********ly demanding copayment for procedure as a result of a PMB

Discovery is demanding an ******** R11,000 upfront copayment from me for surgery on 27 August, despite my condition being a Prescribed Minimum Benefit (PMB).

I have a documented history of deep vein thrombosis (DVT) and pulmonary embolism, for which I was hospitalised for 4 days in June 2026 - an admission Discovery already paid for. This diagnosis is a PMB under Code 209E of Annexure A to the Regulations of the Medical Schemes Act. Because of this history, oestrogen-based contraception is contraindicated for me, and my gynaecologist has formally motivated that my upcoming Mirena insertion must be done under anaesthesia in theatre, specifically because of my clotting risk - not as a matter of choice.

Under Regulation 8 of the Medical Schemes Act, PMB conditions must be funded in full, with no copayment or deposit. Discovery already has the imaging report, the hospital records, and my gynaecologist's motivation. I should not be made to jump through hoops or pay upfront for a condition Discovery has already confirmed and funded.

I need this resolved before my surgery date. This is not how a member with a fully documented, life-threatening PMB condition should be treated.