It’s the fifth month no answer just messages that my comments have been passed to the exgratia department from Nov to Dec nothing

This has been the most disheartening and cruel process. I sent an enquiry please see below. Refer to the below complaint, this has been going on for three months now. I got a call to say page 2 was missing and an invoice. I sent page 2 and an invoice in December 2021 I asked if everything was in order I was told yes. Then the went quiet I enquired again then I got another call saying everything was ok they were waiting for the committee to meet and I must send the invoice. I did then in February I was told documents are missing again and they was this years invoice, why 2022 when the doctor did the eye test in November and is charging using last years prices. Why am I paying almost three thousand rand for a medical aid that will give me a run around. If I calculate this amount and not paying for spectacles I would have been finished paying for them. They don’t take into consideration that no doctor wants to accept their medical aid and some specialists you have to pay cash. I am caught in a catch 22 situation right now, it’s my eyes, it’s a mass on my glands (R1400 per session is required) my last born has special needs she needs a psychologist, psychiatrist and speech the****** they all require R1000 and above) which one do I prioritise? All this I’ve been on the medical aid for nine years but now I am as good as someone who doesn’t have. I don’t know I really don’t know. What’s worse public servants haven’t gotten an increase for three years. This is disappointing. I went to test my eyes and I was told I need multiple focal lense. At Specsavers in Medicross Upon that I thought would make a payment but I was told to add 4700 on top of the bill which is 2000 for the test and 2700 for the glasses. I called gems and was told the doctor must make a reference as to why I need the specie glasses and she said she won’t do it because they would say no. Mind you I had multi focal eyesight and never had to make a payment. The poor eyesight came after IOD now because I can’t afford the spectacles I will teach in that condition if I don’t see what’s written I’ll write what I think it is. You can’t give 1800 for spectacles yet the spectacles cost more that 6000. This is the worst medical aid. I am still waiting for an answer. The spectacles were mad

Then I got this message Good day Thembakazinjabulo,

Kinldy note that our recors show that feedback was sent to on 21 Feb 2022 to the following email adrress: *********** stating the following: The above email was incorrect my e-mail address in ***********

We refer to your complaint received via Hellopeter and our discussion of today. • 7 January 2022, the Ex Gratia (EG) Department requested the following information: ▪ Fully completed page of your Ex-Gratia application (page 2 was not received) ▪ Page 3 of your application has to be certified ▪ Member proof of income ▪ Detailed quotation for the spectacles • 12 January 2022, your proof of income was received. • 13 January 2022, the quotation for 2021 was received. • 26 January 2022, the Callcentre agent advised your documents were received. • 9 February 2022, the EG Department contacted you and requested the following: ▪ Fully completed page of your Ex-Gratia application (page 2 was not received) ▪ Page 3 of your application has to be certified ▪ Detailed quotation for the spectacles for 2022 As discussed, the provider submitted a claim for service date 29 November 2021 which was settled in full on 28 January 2022, as confirmed via MEDIA-11168 on 3 February 2022. The EG Department requires a quotation for 2022 from the Optometrist to submit with your application form including the outstanding documentation as requested. We apologise for any inconvenience caused.

Kindly note that we have requested the releven team to resend same.

Regards, GEMS Private Reply

All the documents they requested were given to them on now a weekly reminder. The doctor as an invoice 13 of January 2022 with all the items, using the prices for 2021, she explained that she will not charge me more because this was done early enough. This has been painfully eye opening. Everything gems asked for they got. Every follow was a different story and yet I am still sitting with same problems months later. No answer just gimmicks of saying this form is missing, I now sent all the documents as listed every week but I get no answer. It hasn’t gotten to a point where I would need to send to the ombudsman and other disciplinary bodies to help and maybe cancel medical aid so the national insurance might be passed before end of March then we can stop medical aids and just to the doctor when i get sick. I think it’ll be cheaper, then that money can help me as a single single income lady.