Dharshanee M

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.