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Gems (Government Employees Medical Scheme)
Verified Business
G(
Gems (Government Employees Medical Scheme)
Verified Business
325 Reviews (last 12 months)
Rated in:
Scores reflect the Overall AI Score for each category
Gems (Government Employees Medical Scheme)
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 deeply frustrating medical aid where claims, authorisations, communication and chronic medication approvals frequently fail. Members report paying high premiums while battling for treatment, with rare positive mentions of named staff who resolved issues. Pensioners, pregnant members and chronically ill patients describe the most distress, often citing emotional and financial harm.
TrustIndex
2.7
Ranking
#17
in Medical Aid
NPS Score
-71
Recommended: Unlikely
Jul '25 - Jun '26
Based on recent customer reviews, Gems (Government Employees Medical Scheme) is described by members as a deeply frustrating medical aid where claims, authorisations, communication and chronic medication approvals frequently fail. Members report paying high premiums while battling for treatment, with rare positive mentions of named staff who resolved issues. Pensioners, pregnant members and chronically ill patients describe the most distress, often citing emotional and financial harm.
The most common complaint about Gems (Government Employees Medical Scheme), based on Hellopeter's AI analysis of recent customer reviews, is Claims Processing & Authorisation. Members describe authorisations being delayed, declined or reversed after treatment, including PMB and emergency cases. Pre-authorised procedures are later short-paid, leaving members liable for shortfalls. Maternity, oncology, cardiology and chronic claims repeatedly cited as rejected on technicalities with no clear appeals pathway. Claims Processing & Authorisation (1.0).
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 Jan 2020
This useless ****ing medical aid must watch when i go to the council of medical schemes. My husband is on Gems and they added a 5% later joining penalty fee. My husband was on a medical aid and was retrenched. Gems is playing with fire. I am going to take this up. He belonged to a medical aid previously so how can they be a later joining penalty fee and further more i submitted proof of membership certificate from his previous medical aid.
1 reviews | Active since Jan 2020
This useless ****ing medical aid must watch when i go to the council of medical schemes. My husband is on Gems and they added a 5% later joining penalty fee. My husband was on a medical aid and was retrenched. Gems is playing with fire. I am going to take this up. He belonged to a medical aid previously so how can they be a later joining penalty fee and further more i submitted proof of membership certificate from his previous medical aid.
1 reviews | Active since Jan 2020
This is a follow-up on the 1st complaint I wrote on the 12th or 11th of May 2026. I indicated in that complaint that I cancelled a new member I wanted to include in the medical aid on the 7th of May, days before GEMS could make the actual funds deduction on the 15th of May 2026, but GEMS nevertheless went ahead and took my money. I then raised this on this platform on the 11th or 12th May, to which GEMS rep**** on the 12th of May, promising to respond to my complaint within the next 7 working days. Today, the 27th May 2026, nothing has come forth from GEMS, no response, no communication, no refund of my money. This shows you the level of disrespect, lack of ethics, and the disdain, that GEMS has towards its customers. No wonder many of the customers/members that one comes across want to leave this non-sense scheme. I had previously written to Hellopeter about Old Mutual and ABSA, and the two companies addressed my complaints in a blink of an eye, showing professionalism and customer service befitting of big organizations that are committed to customer satisfaction. But NOT GEMS, this is an organization that is in business purely for profit motive, undeserved profit if you ask me, because this kind of conduct and behavior, *****ing from poor customers by charging upfront probationary payments, and not refunding monies they did not earn, this points exactly to that, undeserved profits at all costs. GEMS must return my money, my R3500, back into my account as in yesterday, I cannot wait forever for them to return my hard-earned money. I have a family to feed, not that ************ and immoral organization.
1 reviews | Active since Jan 2020
This is a follow-up on the 1st complaint I wrote on the 12th or 11th of May 2026. I indicated in that complaint that I cancelled a new member I wanted to include in the medical aid on the 7th of May, days before GEMS could make the actual funds deduction on the 15th of May 2026, but GEMS nevertheless went ahead and took my money. I then raised this on this platform on the 11th or 12th May, to which GEMS rep**** on the 12th of May, promising to respond to my complaint within the next 7 working days. Today, the 27th May 2026, nothing has come forth from GEMS, no response, no communication, no refund of my money. This shows you the level of disrespect, lack of ethics, and the disdain, that GEMS has towards its customers. No wonder many of the customers/members that one comes across want to leave this non-sense scheme. I had previously written to Hellopeter about Old Mutual and ABSA, and the two companies addressed my complaints in a blink of an eye, showing professionalism and customer service befitting of big organizations that are committed to customer satisfaction. But NOT GEMS, this is an organization that is in business purely for profit motive, undeserved profit if you ask me, because this kind of conduct and behavior, *****ing from poor customers by charging upfront probationary payments, and not refunding monies they did not earn, this points exactly to that, undeserved profits at all costs. GEMS must return my money, my R3500, back into my account as in yesterday, I cannot wait forever for them to return my hard-earned money. I have a family to feed, not that ************ and immoral organization.
1 reviews | Active since Jan 2020
regarding the authorization claim I submitted for my blood pressure monitor nearly a month ago with GEMS . Despite my efforts to follow up on the status of this claim, I have yet to receive any feedback or resolution. I have sought assistance from both my pharmacist and my doctor, who have also attempted to intervene on my behalf. However, I find myself continually directed from one authority to another, with no progress made. It is particularly frustrating to note that while GEMS promptly deducts payments at the end of each month, the support and assistance when it comes to urgent healthcare needs appear lacking. GEMS HAS THE WORST POOR ,CUSTOMER SERVICE EVER
1 reviews | Active since Jan 2020
regarding the authorization claim I submitted for my blood pressure monitor nearly a month ago with GEMS . Despite my efforts to follow up on the status of this claim, I have yet to receive any feedback or resolution. I have sought assistance from both my pharmacist and my doctor, who have also attempted to intervene on my behalf. However, I find myself continually directed from one authority to another, with no progress made. It is particularly frustrating to note that while GEMS promptly deducts payments at the end of each month, the support and assistance when it comes to urgent healthcare needs appear lacking. GEMS HAS THE WORST POOR ,CUSTOMER SERVICE EVER
1 reviews | Active since Jan 2020
I have been trying to resolve a claim that was not fully paid by Gems for more than two months now. The Matter was referred to PMB for review and I got a reference number. Today 20/05/2026 I called again Around 16 minutes being a call. The agent from PMB review was rude and did not want to listen to me. He just transferred to claims while I was trying to explain the reason for my call. GEMS is mistreating us simply because they are the only medical aid subsidized by the employer.
1 reviews | Active since Jan 2020
I have been trying to resolve a claim that was not fully paid by Gems for more than two months now. The Matter was referred to PMB for review and I got a reference number. Today 20/05/2026 I called again Around 16 minutes being a call. The agent from PMB review was rude and did not want to listen to me. He just transferred to claims while I was trying to explain the reason for my call. GEMS is mistreating us simply because they are the only medical aid subsidized by the employer.
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 (4.3). How is the AI Score calculated? →
Gems (Government Employees Medical Scheme) has a TrustIndex of 2.7 out of 10 on Hellopeter, based on 325 reviews in the last 12 months. Hellopeter has tracked Gems (Government Employees Medical Scheme) across 2,787 total reviews. How is the TrustIndex calculated? →