1 reviews | Active since Jul 2013
Chronic application
my son is diagnosed with severe ADHD and Anxiety and have to take 35mg Concerta and 1mg Respidon. i am a single mother with no financial assistance. my sons medicine is r1200, my medical savings is already at r5000 for the rest of the year, and his medicine comes off my savings, and the rest out of my pocket. discovery denied my claim within 30 min, how can someone do an investigation within 30 min. just to be told off. I pay for my medical aid, and discovery is not cheap. to be honest discovery do not value you as an individual customer. the government list for chronic conditions is what is bare minimum to be covered. discovery just works on that and not my sons diagnosis, even though I now have to pay the dr for the motivation letter and reports from school was send. and there is other medical aids whom I contacted who cover the condition. makes one wonder why you even pay so much for medical aid to get so little.
Thank you for your comment.
In terms of legislation, all medical schemes are obliged to fund a list of pre-defined conditions known as Prescribed Minimum Benefit (PMB's). Outside of this, the same legislation permits each scheme to identify which additional treatments and/or medications to fund, as well as from which element of the benefit to provide funding.
ADHD is not classified as a PMB condition and therefore will fund from the available day-to-day benefits on your chosen plan type.
We trust that the information has helped provide more clarity.
Regards
Rishana
Best regards,
Thank you for your comment.
In terms of legislation, all medical schemes are obliged to fund a list of pre-defined conditions known as Prescribed Minimum Benefit (PMB's). Outside of this, the same legislation permits each scheme to identify which additional treatments and/or medications to fund, as well as from which element of the benefit to provide funding.
ADHD is not classified as a PMB condition and therefore will fund from the available day-to-day benefits on your chosen plan type.
We trust that the information has helped provide more clarity.
Regards
Rishana
Best regards,
