Gems (Government Employees Medical Scheme)
Verified Business
Gems (Government Employees Medical Scheme)
Verified Business
294 Reviews (last 12 months)
Responds in 10 hours 26 min
AI Review Summary
Based on recent customer reviews, Gems (Government Employees Medical Scheme) receives overwhelmingly negative feedback across virtually every dimension of its service. Members consistently describe severe failures in claims processing, communication, billing, and coverage transparency. While a handful of named consultants receive heartfelt praise, the dominant experience is one of frustration, neglect, and administrative chaos that directly impacts members' health and finances.
Top Strengths:
- •Customer Service & Staff Quality: A small number of individually named agents such as Luyanda Njomose, Nabeelah, Thandeka Nyambi, and Phumzile Ngubeni receive exceptional praise for going above and beyond, restoring member confidence when they intervene.
Service Quality Ratings
MetricScoreIndustry AvgBest in Class
Performance(last 12 months):
0Trustindex Rating
#12Ranked In Medical Aid
10 hours 26 minutesAverage Time To Reply
-68 NPSRecommended: Unlikely
Replied to 96% of negative reviews
Typically takes less than 10 hours 30 min to reply
TrustIndex
0
Score
Ranking
#12
in Medical Aid
Avg Reply
10 hours 26 minutes
NPS Score
-68
Recommended: Unlikely
Replied to 96% of negative reviews
Typically takes less than 10 hours 30 min to reply
Review Distribution
1.2|294 Reviews
May '25 - Apr '26
5(2.6%)
4(1.5%)
3(1.1%)
2(3.8%)
1(91%)
5(2.6%)
4(1.5%)
3(1.1%)
2(3.8%)
1(91%)
Recent reviews (294)
Used this business recently? Share your experience to help others decide.
Used this business recently? Share your experience to help others decide.
Share Your ExperienceSN
Sondelani N
1 reviews | Active since Jan 2020
17 Mar 2026, 18:54
Incorrect Claim
An incorrect claim was made to my mother’s account and she has been trying to get the claim removed from her account as she never visited that doctor but she has been getting the runaround. We don’t understand how an incorrect claim could be made against someone’s account when she never visited that doctor who is in Limpopo and we stay in Mpumalanga and no one is willing to help
Helpful (0)
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Sondelani N
1 reviews | Active since Jan 2020
17 Mar 2026, 18:54
Incorrect Claim
An incorrect claim was made to my mother’s account and she has been trying to get the claim removed from her account as she never visited that doctor but she has been getting the runaround. We don’t understand how an incorrect claim could be made against someone’s account when she never visited that doctor who is in Limpopo and we stay in Mpumalanga and no one is willing to help
0
Replies (0)YS
YUSUF S
1 reviews | Active since Jan 2020
17 Mar 2026, 14:04
Frustrated at Poor Service Support.
I've learnt to really hate call cues. They waste one's time, serve very little benefit to the client and calls drop at any time after spending 35 minutes. Sometimes they call you back, other times they just don't bother. You escalate due to no meaningful update on claims, but you cannot speak to anyone, "they will call you back" never top happen. I have an outstanding claim since November 2025, Regularly asked for feedback and received non. When an agent (Theodore MH179379233) finally checked, the claim was "in limbo". He promised to resubmit to be loaded and I should have an SMS within 2 days to confirm its logged. Never happened. Next follow up call and the agent won't divulge his name, asked to escalate, puts me through to another department. Ended up at the wrong extension (to be expected). Called again only to speak to another (Andrew MH179699562) who promised to escalate and (Lerato) to call back. Still waiting. And all this while a R2470 claim for refund is somewhere in limbo 4 months later. But the annual increase system don't end up in limbo. That is done like yesterday. Aaargh can pull my hair out with this incompetence.
Helpful (0)
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YUSUF S
1 reviews | Active since Jan 2020
17 Mar 2026, 14:04
Frustrated at Poor Service Support.
I've learnt to really hate call cues. They waste one's time, serve very little benefit to the client and calls drop at any time after spending 35 minutes. Sometimes they call you back, other times they just don't bother. You escalate due to no meaningful update on claims, but you cannot speak to anyone, "they will call you back" never top happen. I have an outstanding claim since November 2025, Regularly asked for feedback and received non. When an agent (Theodore MH179379233) finally checked, the claim was "in limbo". He promised to resubmit to be loaded and I should have an SMS within 2 days to confirm its logged. Never happened. Next follow up call and the agent won't divulge his name, asked to escalate, puts me through to another department. Ended up at the wrong extension (to be expected). Called again only to speak to another (Andrew MH179699562) who promised to escalate and (Lerato) to call back. Still waiting. And all this while a R2470 claim for refund is somewhere in limbo 4 months later. But the annual increase system don't end up in limbo. That is done like yesterday. Aaargh can pull my hair out with this incompetence.
