, 8110 and 8145 deals SPECIFICALLY with the removal of the torus palatinus.

GEMS, I DO HAVE A MEDICAL AID FUND WHICH I PAY FOR WITHOUT ANY SUBSIDY. I only get R6,000.00 per month as a pension from the government of which GEMS already takes almost R4,000.00.

GEMS REFUSES to pay for the removal of the torus palatinus and does not even provide me with an alternative, although I have taken ALL measures in order to make sure I do the RIGHT thing and follow the RIGHT procedures.

I CANNOT live with this HORRIBLE situation forever and CANNOT eat NOR speak properly !!! I am a HUMAN BEING --- TREAT ME AS SUCH !!!

I herewith request GEMS to review the PARTIAL APPROVAL and approve the FULL fees for the removal of the torus palatinus.