Unfair treatment

On the 12 August 2021 we (myself and the Dr) phined GEMS to apply for my medication (Stresam and Zopiclone) to be covered under chronic medication so that it can be paid by GEMS, thus medication is a repeat one for six months. My reference number that I was issued is 120821Q05TK6 and my chronic application number is GMS***. We were told by the consultant that was helping us that I will get a response in two days and the conversation was followed by an sms from GEMS informing me that I will get a feedback I five working days. This was at about 16:00.

At about 07:34 on 13 August 2021 I received an SMS from GEMS saying "your chronic medication authorisation GEMS*** was processed and you will be contacted within 24 hours. At about 08:40 same I received a call from *** and the guy told me that he is calling from GEMS and he requested me confirm my details by asking those question which I have answered all of them. He mention the reason for the call was to inform me that my application has been approved and I can go collect my medication from Clicks pharmacy. The guy even confirmed the physical address of the Clicks pharmacy at which I must collect my medication from and even said if I go to another Clicks I will have to pay from my pocket for the prescription. This conversation was followed by an sms from GEMS which says "Authorisation number (GEMS***) has been processed. You have been allocated to obtain your chronic medicine from CLICKS PHARMACY HAYFIELDS".

At about 14:00 on 13 August 2021 I went to this Clicks pharmacy in Hayfield to collect my prescription. To my surprise I was told by the pharmacist that this prescription is not going to be paid by GEMS as it is not covered on the chronic medicine. The pharmacist immediately phobed GEMS as I showed her that this has been approved by GEMS but to my surprise she was told that my application was declined and unfortunately this was not declined at all.

I phoned GEMS and unfortunately I spoke to a number of consultants. The first consultant from chronic department said she doesn't can't see anything about the response on my application and she can't see any call that was made to me from her department. Then theady transfered me to the other department that she said she thought that's the one that phoned me. The guy from there said he can not understand why I would get a call confirming the payments that GEMS will make for this medication as it is not covered under chronic medication and he cannot understand even the sms confirming the authorisation as he explained a lot of things. At that time it was about an hour on the call and he want to transfer me back to the chronic department. I the said I cannot talk to the chronic department again at all, I advised him to excaliate the matter to the superiors as I could see there was solution. The reference number for that call is 130821Q0687W.

Then I have decided to pay the medication and it was R596.24 as I really wanted to use it.

I am not happy about this situation that GEMS has done to me as I'm sick and really wanted to get help. This medication is expensive and cannot afford it hence I have submitted an application for help. Now when I get an authorization and only to find that was a false one, I really cannot understand at all. So I want This to be thoroughly investigated and a feedback that will make sense t be provided.

Kind Regards Nceba Mkondweni ***