40% PENALTY for using a PHARMACY OF MY CHOICE

<p>SHOCK SHOCK. A new year and a BAD start to this year with Fedhealth!</p> <p>I went to collect my chronic meds from the pharmacy that I have been using for 18 months already, and sat with a co-payment of R557.06 for my meds. WHAT?? I take adjuvant therapy for breast cancer, so cannot NOT take it, so was forced to pay it. My husband and I pay R6739 a monthly for medical aid. I needed to query this over**** of co-payment. SO THE BATTLE STARTS:</p> <p>1) to get through to someone ..... ta dum ta dum ta dum</p> <p>2) Spoke to Chanelle who informed me that a 40% co-payment was charged as I got my medication from a NON DSP provider. WHAT??? I have been using the same pharmacy for almost 18 months.</p> <p>3) Chanelle explained that the Designated Service Providers for Fedhealth from 01 January 2017 is Medi-Rite Pharmacies, Dischem and Pharmacy Direct. Should you NOT use one of these 3, a 40% co-payment will be levied. I told her I am NOT going to pay this 40%, and wanted to speak to a supervisor or manager that would Or COULD make decisions and not BLOCK me - I wanted answers!!</p> <p>4) The popular answer when the consulants are at a loss - ""I will esculate the query for you"" - but where it gets esculated to goodness alone knows.</p> <p>5) I furthermore wanted to know when, where and HOW they notified their members. She said in the October Montly Newletter it was advised. I asked her</p> <p> WHERE in the newsletter and she said under Chronic Medication. Asked her further where under chronic medication, and she said under DSP's. I asked her to please read it to me and it went something along the lines of ..... DSP's for Fedhealth wil be MediRite and Dischem (somewhere Pharmacy Direct also came in) and should you not use the preferred DSP ..... according to the formulary something that sounds like GREEK to me ..... you will pay a 40% co- payment. And there - somewhere in a monthly newsletter you are advised of</p> <p> A REALLY IMPORTANT fact that YOU WILL PAY 40%. SHAME ON YOU FEDHEALTH. WHY was a straight forward letter not emailed or posted or boldly noted on the monthly statements of this fact? What about your members that have no PC at home. People that are NOT allowed to go onto</p> <p> non work related sites from work PC's (so cannot spend 30 minutes reading EVERY newsletter from EVERY company they support, with a fine tooth comb</p> <p> IN CASE it is going to cost them a wack load of extra money they have not budgeted for - and get a SHOCKER just as I did. But pay, you have to as you need the meds. It is CHRONIC meds after all.</p> <p>6) When I told her I INSIST on speaking to a supervisor and AM NOT going to accept paying this 40%, she said that I could take the meds back to my pharmacy</p> <p> and they could reverse it. I could then go and get my meds from a DSP. Fedhealth, SURELY as a medical aid provider, you TRAIN your consultants - and they, better than ANY other person should know you MAY NOT return medicines - it is against the law for a pharmacy to take back and resell medication. And this would all take how long to sort out? Without meds?</p> <p> Would Fedhealth be willing to give me a letter in writing that they accept FULL responsibility that during the time that I will not have meds (to exchange one DSP for their PREFERRED DSP by exchanging meds - if I could), that should I get sick because I never took my medication for a few days, they will cover any and all expenses? </p> <p>7) LASTLY I went and checked for this famous newsletter that advised us of this new ruling ..... we keep EVERY email sent to us by Fedhealth and did NOT receive any newsletter in September or October advising us of any such ruling. The email address Fedhealth "supposedly"sent the newsletter to was correct, but, we never received it. I therefore request the read receipt or proof of this</p> <p> correspondence, containing this ruling, having been emailed to us please.</p> <p>8) My call reference is 100117Q31RYR and was made on 10th January 2017</p> <p> at 16h11. Your explanation and feedback would be appreciated. Our membership number is ***9</p> <p>9) Surely there is some sort of ""ombudsman"" to protect members of medical aids</p> <p> against rulings such as these, unless they have agreed to it?</p> <p> </p> <p> </p>