3 Comments

  1. khululiwe
    2014-05-30 @ 3:27 pm

    i have a mexilo operation/surgery for the left side of my face, where they will be removing a non cancerous tumor, i want to do a pre authorisation as per doctors instructions,but i do not have the email address. i am under the gems medical aid.

    please help.

  2. admin
    2014-06-01 @ 8:55 am

    Please to get in touch with GEMS medical aid directly via their website.

  3. Joyce
    2015-08-26 @ 9:10 pm

    I had a dental procedure done in Feb this year at hospital, and received authorization for the procedure. My option on Gems is Emerald.Thereafter prime cure has not paid the hospital up to now, I followed them up since April. Every time I enquired I was told it was a legitimate claim and will be sorted out in a week or so, but up to now prime cure hasn’t settled it. The hospital has even send me the bill of R19.000 to pay them since the medical aid is not responding to settle account. I was given a very bitter experience by dental prime cure, and at the end they said to me that they were going to pay part of that claim, though my option states 100% coverage in hospital. One of their consultants said it was my duty to ensure how much they are going to be paying prior to the hospital admission, despite my option stating 100% in-hospital coverage. The worse thing is that each time I follow matter up I get a different person who promises that he will sort matter out, but all in vain or else, my call is put on hold for hours until I drop it ,very, very frustrating! And I am not referred to any senior person to talk to, if I ask to, who can probably give me some sense of this matter. I was even advised by the media to go to the medical aid ombudsman for help, and also sort legal aid as well, which I hope will help me resolve my problem. I wouldn’t recommend them to anyone and even decided to terminate my contract with Gems since they contract with some service providers which gives clients a very, very raw deal, because at least if they called me and communicated with me stating why they are not honoring this claim since Feb I could have understood. UNHAPPY CLIENT.

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