JE
Jan E

1 reviews | Active since Apr 2017

23 Feb 2018, 14:57

Nonexistent service

I had a hernia operation in 1989 and disclose it on my application to join GEMS in August 2017 obviously with the intention of not needing an operation ever. However in November 2017 my stomach starts to burn up to my heart and even my shoulder blades felt like it was on fire. My children paid for the doctor and medicine although I paid a medical aid since September 2017, but my benefit date was only from 1 December 2017. Upon phoning GEMS call centre for hospital authorisation on 11 December 2017 for gastroscopy I was told that the underwriters will look into the matter and give feedback which did not happen even after two months. My children had to pay out of there pockets((which I'm grateful for).So I was supp**** with a prescription for 6 months to keep the gastric reflux under control, but soon in January the situation flared up again and so I went to my GP which referred me to the specialist which after conducting more tests told me that the only solution is to have an operation which I'm definitely not looking forward to. So I was told that I need the operation asap. The Specialist booked me for an operation for the 28 February 2018, but now I'm still battling to get an authorization number. When phoning for the number at the call centre the directions is so misleading that I had to phone 3 to 4 times to eventually get through to authorizations department just to be told that the underwriters will look into the matter and only then give feedback, in the meantime there is cases worse than mine and if this is customer service then I don't know what our country is coming too. Every day my stomach ache gets worse, and practically it feels that GEMS or any medical aid just don't care. Our money is good but when it comes to claims/authorizations the service is nonexistent. Is this standard procedures to make people suffer and make them sicker than they already are, or is it only certain people that gets the wrong end of the stick, like me? How long do I really have to wait before this matter gets resolved? Every time that I phone I use my own airtime and then I have to be on the phone for about half an hour to get the answer, still waiting for feedback.

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