PMB joke

Good day,

I am confused to why my botox is not being paid. Why approve it for 4 times per year if it is only paid once a year. My pmb is hemiplegic/ tetra and para. All other accounts related to this pmb was in hospital. Last year there where no issues.Why now? Will we be paying for rest of chronic medication as provided by Dischem. Had bad experience in past with pharmacy direct not deliveringtas.co.za on time and wrong medication. Both me and my husband is not office bound and employers are not allowing taking medications at receptions. Van Heerden Apteek is charging the same as pharmacy direct. What money was available for this pmb and what was paid leading to no funds available. Please list accounts and items.

According to the medical Council

PMB’s were created to: Ensure that medical scheme beneficiaries have continuous healthcare. This means that even if a member’s benefits have run out, the medical scheme has to pay for the treatment of PMB conditions. Ensure that healthcare is paid for by the correct parties. members with PMB conditions are entitled to specified treatments which have to be covered by the Scheme. These specified PMB treatments include treatment and medicines, Provider treatment protocols and formularies.