rR
rsmvubu R

1 reviews | Active since May 2016

23 Sept 2025, 13:03

Im struggling to get...

Im struggling to get good service from gems I have been calling sending emails but I'm not getting any joy I have registered conditions that I have ongoing consultations and medication required for them but they are not authorising and paying the claims and medication I'm struggling with chronic pain from the Gun shot wound that has cause vein damage but I can't get authorization for the medication I am registered for PTSD but they are telling me I have to go see a GP to be referred to a phycologist when I'm in a situation that I cant even move or drive myself Gems is not considerate and they are not even communicating I even resorted to send massages to the counsel of medical aid schemes and hellopeter they respond with a template that is not saying anything about resolving the problems faced by the client I can't be paying medical aid and also pay doctors and medication out of my pocket Hope you assist me

0
Replies (2)
rR
rsmvubu R's update23 Sept 2025, 13:34
Reviewer Update
Gems is always not paying claims why do us as members of gems have to suffer always I was shot and registered it as PMB with gems but they are refusing to pay claim related to the fracture I fail to understand why I need these claims paid ASAP I can not deal with all this admin,pay gems and pay Doctors never gems must own up and pay these claims that I related to the fracture on my right leg all these claims are for the right leg and you cal see it stop stalling and wanting information that I don't have as a patient

Refilwe Tisane
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply23 Sept 2025, 13:34
Official
Good day,

 

 Thank you for engaging with us.  We are following your message, and feedback will be provided. If you have an urgent query, please contact us on:  ***(members Toll-free number) & ***(providers).

 

 Call Centre Hours: Monday - Friday: 8h00 - 17h00 & Saturday: 8h00 - 12h00.

 Emergency number: ***(available 24 hours)

 

 If you wish to submit a compliment, please email us on at ***. 

 

We look forward to receiving your positive feedback. 

  Regards, GEMS