Scores reflect the Overall AI Score for each category
Based on recent customer reviews, Gems (Government Employees Medical Scheme) is described by members as a scheme that collects contributions reliably but struggles to deliver when care is actually needed. Recurring themes include stalled chronic medication approvals, declined hospital authorisations and unanswered emails. Customer Service & Staff Quality (1.5) scores highest, carried by a handful of named consultants, while Communication & Responsiveness (0.8) attracts the sharpest and most consistent criticism.
Top Strengths:
- •Customer Service & Staff Quality: The scheme's only real bright spots sit here. Members name individual consultants such as Luyanda Njomose, Thandeka Nyambi, Nabeelah and Phumzile Ngubeni who resolved long running disputes with patience and genuine ownership, restoring some confidence.
Replied to 100% of negative reviews
Reply time on negative reviews: 10h 12m
TrustIndex
2.4
Ranking
#16
in Medical Aid
Reply Time
10h 23m
NPS Score
-77
Recommended: Unlikely
Replied to 100% of negative reviews
Reply time on negative reviews: 10h 12m
Oct '25 - Sep '26
Frequently Asked Questions About Gems (Government Employees Medical Scheme)
What do customers say about Gems (Government Employees Medical Scheme)?
Based on recent customer reviews, Gems (Government Employees Medical Scheme) is described by members as a scheme that collects contributions reliably but struggles to deliver when care is actually needed. Recurring themes include stalled chronic medication approvals, declined hospital authorisations and unanswered emails. Customer Service & Staff Quality (1.5) scores highest, carried by a handful of named consultants, while Communication & Responsiveness (0.8) attracts the sharpest and most consistent criticism.
What is Gems (Government Employees Medical Scheme)'s biggest strength?
Gems (Government Employees Medical Scheme)'s biggest strength, according to Hellopeter's AI analysis, is Customer Service & Staff Quality. The scheme's only real bright spots sit here. Members name individual consultants such as Luyanda Njomose, Thandeka Nyambi, Nabeelah and Phumzile Ngubeni who resolved long running disputes with patience and genuine ownership, restoring some confidence.
What are the most common complaints about Gems (Government Employees Medical Scheme)?
The most common complaint about Gems (Government Employees Medical Scheme), based on Hellopeter's AI analysis of recent customer reviews, is Coverage, Benefits & Plan Transparency. Members repeatedly describe chronic medication being stopped or substituted, PMB conditions refused despite specialist motivation, and condition specific waiting periods surfacing only at claim time. Dental and day to day limits are widely described as unrealistic.
How does Gems (Government Employees Medical Scheme) compare to other Medical Aid companies?
Gems (Government Employees Medical Scheme) scores 1.1 out of 5 on Hellopeter's AI analysis of service quality in Medical Aid, compared to the Medical Aid industry average of 1.8. Their strongest theme is Customer Service (1.5); their weakest is Claims Processing (0.8). The top AI-rated Medical Aid business on Hellopeter is AGS Health (4.1). How is the AI Score calculated? →
Is Gems (Government Employees Medical Scheme) trustworthy?
Gems (Government Employees Medical Scheme) has a TrustIndex of 2.4 out of 10 on Hellopeter, based on 332 reviews in the last 12 months. They reply to 100% of negative reviews, typically within 10 hours 12 min. Hellopeter has tracked Gems (Government Employees Medical Scheme) across 2,867 total reviews. How is the TrustIndex calculated? →
Recent reviews (332)
Used this business recently? Share your experience to help others decide.
Used this business recently? Share your experience to help others decide.
Share Your Experience1 reviews | Active since Jun 2024
Pathetic Service
Gems authorized my NIPS test but the payments keep being reversed because of an ICD code error made by the pathologist. I have been calling Gems and their PMB department for the past three months with no resolution. The lack of service delivery and poor customer service has been extremely frustrating.
1 reviews | Active since Jun 2024
Pathetic Service
Gems authorized my NIPS test but the payments keep being reversed because of an ICD code error made by the pathologist. I have been calling Gems and their PMB department for the past three months with no resolution. The lack of service delivery and poor customer service has been extremely frustrating.
1 reviews | Active since May 2020
GEMS says one thing then does another! Poor show GEMS!
After phoning on Friday 25 September 2026 to confirm if my chronic medication has been approved, I go to the store to collect my chronic medication only to be told that there is a R60 co payment for my anti depressant. I was not told this when I phone on Friday 25 September, all I was told when asked that there would be no problem collecting my medication. So I took this as everything was fine and I want to point out that there was absolutely no mention of a co payment. Today, 29 September 2026, I am told that there is a R60 co payment. I phoned GEMS and your chronic department especially Myra were absolutely no help at all. All I was told was to take a generic. If I had to take a generic surely the doctor with a MEDICAL DEGREE would have prescribed it. The doctor even sent a motivation as to why I specifically needed Budep but GEMS prefers to have clients suffer and change medication or possibly land up back in hospital again. Never in my life have I ever experienced such incompetence as I experience with GEMS when ever I have to interact with them. The most pathetic medical aid ever!
1 reviews | Active since May 2020
GEMS says one thing then does another! Poor show GEMS!
