DISCOVERY & MEDXPRESS EVADING PAYMENT FOR PMB MEDICATION

13 January 2020

I am a 76 year old pensioner and was repeatedly held hostage by Discovery MedXpress who repeatedly blocked the dispensing and funding of my approved chronic medication under one pretext or another.

My most recent experiences left me feeling as if I were beiing ****** by ****s who held me hostage and powerless as they rifled through and stole my money and possessions.

I simultaneously felt nauseated and close to tears, but also was filled with such rage that would have driven a younger, stronger and more violent person to an explosive response.

Discovery Health is, a non profit scheme ostensibly conducted in the interests of its members.

Alas, by no stretch of the imagination can the same be said about its management company, Discovery Health (Pty) Ltd and the monopolistic invention, MedXpress.

Membership fees and subscriptions are increased yearly without fail by hugely more than the rate of inflation.

Monetarily capped items on the PMB formulary are not.

Medication is dispensed in cycles of thirty days which makes for 360 days in 12 months of 30 days, while the calendar year has 365 days for a normal year and 366 in leap years.

In theory, you can order medicines a few days earlier in each succeeding month, to compensate for months that have have 31 days, but, in practice, you will soon discover that dispensing is blocked through Discovery Health and MedXpress, forcing members to pay for approved and due chronic prescription medicine out of their own pocket and encounter some times unconscionable co payments and or refusal to refund.

I received my September 2019 chronic medicine refill on 10 September 2019 from MedXpress, via Dischem Sunninghill.

I received my October 2019 prescription refill on 9 October 2019.

In theory, my next refill should have been available to me as from about 4 or 5 November 2019, but my car broke down in the Kglagadi Desert and I was only able to collect my next medicine refill on about 14 November 2019 and had to go for a few days without some of my medication.

I was informed that I needed new scripts from the doctor and they were obtained and uploaded on 26 November 2019.

Even though my new repeat script was practically the same as before, I was required to confirm with the MedXpress call centre before the medication was dispensed through them on the first time for that script, but was repeatedly frustrated by the call centre being too busy or offline.

Nowhere on the Discovery web site or in the call centre was there a fair warning that while other sections were available through extended hours including partially over weekends and holidays, not only MedXpress closes altogether on weekends and holidays but when ostensibly they are available until 17:00 on weekdays, when you try to contact them much earlier the calls are dropped or remain unanswered.

To add insult to injury, I tried to arrange for my medication to be available as from 7 December because I was leaving for a destination without a suitable pharmacy or voice or data connectivity.

I was forced to pay for my medication in full at Dischem Sunninghill on 8 December, because MedXpress blocked them on the system from dispensing it through Discovery and MedXpress.

On my return, I submitted a claim and was expecting my refund, which was apparently refused on the pretext that my medication refill was too early, which, factually it was not.

When I raised the issue with Dischem and MedXpress they disingenuously pretended to solve the problem by **********ly kicking the ball forward, cancelling my claim and getting Dischem to cancel the 8 December 2019 invoice and re invoicing my medication refill as though it was dispensed on 23 December 2019.

Instead of refunding me directly, Discovery and MedXpress then got Dischem to refund me, less co payments, pretending that the matter was solved.

To avoid encountering the same problem again, I called the Discovery Call Centre at 16:02 on Thursday 9 January 2020, and, after navigating the obstacle course and delays and useless messages provided, I was eventually put through to an organic telephone answering device at MedXpress who assured me that everything was is in order and I could even put the order for my chronic prescription medication directly with their designated service provider being any Dischem or Clicks pharmacy, which in that case was Dischem Sunninghill.

I only discovered later that he organic telephone answering device I spoke to was untruthful.

Early on Friday 10 January 2020 I emailed to Dischem Sunninghill a detailed list of the items I required. (Some items on my script I did not even order because I still had enough).

After delays I discovered that MedXpress was still blocking everything (except the one item) under the pretext that it was a too early refill, despite being assured the day before that this was not the case.

Taking the matter up again with the MedXpress organic telephone devices and working through the so called agents, supervisors and supervisor’s supervisors, each lacking the initiative or authority to actually solve the problem. I felt nauseated again when MedXpress staff offered, as an interim pretend solution, to dispense to me a three days emergency supply, of my chronic medication for which I would have had to pay upfront.

Because of delays caused by MedXpress while failing to solve the matter ,I tried to get my medical prescription refilled by MedXpress Service Provider - Dischem Sunninghill,but they did not have stock of a vital item, Accord Metformin XR 500 mg, and suggested I should accept Glucophage XR 1000 mg at about twice the cost, or Glucophage XR 500 mg at nearly three times the cost, in each case with me (un)naturally) having to bear the extra cost.

I was already unhappy with Dischem Sunninghill previous collusion with MedXpress pretending to “kick the ball forward” by **********ly re invoicing my medication as though I had received the previous supply on 23 December 2020 , and not as truly happened on 8 December 2020.

Clicks Chilli Lane had stock, and though they had previously earned some mistrust, I ordered and received my medication refill from them, and paid them in full because again Discovery Health and MedXpress would not process the items that should have been paid by them either in full or in part.

I am now submitting my medication invoice that was fully prepaid by me to Discovery Health to claim my refund from them, demanding a refund by not later than 15 January 2020 failing which, in addition would claim interest at Mora rate and costs including wasted telecommunication and travelling, and, if so advised, also general damages.

I am advised that I may, and should, share this information with the Medical Schemes regulatory authorities, the Health Care and al**** regulatory authorities, the Consumer Protection regulatory authorities, the Monopolies regulatory authorities, and anyone else who has a legitimate interest in receiving it, including, inter alia, the consumer protection media and all present and prospective Discovery Health members.

I also require a written assurance that this dismal behaviour of Discovery Healt, MedXpress and their service providers would not be repeated.

Uri Zalk