SF
SimAA3ne Ferreira
1 reviews | Active since Oct 2014
17 Apr 2015, 08:21
All expenses taken from MSA
I have been with Discovery for just over 2 years and since I have been on this medical aid I have been on chronic medication. In 2013 and 2014 most of my medication (on the Discovery medication list) was approved and the costs formed part of my benefits. However, this year EVERYTHING has been taken from my medical savings account (which is my money and does not form part of my general benefits) this includes my medication (which was submitted for approval once again this year and declined)
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Discovery Health's replyOfficial
21 Apr 2015, 08:37Hello Sim1ferreira,
Thank you for your comment.
The Medical Savings Account (MSA) covers the cost of day-to-day expenses, such as visits to the general practitioner (GP) and to the dentist, as well as the cost for medicine.
The Chronic Illness Benefit (CIB) covers 27 conditions on all plans as prescribed by legislation. The same legislation permits schemes to compile lists of medications called formularies, which complies with guidelines issued by the Council for Medical Schemes. Medicines on the list are safe, clinically appropriate and cost-effective for the treatment of the specified conditions. To ensure cover in full, medicines on the scheme's formulary should be used.
As discussed I confirmed which medication is approved under the Chronic Illness Benefit and how pharmacy claims have been processed based on this approval. I have confirmed the correct MSA balance and that the website is reflecting this information correctly. I sent an email with the Chronic Illness Benefit decision letter that we send to both member and provider once a CIB application is reviewed.
Thank you for allowing me to assist with your query.
Kind regards
Jashvir
Thank you for your comment.
The Medical Savings Account (MSA) covers the cost of day-to-day expenses, such as visits to the general practitioner (GP) and to the dentist, as well as the cost for medicine.
The Chronic Illness Benefit (CIB) covers 27 conditions on all plans as prescribed by legislation. The same legislation permits schemes to compile lists of medications called formularies, which complies with guidelines issued by the Council for Medical Schemes. Medicines on the list are safe, clinically appropriate and cost-effective for the treatment of the specified conditions. To ensure cover in full, medicines on the scheme's formulary should be used.
As discussed I confirmed which medication is approved under the Chronic Illness Benefit and how pharmacy claims have been processed based on this approval. I have confirmed the correct MSA balance and that the website is reflecting this information correctly. I sent an email with the Chronic Illness Benefit decision letter that we send to both member and provider once a CIB application is reviewed.
Thank you for allowing me to assist with your query.
Kind regards
Jashvir
Discovery Health's reply21 Apr 2015, 08:37
Official
Hello Sim1ferreira,
Thank you for your comment.
The Medical Savings Account (MSA) covers the cost of day-to-day expenses, such as visits to the general practitioner (GP) and to the dentist, as well as the cost for medicine.
The Chronic Illness Benefit (CIB) covers 27 conditions on all plans as prescribed by legislation. The same legislation permits schemes to compile lists of medications called formularies, which complies with guidelines issued by the Council for Medical Schemes. Medicines on the list are safe, clinically appropriate and cost-effective for the treatment of the specified conditions. To ensure cover in full, medicines on the scheme's formulary should be used.
As discussed I confirmed which medication is approved under the Chronic Illness Benefit and how pharmacy claims have been processed based on this approval. I have confirmed the correct MSA balance and that the website is reflecting this information correctly. I sent an email with the Chronic Illness Benefit decision letter that we send to both member and provider once a CIB application is reviewed.
Thank you for allowing me to assist with your query.
Kind regards
Jashvir
Thank you for your comment.
The Medical Savings Account (MSA) covers the cost of day-to-day expenses, such as visits to the general practitioner (GP) and to the dentist, as well as the cost for medicine.
The Chronic Illness Benefit (CIB) covers 27 conditions on all plans as prescribed by legislation. The same legislation permits schemes to compile lists of medications called formularies, which complies with guidelines issued by the Council for Medical Schemes. Medicines on the list are safe, clinically appropriate and cost-effective for the treatment of the specified conditions. To ensure cover in full, medicines on the scheme's formulary should be used.
As discussed I confirmed which medication is approved under the Chronic Illness Benefit and how pharmacy claims have been processed based on this approval. I have confirmed the correct MSA balance and that the website is reflecting this information correctly. I sent an email with the Chronic Illness Benefit decision letter that we send to both member and provider once a CIB application is reviewed.
Thank you for allowing me to assist with your query.
Kind regards
Jashvir