Medication authorization

This letter serves to lodge a complain in the manner which Gems Medical aid handle the application for authorization for medication Sensiper. We initially submitted the request on the 14th February 2024 telephonically, nothing was done on the instruction. We made follow up calls daily with Gems not calling or giving feedback to date. Then on the 21st of February we made a call, and we were advised that we need to submit the motivation from the doctor, the Lancet results, and the prescription. All these documents were submitted the very same day on the 21st of February 2024 as per the attached. We kept on calling Gems daily and only yesterday Gems responded with the attached e-mail that my we have to apply for Ex Gracia which was not even explained to us what it is. We don’t need to apply for Ex Gracia Fund we want Gems to pay from the Chronic Funds as my husband is a chronic patient who goes for Dialysis 3 times a week and 4hrs per session. We have been unfairly treated by Gems and they need to pay for this medication fully. Currently he is buying this medication alone with R3000 per month out of our cash. My question is why this medication is not funded from his chronic medication. Till today no answer has been provided to us, no telephonic call has been made and this is Highly UNACCEPTABLE TREATMENT.

Resolve this matter as a matter of urgent and do what is correct for my husband. All results, motivations and scrips are sitting with you.