0
Replies (0)BS
Belinda S
1 reviews | Active since Jan 2020
17 Mar 2026, 09:42
GEMS Wasting money while increasing premiums
I am very frustrated with GEMS. You claim a 9.8 persent increase, yet when members calculate how much more they are paying it is sometimes up to 100 persent or more…. The unions are fighting this but GEMS claims they need it to keep afloat. Now I see posters in BFN about a wellness screening on 23 March which not only covers PSA members but also POLICE ACT members….. and there were already wellness screenings at a lot of Police Stations in Bloemfontein. Please spend our money wisely!
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Belinda S
1 reviews | Active since Jan 2020
17 Mar 2026, 09:42
GEMS Wasting money while increasing premiums
I am very frustrated with GEMS. You claim a 9.8 persent increase, yet when members calculate how much more they are paying it is sometimes up to 100 persent or more…. The unions are fighting this but GEMS claims they need it to keep afloat. Now I see posters in BFN about a wellness screening on 23 March which not only covers PSA members but also POLICE ACT members….. and there were already wellness screenings at a lot of Police Stations in Bloemfontein. Please spend our money wisely!
0
Replies (0)IU
ImHereBczOf U.
1 reviews | Active since Jan 2020
16 Mar 2026, 11:59
High premiums, High increase rates yet no claim paid. TOTAL *******!!!
No payment made to service provider after a motivation letter was submitted over a month ago and now the service provider is requesting payment from the patient. We pay GEMS so much money only for them not to pay the service providers. Then they have the audacity to ask for increases when they don't deliver on their side. No wonder service providers are opting not to work with GEMS.I am seriously considering going to a different medical aid because this kind of service or lack there off is honestly pathetic.
Helpful (0)
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ImHereBczOf U.
1 reviews | Active since Jan 2020
16 Mar 2026, 11:59
High premiums, High increase rates yet no claim paid. TOTAL *******!!!
No payment made to service provider after a motivation letter was submitted over a month ago and now the service provider is requesting payment from the patient. We pay GEMS so much money only for them not to pay the service providers. Then they have the audacity to ask for increases when they don't deliver on their side. No wonder service providers are opting not to work with GEMS.I am seriously considering going to a different medical aid because this kind of service or lack there off is honestly pathetic.
0
Replies (0)DM
Dharshanee M
1 reviews | Active since Jan 2020
13 Mar 2026, 16:54
Parkinson’s Patient Terminated Despite Repeated Attempts to Arrange Payment
My 65-year-old mother has been living with Parkinson's disease for the past 22 years and relies on her medical aid for chronic medication and hospitalisation cover. While I was a student, I was listed as a dependant on her membership. After I completed my studies, the scheme requested proof of continued student status which I unfortunately did not submit. Despite this, premiums for my membership continued to be charged to my mother’s account. My mother attempted multiple times over the phone to have me removed as a dependant, but these requests were not successfully processed. When I was eventually removed from the membership, the removal was backdated, which resulted in arrears of approximately R16,000. As I had previously been receiving a government subsidy, that subsidy was also backdated, increasing the arrears amount. We were advised that my mother would need to enter into a repayment arrangement over 12 months, and that her membership would remain suspended until the arrangement was put in place. My mother attempted many times to contact the scheme to arrange payment. In most cases she reached an automated message stating that someone would call her back, however those calls did not materialise. On the occasions she did reach an agent, she was advised that she needed to first pay her current monthly premium before entering into a repayment arrangement. She paid the premium as instructed but subsequently experienced the same difficulty reaching the relevant department again to finalise the arrangement. An email communication was later sent indicating that the arrears needed to be settled within 21 days, failing which the membership would be terminated. Unfortunately we missed this email. During the times she managed to speak to agents, she was not advised that termination of the membership was imminent. My mother visited the offices of Government Employees Medical Scheme (GEMS) today seeking assistance and was informed that the membership cannot be reinstated, that she would need to apply again as a new member, and that her government subsidy has been cancelled and would need to be reapp**** for, which may not be guaranteed. This leaves a 65-year-old member with a chronic neurological condition without access to her medication and hospital cover, despite her attempts over several months to resolve the arrears and arrange payment. We respectfully request that this matter be reviewed and that consideration be given to reinstating her membership and allowing a reasonable repayment arrangement, given the circumstances and her ongoing medical needs.
