GEMS Is Making Me Fight for Every Prescription While My Health Deteriorates

I am extremely frustrated and disappointed by the way GEMS has handled my medical aid matters over the past few months.

For almost three months, I have been struggling to get approval for medication prescribed by my treating doctors, despite medical motivations being submitted and my medical history already being available on the GEMS system.

My psychiatrist previously prescribed medication that was even approved during my in-patient psychiatric treatment, yet after discharge I was suddenly forced into a long and emotionally exhausting battle just to continue treatment. I have sent countless emails, prescriptions, medical reports, and follow-ups, only to continuously receive delays, generic responses, and excuses.

What made the situation even worse is that I recently received a call informing me that my medication had finally been approved. To my shock and embarrassment, when I arrived at the pharmacy, the medication still reflected as declined on the system. This was humiliating, stressful, and completely unacceptable.

I have now also submitted another prescription from my orthopaedic surgeon, Dr Tau, and that prescription has also been declined.

At this point, I honestly feel like I have to fight GEMS every single time a doctor prescribes medication for me. Is this what members are expected to go through just to access treatment?

Instead of focusing on recovery and healing, I spend my time sending emails, begging for approvals, following up endlessly, and worrying whether I will receive medication that my doctors have already motivated for. This ongoing situation has affected me emotionally, mentally, physically, and financially.

The lack of urgency and poor communication from GEMS is deeply concerning, especially considering that these are serious health matters affecting people’s lives and wellbeing.

I am not asking for special treatment. I am simply asking for access to medically necessary treatment without having to go through months of stress, delays, contradictions, and emotional trauma every single time.

GEMS needs to improve its service delivery, communication, and approval processes urgently because this experience has been absolutely exhausting and unacceptable.