Wrong advice/CMS Complaint on chronic illness

I was diagnosed with Ankylosing spondylitis three and a half years back. My illness progressed quicker than expected and last year in June I was admitted to ICU due to my illness causing heart failure. I then phoned discovery to see if I can upgrade earlier which was declined as expected. However in December when the window opened to upgrade my medical aid I jumped at the opportunity as I urgently needed to go on Humira injections.

On te 10th of December I phoned in with ref ********** 430 where the consultant confirmed the following to my questions, I was advised that AS is covered under the Essential comprehensive plan and that Humira injections will be covered up to R200 000.00 per annum without any co-payment. Now all of a sudden after I upgraded, in february there is a 20% co-payment which equate to an additional R24 000.00 a year.

I have made complaints and referred to the conversations I had with multiple employee's of discovery and they all confirmed that the incorrect information was given but they are not willing to fix the issue.

This is to inform you that a case has been opened with CMS as well as all my information and proof was sent to AICF attorneys with the CMS complaint attached. You are taking advantage of people that are very ill and need this medication to survive as well as have no remorse for wrong advice given or any suffering you are causing. I would have never upgraded if I knew this upfront.

This is unacceptable and I am taking this further.

Here is all the ref # ********** ********** 023 ********** 414 ********** 973 ********** 026 ********** 250936