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rsmvubu R

1 reviews | Active since May 2016

27 Mar 2026, 15:19

Terrible Service from GEMS – No Care for Members’ Health

I am extremely disappointed and frustrated with the way GEMS treats its members. Every single time I need to get my prescribed medication, it turns into a stressful and exhausting battle.

I have a documented medical history on their system, including being admitted to a psychiatric hospital and being diagnosed with PTSD. My treating doctor, Dr Matshoene, knows my condition and prescribes medication that is appropriate for my health. Yet GEMS continues to delay or refuse approval for this medication without valid reason.

This is not just an inconvenience — it is putting my health at serious risk. The constant back-and-forth, lack of feedback, and unnecessary obstacles are taking a huge toll on my mental well-being.

It is unacceptable that a medical aid scheme can ignore a patient’s medical history and a doctor’s professional recommendations. Members are paying for a service, but when it matters most, there is no support.

GEMS needs to:

Start prioritizing patients’ health over administrative delays Respect doctors’ medical decisions Improve communication and provide clear, timely feedback

Right now, it feels like they simply do not care about their members.

I would not recommend this medical aid based on my experience.

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Replies (2)
Gems (Government Employees Medical Scheme)
Gems (Government Employees Medical Scheme)'s reply27 Mar 2026, 15:27
Official
Thank you for engaging with us.  We are following your message, and feedback will be provided. If you have an urgent query, please contact us on  ***(members Toll-free number) & ***(providers).

Call Centre Hours: Monday - Friday: 8h00 - 17h00 & Saturday: 8h00 - 12h00.

 Emergency number: ***(available 24 hours)

If you wish to submit a compliment, please email us on at ***. 

We look forward to receiving your positive feedback. 

Regards, GEMS
rR
rsmvubu R's update28 Mar 2026, 16:52
Reviewer Update
I am beyond frustrated with the way GEMS is handling my case. Not only are they refusing to approve my prescribed medication, but their responses to my complaint are completely generic and unhelpful.
After raising a serious concern about my health, I received a standard copy-and-paste response that does not address my situation at all. This clearly shows that complaints are not being properly reviewed, and responses are sent just for the sake of responding—not to actually assist members.
My treating doctor, Dr Matshoene, has already provided detailed medical motivation explaining why this specific medication is necessary and how it has been helping me. Despite this, GEMS still declined the medication without proper explanation.
Because of this delay and refusal:
  • I have been without my medication
  • The progress I made while admitted in a psychiatric facility has gone to waste
  • I have relapsed and feel worse than before
I am now struggling with severe anxiety, depression, and frustration—all because of the lack of support from my medical aid. GEMS has all my medical records and knows my condition, yet they continue to ignore the urgency of my situation.
How is a patient supposed to recover under this kind of stress from the very people who claim to care?
This is not just poor service—it is negligence towards a member’s health and well-being.
GEMS needs to:
  • Stop sending generic, automated responses
  • Actually review and respond to individual cases properly
  • Respect doctors’ medical recommendations
  • Urgently approve necessary treatment for members
At this point, I feel completely unsupported and let down by gems.