1 reviews | Active since Jan 2012
Ongoing Poor Service
<p>I have two claims that i am following up with GEMS since 2014. The first one is for my mum who is my dependant, she had dentures put in, in 2014. We were advsied by Gems that we should pay cash and then claim once the procedure was done as Gems doesn not cover everything and some of the payment would have to be cash. So my father used his retirement money to pay the R11 420 as my mother really needed the dentures. We submitted all the documentation to Gems afterwards and they requested further documents, invoices and proof of payment which we submitted, and then we never heard from Gems again. When i followed up i was requested to submit these documents over and over, but once submitted there was no response, this has been ongoing ever since and we are still waiting for a response. The second problem was when i had to see a doctor whilst visiting my sister in Johannesburg in January 2015, medication was prescribed, I went to the chemist to get it and they told me that they were having a problem with Gems as Gems were implementing new codes and the codes were not working, the pharmacist called Gems to find out how to proceed and was told to request me to pay cash and then claim. I was desperate for the meds so i paid, and i submitted everything to Gems, they requested me to send them the doctors practice number and details and the script that was issued, i sent everything and then never heard from them. I have been following up on these two claims ever since but no help is received from Gems at all. I honestly have had a problem with Gems since joining in 2010, the only reason i stayed is because as a government employee it is the only subsidised medical aid, but i think that i have had enough of their poor service and i will be moving myself and my parents to another medical aid.</p>
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are looking into your complaint and we will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are pleased to confirm that we have resolved the chronic medication dispensing and delivery processes.
We can only confirm that the account for service dated 19 November 2014 was received and processed in line with your available benefits. A payment was generated in respect of this claim and the refund details are reflected on your remittance advice.
The account for services received on 28 October 2014 was unfortunately rejected as your maximum benefit for 2014 had been reached.
We trust the above is in order.
Please accept our sincere apologies for the delay in finalising this matter.
Kind regards
The GEMS online team
Good day
Thank you for bringing your claim concerns to our attention.
We are pleased to confirm that we have resolved the chronic medication dispensing and delivery processes.
We can only confirm that the account for service dated 19 November 2014 was received and processed in line with your available benefits. A payment was generated in respect of this claim and the refund details are reflected on your remittance advice.
The account for services received on 28 October 2014 was unfortunately rejected as your maximum benefit for 2014 had been reached.
We trust the above is in order.
Please accept our sincere apologies for the delay in finalising this matter.
Kind regards
The GEMS online team