1 reviews | Active since Aug 2014
Why Do I Have Medical Aid???
Good day,<br> <br> I am beyond disappointed in the response I received from Discovery Health. I have a condition called \Urticaria"and have been on medication for more than a year and a half. This medication I paid for from my medical savings as well as from my own pocket. The Dermatologist whom I went to even tripled dosed me but I stopped responding to the antihistamines and my doctor said the next step of treatment will be Xolair. Unfortunately I can't afford the treatment of Xolair and my doctor told me to ask my medical aid to pay for it as its affecting my performance at work as I'm a flight attendant and I actually breakout in hives. I took this up with discovery and was told I must pay for it from my medical savings and if it's not enough I must cover the costs. Now my question is...why the hell do I have medical aid? I pay them over R2000 a month and because it's not on your conditions or chronic list discovery won't pay for it. I'm then told to apply it as a chronic condition but the point is we all know it's not on your list so it won't get approved. So basically I'm stuck with this condition and must just deal with it even though I'm still paying more than R2000 every month!!"""
Thank you for your comment.
As discussed the Council for Medical Schemes determined that all medical schemes must provide a minimum level of cover for a list of 27 chronic conditions (including HIV), in any setting, according to treatment guidelines. These are called the Prescribed Minimum Benefit Chronic Disease List conditions. Medical schemes are obliged to cover the diagnosis, medical management and medicine for these conditions on all plan types.
Outside of the legislated Prescribed Minimum Benefit (PMB), schemes are entitled to decide which tests and procedures it funds and from which benefit and I confirmed that urticaria is not part of the Chronic Illness Benefit list. This means should you need any medication for this treatment it will be funded from your available day to day benefit subject to the Scheme rules.
I am sorry I could not provide you with a different outcome to your query however if you need any further assistance you may contact us directly.
Kind regards
Jashvir
Thank you for your comment.
As discussed the Council for Medical Schemes determined that all medical schemes must provide a minimum level of cover for a list of 27 chronic conditions (including HIV), in any setting, according to treatment guidelines. These are called the Prescribed Minimum Benefit Chronic Disease List conditions. Medical schemes are obliged to cover the diagnosis, medical management and medicine for these conditions on all plan types.
Outside of the legislated Prescribed Minimum Benefit (PMB), schemes are entitled to decide which tests and procedures it funds and from which benefit and I confirmed that urticaria is not part of the Chronic Illness Benefit list. This means should you need any medication for this treatment it will be funded from your available day to day benefit subject to the Scheme rules.
I am sorry I could not provide you with a different outcome to your query however if you need any further assistance you may contact us directly.
Kind regards
Jashvir