MH
Mahomed H
1 reviews | Active since Feb 2011
16 May 2025, 16:38
Inappropriate deceit ineffective and oneffecient
Dear Discovery
I trust you are well.
I am following up regarding the invoices I submitted for Micrabegron constipates/Urton recommended with catheters. These were prescribed by my doctor and recognized by the medical aid as PMB-related, with coverage backdated to March 2024. However, I have yet to receive reimbur*****t for Micrabegron/Urton, which I have had to pay for out of pocket—despite already struggling to afford 12 months' worth of essential medical supplies that are critical to both my health and preventing further infection.
I kindly request clarification on the following:
Monthly Supply Process: Has the medical aid now approved direct coverage of Micrabegron/Urton and catheters at the pharmacy going forward? May I collect my supply as needed, starting today?
Payment and Claims Procedure: If not, am I still required to pay upfront and submit claims to you for reimbur*****t each month?
Status of Previous Claims: What is the status of the claims and receipts I submitted for the past 12 months? A medical aid consultant advised me to submit them for reimbur*****t, which I have done, but I am still awaiting payment.
Your urgent response would be greatly appreciated, as these are life-sustaining treatments.
Despite the medication being approved were unable to receive at the pharmacy on chronic and pmb.
Kind regards, Very concerned patient
Helpful (0)
Replies (4)0
Replies (4)MH
Mahomed H's updateReviewer Update
17 May 2025, 13:07Dear Discovery Team,I trust this message finds you well.Please find attached the relevant invoices and proof of payment for medical expenses that require urgent reimbur*****t, in line with the conditions of my medical aid. Kindly note that the Prescribed Minimum Benefit (PMB) condition has been backdated to March 2024.Despite having submitted these documents multiple times, I have yet to receive any reimbur*****t for Migrabegon or related medical supplies over the past 12 months. This includes essential items such as catheters, which were rejected by the scheme—despite clear motivation submitted as requested by the medical aid. This rejection appears to be in contradiction of the Health Act and PMB regulations, and has left me to cover these expenses out of pocket.All required documentation, including banking details and full records of medical supplies, has been submitted since March 2024. As the chronic medication has now been acknowledged and backdated, I urgently request confirmation of reimbur*****t and proof of payment.Your prompt attention to this matter is appreciated, as the ongoing delay is causing both financial and emotional strain.Kind regards,
A very concerned patient
A very concerned patient
MH
Mahomed H's update17 May 2025, 13:07
Reviewer Update
Dear Discovery Team,I trust this message finds you well.Please find attached the relevant invoices and proof of payment for medical expenses that require urgent reimbur*****t, in line with the conditions of my medical aid. Kindly note that the Prescribed Minimum Benefit (PMB) condition has been backdated to March 2024.Despite having submitted these documents multiple times, I have yet to receive any reimbur*****t for Migrabegon or related medical supplies over the past 12 months. This includes essential items such as catheters, which were rejected by the scheme—despite clear motivation submitted as requested by the medical aid. This rejection appears to be in contradiction of the Health Act and PMB regulations, and has left me to cover these expenses out of pocket.All required documentation, including banking details and full records of medical supplies, has been submitted since March 2024. As the chronic medication has now been acknowledged and backdated, I urgently request confirmation of reimbur*****t and proof of payment.Your prompt attention to this matter is appreciated, as the ongoing delay is causing both financial and emotional strain.Kind regards,
A very concerned patient
A very concerned patient
MH
Mahomed H's updateReviewer Update
17 May 2025, 13:40Subject: Urgent Reimbur*****t Request – Outstanding Medical Claims and PMB AcknowledgementDear Discovery Team,I trust this message finds you well.Please find attached the relevant invoices and proof of payment for medical expenses requiring urgent reimbur*****t, in line with the conditions of my medical aid. Kindly note that the Prescribed Minimum Benefit (PMB) condition has been officially backdated to March 2024.Despite multiple prior submissions, I have yet to receive any reimbur*****t for Migrabegon or related medical supplies over the past 12 months. This includes essential items such as catheters, which were rejected by the scheme despite the submission of clear clinical motivation, as requested. This decision appears to conflict with the Health Act and PMB regulations, forcing me to cover these necessary medical expenses personally.All required documentation—including banking details, invoices, prescriptions, and supporting medical records—has been submitted since March 2024. Now that the chronic condition has been acknowledged and the PMB status backdated, I urgently request confirmation of reimbur*****t and proof of payment.Your prompt attention to this matter is sincerely appreciated, as the ongoing delay is causing significant financial and emotional strain, directly impacting my health and well-being.Kind regards,
A very concerned patient
A very concerned patient
MH
Mahomed H's update17 May 2025, 13:40
Reviewer Update
Subject: Urgent Reimbur*****t Request – Outstanding Medical Claims and PMB AcknowledgementDear Discovery Team,I trust this message finds you well.Please find attached the relevant invoices and proof of payment for medical expenses requiring urgent reimbur*****t, in line with the conditions of my medical aid. Kindly note that the Prescribed Minimum Benefit (PMB) condition has been officially backdated to March 2024.Despite multiple prior submissions, I have yet to receive any reimbur*****t for Migrabegon or related medical supplies over the past 12 months. This includes essential items such as catheters, which were rejected by the scheme despite the submission of clear clinical motivation, as requested. This decision appears to conflict with the Health Act and PMB regulations, forcing me to cover these necessary medical expenses personally.All required documentation—including banking details, invoices, prescriptions, and supporting medical records—has been submitted since March 2024. Now that the chronic condition has been acknowledged and the PMB status backdated, I urgently request confirmation of reimbur*****t and proof of payment.Your prompt attention to this matter is sincerely appreciated, as the ongoing delay is causing significant financial and emotional strain, directly impacting my health and well-being.Kind regards,
A very concerned patient
A very concerned patient
Discovery Health's replyOfficial
19 May 2025, 07:39Dear Mahomed H
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. Regards Discovery Health Servicing Team
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. Regards Discovery Health Servicing Team
Discovery Health's reply19 May 2025, 07:39
Official
Dear Mahomed H
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. Regards Discovery Health Servicing Team
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. Regards Discovery Health Servicing Team
Discovery Health's replyOfficial
20 May 2025, 13:24Dear Mahomed H
We have been in contact with you. Regards Discovery Health Servicing Team
We have been in contact with you. Regards Discovery Health Servicing Team
Discovery Health's reply20 May 2025, 13:24
Official
Dear Mahomed H
We have been in contact with you. Regards Discovery Health Servicing Team
We have been in contact with you. Regards Discovery Health Servicing Team