Medical aid plan lets woman be driven 1000km

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Published Sep 23, 2017

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Cape Town  - A distraught member of the Government Employees Medical Scheme (Gems) has slated it for refusing to fly her very sick mother to Cape Town via their air ambulance service. Instead the woman was driven nearly 1000km home on the back seat of her son’s car.

Western Cape government employee Marica Stevens, of Strandfontein, said her 70-year-old mother Louise Stevens is a beneficiary on her Gems Emerald Option membership. 

She had increased her premiums to R2 215 a month to cover her mother. While on holiday in Kimberley last month, Stevens’s mom fell ill and was rushed to Lenmed Royal Hospital and Heart Centre. She had an emergency operation on August 30 to remove her gall bladder which turned out to be gangrenous.

“The doctor then did further testing on my mother and she was diagnosed with colorectal cancer which has spread to her liver and lungs. She had to endure more surgery to have fluid and a blood clot removed from her liver.

“I begged and pleaded with Gems to please authorise her medical transfer to a hospital in Cape Town for further treatment,” said Stevens.

Gems suggested that her mother be transferred to a Bloemfontein hospital, said Stevens, who deemed this “inhumane” because there would be “nobody there to support her and comfort her during this extremely challenging time in her life”. She added: “I have no idea how much time I still have left to spend with my mom. If I could have afforded it I would have paid for an air ambulance but I couldn’t.”

Stevens appealed to Gems for an ex-gratia payment to fly her mother home to Cape Town, posted on the Gems Facebook page and Hello Peter called the medical aid’s call centre several times and complained to the Medical Aid Ombudsman.

Despite all this, the medical aid was unmoved and Stevens's brother Edwin had to drive to Kimberley last Friday to collect their mom from hospital, and then drive her home on the back seat of his car.

“He had to take two oxygen tanks with him which had to be filled en route. He drove back with my mom on the back seat, on oxygen and still with the catheter for urine and the bile discharging bags attached.

“She was in pain and very weak when they arrived in Cape Town. We had to rush her to Tokai Melomed by midnight on Saturday,” said Stevens.

Doctors there were assessing her condition after the operations and conducting further tests before she is referred for cancer treatment. Stevens said she was “completely disgusted and disheartened” by Gems’s attitude.

In response to the Weekend Argus query, the Gems Online Team indicated that Gems' managers were conducting an investigation and would provide feedback soon.

Weekend Argus

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