UNABLE / DECLINING CHRONIC MEDICATION UNDER PMB WITHOUT REASON
I have been registered for Chronic illness benefit with Bankmed since 2023. I submitted a new script at the pharmacy as I do every 6 months after a checkup. However I was informed the claim was rejected as there is no chronic benefit. After calling into Bankmed I was assisted by Mikayla, who also confirmed there was no chronic benefit on my profile. She has unable to assist and requested that I call in today as the Chronic department is only available till 5pm.
I called in today (ref ***)and spoke to Bontle who once again confirmed there is no chronic benefit, and went on to confirm with the claims department. Her feedback is the system is not linked or updated for the claims department to payout for my medication. After almost 3 years of being with Bankmed I am unable to receive medication due to system update failure? She advised that I return to the pharmacy and resubmit the claim and it will be escalated. So I went back to the pharmacy, only for the claims to be rejected again. Bontle also advised that I purchase the medication myself and submit a claim, assuming that I make provision in my budget to purchase medication while contributing monthly to a medical aid that is supposed to serve that very purpose.
As it stands now I do not have any Medication to take and I was advised it would be escalated to case managers with an SLA of 1-2 days. For the first time in 6 years due to bankmed I have not received my medication. Is it an error, incompetence or just lack of attention? Now what I would like to know is what happens to my health in the process of your update Bankmed? What happens to my health ?
I cannot begin to stress the sensitivity of my condition, something you are well aware of or should be. And as a whole Chronic illness department, your lack of urgency and the response to this just screams we don't care and it's okay just wait for the SLA there's nothing else to be done.
Regards Miss Nomusa J Mahlangu *** Bankmed membership number ******