After phoning on Friday 25 September 2026 to confirm if my chronic medication has been approved, I go to the store to collect my chronic medication only to be told that there is a R60 co payment for my anti depressant. I was not told this when I phone on Friday 25 September, all I was told when asked that there would be no problem collecting my medication. So I took this as everything was fine and I want to point out that there was absolutely no mention of a co payment. Today, 29 September 2026, I am told that there is a R60 co payment. I phoned GEMS and your chronic department especially Myra were absolutely no help at all. All I was told was to take a generic. If I had to take a generic surely the doctor with a MEDICAL DEGREE would have prescribed it. The doctor even sent a motivation as to why I specifically needed Budep but GEMS prefers to have clients suffer and change medication or possibly land up back in hospital again. Never in my life have I ever experienced such incompetence as I experience with GEMS when ever I have to interact with them. The most pathetic medical aid ever!
1 reviews | Active since Apr 2011
Opticlear puts you on hold for more than 30 minutes without providing answers to your queries
I called Opticlear this morning at around 8h35 and spoke to Nelson to follow up on a claim for Omphile Mashele member number *** DOS 02 Sep 2026 , Nelson put me on hold for over 30 minutes and then the call was redirected. We have been following up on this claim every week and the main member as well did likewise. I received a Remittance showing that only R473.40 was accepted for payment instead of the full amount of R1045.60. We have been given the run around with regards to this claim, I would expect Nelson to get back to me after having put me on hold for almost half an hour given that he already has the practice details. Meaning I would have to call again and be subjected to the same scenario with a totally different agent , this is pathetic service , I'm under the impression that each member on Tanzanite one has R1045.60 for Single Vision spectacles yet only R473.40 has been approved.
1 reviews | Active since Apr 2011
Opticlear puts you on hold for more than 30 minutes without providing answers to your queries
I called Opticlear this morning at around 8h35 and spoke to Nelson to follow up on a claim for Omphile Mashele member number *** DOS 02 Sep 2026 , Nelson put me on hold for over 30 minutes and then the call was redirected. We have been following up on this claim every week and the main member as well did likewise. I received a Remittance showing that only R473.40 was accepted for payment instead of the full amount of R1045.60. We have been given the run around with regards to this claim, I would expect Nelson to get back to me after having put me on hold for almost half an hour given that he already has the practice details. Meaning I would have to call again and be subjected to the same scenario with a totally different agent , this is pathetic service , I'm under the impression that each member on Tanzanite one has R1045.60 for Single Vision spectacles yet only R473.40 has been approved.
1 reviews | Active since May 2012
Termination without legit reason
GEMS doesn't seem to care about its members or people working for Gems do not check the system before giving people answers. I couldn't pay an installment in June then decided to downgrade after reading the schemes terms and conditions where it is states that your medical aid gets terminated after three months of non payment. Then decided to pay the premium of the downgrade and part of the outstanding knowing that everything would be in order before end September which would be the 3rd month. In July I received an *** suspending my *** and i understood end of August I asked for tax certificate immediately after that received another *** stating that my membership had been terminated with effective from June 30 and all my payments there after have been allocated because I was still active a message that doesn't make sense to me. I don't want to dwell on many different reasons from different people about why it has been terminated or how was I still active. I think their main goal is for people to reapply to make extra money for the scheme. I've sent a second complaint and am still awaiting an answer.
1 reviews | Active since May 2012
Termination without legit reason
GEMS doesn't seem to care about its members or people working for Gems do not check the system before giving people answers. I couldn't pay an installment in June then decided to downgrade after reading the schemes terms and conditions where it is states that your medical aid gets terminated after three months of non payment. Then decided to pay the premium of the downgrade and part of the outstanding knowing that everything would be in order before end September which would be the 3rd month. In July I received an *** suspending my *** and i understood end of August I asked for tax certificate immediately after that received another *** stating that my membership had been terminated with effective from June 30 and all my payments there after have been allocated because I was still active a message that doesn't make sense to me. I don't want to dwell on many different reasons from different people about why it has been terminated or how was I still active. I think their main goal is for people to reapply to make extra money for the scheme. I've sent a second complaint and am still awaiting an answer.
1 reviews | Active since Feb 2021
Worst experience
Absolutely shocking service from GEMS. We submitted our medical aid application close to a MONTH ago. Since then, we have followed up repeatedly and have been told FOUR OR FIVE TIMES that the matter has been "escalated internally". And yet, here we are on 28 September with absolutely no resolution. Our existing medical aid ends at the end of September. GEMS is fully aware of the urgency, they have been made aware of it repeatedly, and somehow every "escalation" disappears into a black hole with nobody taking ownership and nobody actually resolving the application. This is not a minor inconvenience. This is MEDICAL COVER. People cannot simply sit around indefinitely while an application gets passed from one internal department to another with no accountability, particularly when their existing cover is about to expire. What makes this even worse is that every time we follow up, we are essentially given the same response: it has been escalated. At what point does an escalation actually result in somebody doing something? We submitted everything well in advance specifically to avoid this situation. We have done our part. GEMS has now left us days away from potentially being without medical aid because they cannot seem to process an application or provide a meaningful answer after almost a month. This has been an unbelievably frustrating introduction to GEMS and, frankly, an appalling level of service from an organisation dealing with something as important as people's healthcare. If anyone senior at GEMS actually monitors these reviews: please stop "escalating" the matter and RESOLVE IT. We need an outcome urgently, before our existing medical aid terminates on 30 September.
