ll
lethabo.mokomane lethabo.mokomane

1 reviews | Active since Jul 2013

11 Apr 2018, 10:37

Horrible service am receiving from Gems

Was required to cancel my medical aid with another provider in November last year 2017 so that my activation will not have complications when applying with Gems, on the 28th of November 2017 I filled the form and submitted with the required documentation needed and were told that within two weeks everything will be processed so that come January we will be able to have a medical aid and was advised that I cannot fill the chronic application form as my medical is not activate as yet and should wait until it is active before I can apply for the chronic. It took Gems 2 months to activate my medical aid, now have filled my chronic application and I was told that I am going to be put under probation as the was a break in between.

When I filled my gems application I did specify on my application that a have chronic and my previous medical aid did cover for my chronic, how can I be put under probation as my application was submitted on time and people from gems took their time in processing my application now I must be put under probation as I submitted my application on the 28th of November 2017, and was covered by previous medical? Were in your terms and conditions is this rule that when you come from another medical aid you have to wait for 3 months? As I did not have a break between my medical application as I submitted everything on time as it took gems the whole two months to process my application.

Your gems underwriting stated the following:

1. No condition-specific underwriting: Full cover without any waiting periods for people who join with chronic or life-threatening conditions. 2. Principal members who resign from the Scheme with their dependent’s (without also resigning from the Public Service) and then re-join the Scheme at a later stage. (of which I was coming from another medical why impose on a waiting period on my chronic application as I submitted on time?

Today called Gems and it seems like no one from gems know what they are doing, have spoken to three different people in one day. Firstly I spoke to Vuyo from chronic authorization and she told me that they only deal with authorization and the only people who deals with waiting period for chronic are people from client department, she transferred me to client department and spoke to Sophie and asked why am I been put on a waiting period as I submitted my application on time and took gems two months, full two months to process and activate my application to make matter worse is that I did specify on my application I had chronic and was covered by my previous medical aid, she could not help me what she ended up doing she told me to hold the line and ended up ending the call while I was waiting for her to get back at me. Called again and spoke to another lady called Archie/Artie and explained my problems and she told me the same thing Sophie told me that she is checking while I was busy holding the line she hanged up on again.

I am failing to understand what is happening with people from gems and it shows that gems does not value peoples health, I am failing to understand why 12 months waiting period as I didn’t have a break in between my previous and current medical aid and I did inform gems when I submitted my application

0
Replies (3)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply11 Apr 2018, 12:59
Official

Good day

We are so sorry to hear of your troubles. We are looking into this mater and will provide feedback shortly.

Kind regards

The GEMS online team

ll
lethabo.mokomane lethabo.mokomane's update11 Apr 2018, 14:15
Reviewer Update
Will wait for feedback
ll
lethabo.mokomane lethabo.mokomane's update30 Apr 2018, 09:08
Reviewer Update
I think you for resolving my Issue