Gems ***** us again

Gems deserves a minus score. My husband had an operation done. Medical aid authorized the operation. The hospital chosen was on their network list yet when the bill arrived they only paid 1/4 of the amount.

I understand that hospital and doctors charge over medial aid rates but the rates of gems will not ever cover a specialist. How do they except people to get proper care. 27k shortfall because they authorized the procedure at a hospital on their network that charges way about medical aid rates.

Same things last year. My water broke and I required an emergency c-section gems paid less than 1/4 of the gyne as they told me it was not an emergency. What the actual F how is your water breaking not an emergency when you require a c-section. Was I supposed to keep the kid inside for a their week to make it to the date of the planned c-section. So because Gems didnt pay more, nor acknowledge it as an emergency the gap cover would not pay the 500% they offer for emergencies.

Way to go GEMS the only option for government employees