1 reviews | Active since Feb 2021
Worst experience
Absolutely shocking service from GEMS. We submitted our medical aid application close to a MONTH ago. Since then, we have followed up repeatedly and have been told FOUR OR FIVE TIMES that the matter has been "escalated internally". And yet, here we are on 28 September with absolutely no resolution. Our existing medical aid ends at the end of September. GEMS is fully aware of the urgency, they have been made aware of it repeatedly, and somehow every "escalation" disappears into a black hole with nobody taking ownership and nobody actually resolving the application. This is not a minor inconvenience. This is MEDICAL COVER. People cannot simply sit around indefinitely while an application gets passed from one internal department to another with no accountability, particularly when their existing cover is about to expire. What makes this even worse is that every time we follow up, we are essentially given the same response: it has been escalated. At what point does an escalation actually result in somebody doing something? We submitted everything well in advance specifically to avoid this situation. We have done our part. GEMS has now left us days away from potentially being without medical aid because they cannot seem to process an application or provide a meaningful answer after almost a month. This has been an unbelievably frustrating introduction to GEMS and, frankly, an appalling level of service from an organisation dealing with something as important as people's healthcare. If anyone senior at GEMS actually monitors these reviews: please stop "escalating" the matter and RESOLVE IT. We need an outcome urgently, before our existing medical aid terminates on 30 September.
1 reviews | Active since May 2020
GEMS gladly takes money excepts does proper research
Please explain to me why you are taking R3000 off my salary for a new member who was a member last year and has had previous medical aid. Furthermore GEMS never not once indicated that the additional R3000 would be taken off my salary. I'm fed up with GEMS just doing and taking money as they please without informing paying members. Please go and check that dependent *** was previously on GEMS and refund me the R3000 that has been taken off my salary for three months.
1 reviews | Active since May 2020
GEMS gladly takes money excepts does proper research
Please explain to me why you are taking R3000 off my salary for a new member who was a member last year and has had previous medical aid. Furthermore GEMS never not once indicated that the additional R3000 would be taken off my salary. I'm fed up with GEMS just doing and taking money as they please without informing paying members. Please go and check that dependent *** was previously on GEMS and refund me the R3000 that has been taken off my salary for three months.
1 reviews | Active since May 2016
⭐ GEMS: 1/10 Extremely disappointing service
⭐ GEMS: 1/10 Extremely disappointing service. My mental-health condition is registered as a ***, yet my psychologist has an outstanding unpaid claim and is refusing to see me until it is resolved. I have followed up with GEMS repeatedly, including on 11 and 18 August 2026, but still have no clear written confirmation that I can continue seeing my psychologist and psychiatrist under ***. This delay is affecting my access to ongoing treatment. GEMS needs to urgently resolve the claim and provide clear written confirmation of my *** cover.
1 reviews | Active since May 2016
⭐ GEMS: 1/10 Extremely disappointing service
⭐ GEMS: 1/10 Extremely disappointing service. My mental-health condition is registered as a ***, yet my psychologist has an outstanding unpaid claim and is refusing to see me until it is resolved. I have followed up with GEMS repeatedly, including on 11 and 18 August 2026, but still have no clear written confirmation that I can continue seeing my psychologist and psychiatrist under ***. This delay is affecting my access to ongoing treatment. GEMS needs to urgently resolve the claim and provide clear written confirmation of my *** cover.
1 reviews | Active since Apr 2017
No honest communication
I was diagnosed with cancer in June and subsequently operated on by Dr moller. Before this I contacted gems to ask who pays for what. The lady at the call center all procedures are covered by Gems. That is because of cancer. Operation done and then the accounts started arriving. Horror upon horrors. R15000 paid by Gems. One item on the pathologist account got R7955 not paid. I contacted gems several times and the seem to apply delay tactics. The ask for Dr's accounts and pathologist accounts. Stalingrad tactics. All I asked why?, No reply, they send *** requesting accounts again and again. I am 77 and do not have a pension. I am on my wife's medical aid. NO DECENT ANSWERS FORTHCOMING.....sad sad
1 reviews | Active since Apr 2017
No honest communication
I was diagnosed with cancer in June and subsequently operated on by Dr moller. Before this I contacted gems to ask who pays for what. The lady at the call center all procedures are covered by Gems. That is because of cancer. Operation done and then the accounts started arriving. Horror upon horrors. R15000 paid by Gems. One item on the pathologist account got R7955 not paid. I contacted gems several times and the seem to apply delay tactics. The ask for Dr's accounts and pathologist accounts. Stalingrad tactics. All I asked why?, No reply, they send *** requesting accounts again and again. I am 77 and do not have a pension. I am on my wife's medical aid. NO DECENT ANSWERS FORTHCOMING.....sad sad