Helpful (0)
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Dharshanee M
1 reviews | Active since Jan 2020
13 Mar 2026, 16:54
Parkinson’s Patient Terminated Despite Repeated Attempts to Arrange Payment
My 65-year-old mother has been living with Parkinson's disease for the past 22 years and relies on her medical aid for chronic medication and hospitalisation cover. While I was a student, I was listed as a dependant on her membership. After I completed my studies, the scheme requested proof of continued student status which I unfortunately did not submit. Despite this, premiums for my membership continued to be charged to my mother’s account. My mother attempted multiple times over the phone to have me removed as a dependant, but these requests were not successfully processed. When I was eventually removed from the membership, the removal was backdated, which resulted in arrears of approximately R16,000. As I had previously been receiving a government subsidy, that subsidy was also backdated, increasing the arrears amount. We were advised that my mother would need to enter into a repayment arrangement over 12 months, and that her membership would remain suspended until the arrangement was put in place. My mother attempted many times to contact the scheme to arrange payment. In most cases she reached an automated message stating that someone would call her back, however those calls did not materialise. On the occasions she did reach an agent, she was advised that she needed to first pay her current monthly premium before entering into a repayment arrangement. She paid the premium as instructed but subsequently experienced the same difficulty reaching the relevant department again to finalise the arrangement. An email communication was later sent indicating that the arrears needed to be settled within 21 days, failing which the membership would be terminated. Unfortunately we missed this email. During the times she managed to speak to agents, she was not advised that termination of the membership was imminent. My mother visited the offices of Government Employees Medical Scheme (GEMS) today seeking assistance and was informed that the membership cannot be reinstated, that she would need to apply again as a new member, and that her government subsidy has been cancelled and would need to be reapp**** for, which may not be guaranteed. This leaves a 65-year-old member with a chronic neurological condition without access to her medication and hospital cover, despite her attempts over several months to resolve the arrears and arrange payment. We respectfully request that this matter be reviewed and that consideration be given to reinstating her membership and allowing a reasonable repayment arrangement, given the circumstances and her ongoing medical needs.
0
Replies (0)S
HS
Henriette S
1 reviews | Active since Jan 2020
13 Mar 2026, 07:07
Gems customer service non existent
What on earth is happening at Gems call centre! Since February there is just NO answer at the call centre or the suppliers contact centre. No feedback on emails. We had to admit a patient with a hip fracture yesterday WITHOUT auth. It usually was easy working with Gems but this year it is a nightmare!!!
Helpful (0)
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Henriette S
1 reviews | Active since Jan 2020
13 Mar 2026, 07:07
Gems customer service non existent
What on earth is happening at Gems call centre! Since February there is just NO answer at the call centre or the suppliers contact centre. No feedback on emails. We had to admit a patient with a hip fracture yesterday WITHOUT auth. It usually was easy working with Gems but this year it is a nightmare!!!
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Replies (0)KN
Kerusha N
1 reviews | Active since Jan 2020
12 Mar 2026, 09:50
Poor service delivery
On the 17/02/26 I emailed gems for authorisation of a nebuliser machine got the quotation from the pharmacy got the motivation from the GP for the second time. I received an email from gems stating they will give me feedback in 48 hours no feedback from gems called in on the 6/3/26 to be told by the agent there is no response from appliance approvals to call back in a few days called in on the 12/03/26 to be told by another agent there is still no feedback and it takes 30 days. I don't believe this statement because i have previously app**** for this nebuliser machine December 2025 nothing came of it so I continue visiting the doctor just to be nebulised, it is becoming costly and depleting my funds to keep visiting the doctor everytime I require or my dependent requires to be nebulised. Previously I app**** for a blood pressure machine a glucose monitoring machine and those to 30 days passed and I had to purchase them due to no response from gems. When it is urgent and required you have to utilize your own funds but if gems does not receive their monthly contributions your medical aid will be suspended how ever what about when u pay your monthly contributions and gems does not provide services that you pay for to receive. And the only feedback you can get from call centre agents are I ESCALATED THE MATTER.. Do better gems. Before increasing our monthly contributions how about you provide a better service to your clients. We have to pay these increased contributions but receive poor service delivery!
Helpful (0)
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Kerusha N
1 reviews | Active since Jan 2020
12 Mar 2026, 09:50
Poor service delivery
On the 17/02/26 I emailed gems for authorisation of a nebuliser machine got the quotation from the pharmacy got the motivation from the GP for the second time. I received an email from gems stating they will give me feedback in 48 hours no feedback from gems called in on the 6/3/26 to be told by the agent there is no response from appliance approvals to call back in a few days called in on the 12/03/26 to be told by another agent there is still no feedback and it takes 30 days. I don't believe this statement because i have previously app**** for this nebuliser machine December 2025 nothing came of it so I continue visiting the doctor just to be nebulised, it is becoming costly and depleting my funds to keep visiting the doctor everytime I require or my dependent requires to be nebulised. Previously I app**** for a blood pressure machine a glucose monitoring machine and those to 30 days passed and I had to purchase them due to no response from gems. When it is urgent and required you have to utilize your own funds but if gems does not receive their monthly contributions your medical aid will be suspended how ever what about when u pay your monthly contributions and gems does not provide services that you pay for to receive. And the only feedback you can get from call centre agents are I ESCALATED THE MATTER.. Do better gems. Before increasing our monthly contributions how about you provide a better service to your clients. We have to pay these increased contributions but receive poor service delivery!
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Replies (0)