Executive Elite Plan Downgraded Benefits in ATB Threshold is very concerning yet frustrating , not worth the expensive premiums

Dear Discovery Health Team, Membership Number: ***

I would like to formally raise my concern and disappointment regarding the recent medicine funding experience on the Executive Plan.

Having now reached my Above Threshold Benefit (ATB), I was extremely surprised to discover significant co-payments being app**** to prescription medication. My understanding is that Discovery now appears to be applying Tier 1, Tier 2 and Tier 3 medicine funding structures linked to a preferred formulary list. My concern is the following:

This was never experienced by me during 2025, and if this is indeed a benefit Downgrade change to the Executive Plan medicine funding structure, why was this not clearly highlighted as one of the MOST critical impacts affecting members?

The Executive Plan carries an exceptionally high monthly premium, and naturally one would expect clear transparency upfront regarding major medicine funding limitations and co-payments once in ATB.

What is even more frustrating is the lack of visibility and usability within the Discovery Health App and MedAdvisor functionality.

Where is this 2026 Formulary List??

Yesterday, both my doctor and I spent approximately 45 minutes trying to identify an approved/preferred alternative for Pantocid 40mg on the MedAdvisor App, without success. Neither of us could clearly determine:

which medicine is preferred, which medicine would attract no co-payment, nor which option would be fully funded from ATB. Where is a reference list, advise this is formulary at 100%, alternatives provided NON in on thr Formulary??

As a Diabetic for 48 years, I opted for this plan for my health needs at exceptional price

This creates an extremely difficult situation during consultations, where members and doctors are expected to make medicine decisions without access to a clear, transparent and usable formulary reference.

In addition, I am also unable to trace or clearly understand how my Medtronic insulin pump consumables are funded under my chronic profile.

Specifically: Medtronic 780G pump consumables Guardian 4 Sensors The claims indicate partial payment from Chronic Benefits and a balance/member liability seemingly linked to Savings or ATB.

However: these items cannot be located on the MedAdvisor App, I cannot determine their funding structure, I cannot determine preferred suppliers, and I cannot determine whether the shortfall will eventually be funded from ATB once available.

I therefore require clarity on the following:

Will chronic consumable shortfalls for approved diabetes devices and sensors automatically be funded 100% from ATB once savings are depleted? Why are these approved chronic consumables not visible and traceable within MedAdvisor? Where can members access the FULL preferred medicine formulary list applicable to the Executive Plan? Why is there no clear functionality available to doctors and members to immediately identify: preferred medicines, expected co-payments, and fully funded alternatives during consultations?

At present, this process feels highly non-transparent and extremely frustrating for members paying premium-level contributions monthly and diligently maintaining their membership obligations.

I would appreciate a detailed written response and clarification on the above concerns. Kind regards, Mariana