Stressful medical aid ever

I am so stressed with the short payments by the scheme. They promised that during in hospital surgery everything will be paid and also authorized 3 follow up consultation with the specialist. But booom phone calls and statements that medical aid declined some of the payment. I phoned them they promised that those procedures and consultation are covered under PMB. GEMS is a nightmare really ever since I got injured I don't get treatment I deserve. O am all stressful.