Anglo Medical Scheme Complaint
 SUPPLIER |
Anglo Medical Scheme |
 INDUSTRY |
Medical Aid |
| BRANCH / AREA | Chronic care | COUNTRY | South Africa |
| TIME / DATE | 10:19 Wed 26 Oct | PERSON RESPONSIBLE | |
| CUSTOMER | KimDe | View all reports by user |
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7
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| PROBLEM | problems with PMB Chro... |
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| INCIDENT | Wed 26 Oct | ||
| HEADLINE | problems with PMB Chronic approval |
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I have a PMB Chronic condition ( Epilepsy) which requires Meds daily to control Seizures. Up unti 2 months ago the Anglo Medical Scheme paid for the Chronic ea month & supplied the full dose as per the doctors prescription. However for the past 2 months they are only willing to authorise 3 weeks worth of meds. The 1st time i called the medical aid they claimed i was requesting an early refill but they overode the system to supply me the full dose. This month i was told the medical aid is only willing to pay for 60 tablets a month regardless of the script or dosage, this is determed by a MIMS Book????. I have been on the medical aid for 3 years using this same medicaion but this is the first time a MIMS dosage restriciton has happened. Now apparently i have to get a special motivation letter (R1000.00 a consultation to get the letter - medical aid refuses to pay for) and it has to go before a special board for approval. I was accused of taking more medication per day than prescribed & told if the medical aid rejected the motivation they would force me to go onto a diff medication despite the fact that i am fully controlled on this medication. I currently have no medication!!!!! |
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| SUPPLIER'S RESPONSE | Anglo Medical Scheme | Time and Date | 12:33:48 | Wed 26 Oct 11 |
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Hello KimDe, Kindly note that we are currently looking into your query and will provide you with feedback shortly. Kind Regards Priscilla Moodley |
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| UPDATED RESPONSE | Anglo Medical Scheme | Time and Date | 15:49:45 | Wed 2 Nov 11 |
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Hello KimDe, Further to our discussion this afternoon, kindly note that your query has been resolved. Kind Regards Priscilla Moodley |
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