Acute Medication Rejected

I have been with Essential Med for probably 5 years now. I've never had any issues until today.

On 04/07/2019 we took my three stepchildren to the doctor with tonsillitis. The doctor prescribed Antibiotics, and Acuflu. The middle child was constipated and received medication for her problem.

The medicine was rejected at the pharmacy (because the pharmacist didn't capture our details correctly) and I paid cash for the medicine.

On 09/07/2019 I sent the claims through to essential med. I was told by Chantelle Pedro: "Good day,

Trust you are well.

Your claim has been send through for processing.

We will refund medication according the formulary.

Regards Chantelle Pedro"

On 08/08/2019 I enquired to find out when the claim will be processed. Later that day I received a response:

"Good day,

Medication will not be refunded as it is not formulary based.

Kind regards, Radine Beukes"

I rep****:

"Hi Radine,

I’m sorry, but I don’t understand. It’s antibiotics and other medication. What do you mean that it’s not formulary based?

Thank you, Anette"

Radine rep****:

"Good day Ms Snyman,

We have a list of medication we covered. The medication prescribed to you is not on the list of medications we cover.

Kind regards, Radine Beukes"

According to EssentialMed's Website they cover Unlimited Acute Medication. Acute Medication is defined as: Acute: Of abrupt onset, in reference to a disease. Acute often also connotes an illness that is of short duration, rapidly progressive, and in need of urgent care.

So they cover acute medication, but refuse to pay for prescribed antibiotics.

PLEASE CAN SOMEONE JUST PROCESS MY CLAIM CORRECTLY?