WORST SERVICE SINCE I JOINED

My medical aid number is ***

Ive had the worst experience with GEMS since i've joined it in 2016 It started with their maternity program, the midwife was suppose to call me and she refused to, actually this particular midwife was even emailed and notified to call me back but she never did, did not take me serious then it i went to Lifepoortview hospital on the 13th December last year, they sent me an approval from them that they will pay, but guess what today is 4 April 2023, they are refusing to pay that hospital bill while i have approval from them stating that they will cover the costs, i have made more that 10 call, its not even an exaggeration, i have literally made more than 10 calls with me airtime, calling them, telling them to pay that bill and each time...i speak to different call centre agents, one tells me this, another tells me that, another one even told me that i never sent the Lifepoortview hospital to them at all which i have sent initially on the 13th march 2023 and even received an enquiry number from them which is 130323Q9FV9M The lady who told me i never sent anything told me she cant see anything on the system, i need start all over again and resend, so she was just lying to me and taking me back and forth this enquiry they never attended to it , actually they don't want to pay, thats it! Even after resending it for the second time on 22 March 2023 and getting a new query number: 220323Q9L0MP no feedback has been given I have to call 10 times again, be on hold, speak to someone who promises to do his and her job and never does it and the funny thing about all this, the person still expect you to give them a rating after the call, they will say i will attend to you but please rate me, they just want good ratings having done absolutely nothing

My other issue was that on 21 February i went to consult at a paediatrician Dr Mohlabi I, on the 27th February i emailed GEMS telling them to refund me because i paid the doctor cash, i'm telling you the run around i was given is crazy....i submitted all the documents they said i must submit, my bank account statement and prove of payment, but they never bothered to attend them they did a run and instead of refunding me they went ahead and paid the doctor, so this doctor was paid twice by me and by GEMS for the same service

Another incidence, and all these incidences are recent...i asked them to give me a dental authorisation so that i can do tooth removal, i called, a lady answered and after answering she told me "to wait for her" i waited and waited for more than ten minutes with my airtime while she was chatting in the background with her colleagues, laughing and enjoying herself, she spoke xhosa, can you imagine??

I am calling with a problem yet their agents tell you to wait, and have chats and laughs with their colleagues while you are waiting for more than 10 minutes, its unprofessional and its a disgrace! it shows that their agents don't want to work just to get paid for nothing i had to call again as usual and this time i talked to an agent she told me that GEMS will pay but she is not the one who is suppose to give me that dental approval statement, i asked her who is suppose to give me, she didn't tell me she just said 'THEY' will give send you....and no one send me anything i had to call again and again to get it, this is pathetic!

I am just getting a horrible service from GEMS, i'm not sure which point they are trying to prove because, GEMS is not for free, i pay my monthly contribution without fail especially with EMERALD those who are using this option know very well that it is the most expensive option yet EVERY TIME, literally every time i have a problem, it never gets resolved i have to call more than 10 times and even after that, it will still be unresolved

I am going to cancel it and go and join my husband's medical aid, he told me his medical aid is very good in service delivery doesn't do these run arounds like GEMS