The worst medical aid

This is the absolute worst medical scheme, especially if you are on a lower tier. They absolutely do not care about lower tiers. I joined GEMS in May 2024. I am on the Beryl plan. I chose this plan because it allows for 3 specialist appointments, one dental and "unlimited" (at least up to 8) visits to your nominated GP. Firstly, they cover about R300 of the GP. What GP honestly charges R300 these days? Pathetic. I chose my dentist off the network practitioners list on the GEMS website and then booked. When I submitted the claim, I was told that the dentist is no longer on the network. I spent copious amounts of airtime (and physical time) trying to explain that I got the dentist off their list and it is their error for not updating the list if a practitioner leaves the network. This was never resolved...NO DENTIST COVERAGE FOR ME.

I also went to my nominated GP and she had to phone GEMS to obtain a specialist referral authorisation in order for me to go to a gynae check-up. I got the authorisation, but THEY DO NOT PAY SPECIALIST CLAIMS even if you have an authorisation. I keep phoning and emailing and trying to escalate the matter. My statement keeps saying that they cannot pay because I require specialist authorisation. It's enough to drive a person mad.

I am paying about R2200 for my plan. I can move to Discovery and pay R1800 for similar coverage to what GEMS is actually giving. I fear for ever needing hospital care under GEMS, luckily I do have gap cover.

They say they will respond to emails within 72 hours...they of course do not. When you phone them you have to listen to robots for 5 minutes and be put on hold constantly and nothing gets resolved after much airtime (and time) spent. I honestly HATE GEMS. I do not recommend. Maybe they are better on higher plans, but do not get Beryl or heaven-forbid, the one below it.

I would like to move to Discovery immediately, but I am legitimately afraid that GEMS will keep charging me and I won't be able to stop them. I will rather wait until my contract ends and they actually cannot physically take my money. This is how little faith I have in them. They raise my blood pressure. Please protect your sanity and health and DO NOT GO ON GEMS!