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Question
Posted by: Chez | 2008/05/21

Discovery Med Aid won't pay for Dystonia

Dear Cyber Doctor,

Could you please give me advise regarding the above disease I have sufered from for approximately thirteen years. This is the third year my medical aid Discovery Heakth won't pay for my chronic medication, with the result that my funds are already exhausted by end of April each year, I am a widow and finding it most difficult to make ends meet by paying medical aid contributions and medication.

Could you kindly forward me the ombudsman for medical aids contact details.

Thank You.

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Our expert says:
Expert ImageCyberDoc

Hallo Chez
complaints@medicalschemes.com
Tel: (012) 431 0508/47 - complaints
Fax: (012) 430 7644

Sien ook http://www.mayoclinic.com/health/dystonia/DS00684/DSECTION=7
Dr Bets

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

3
Our users say:
Posted by: anon | 2008/05/22

ALL medical aids are required to cover the 25 PMB chronic conditions e.g. diabetes, asthma, high blood pressure etc

Any other chronics are ONLY covered on medical aids by the highest plans.

The council for medical schemes provides the required chronic list. When you join a med aid you should FIRST find out if it covers your chronic. If you develop the chronic afterwards then you have the option the following year to upgrade your plan

Reply to anon
Posted by: anxious | 2008/05/21

Do you want to join me in writing a book about the ****** Discovery get away with? I was diagnosed last year with chronic lymphoedema of my right leg and my surgeon prescribed Paravon for me to take 2 a day - I submitted my application for chronic and for Ex-Gratia - of course they threw out both - "its not on our list!" No doubt you got that same maddenning answer! Please could someone tell me what Council for Medical Schemes is around for? It certainly is NOT protecting medical aid members. If anything its protecting medical aids by allowing them to get away with shocking rules! Discovery get away with appalling murder, especially with regard to chronic medication, one thing being they have their "formulary price list" where the figures on it are so pathetic and that's what they pay for "such and such" medication end of story. I could go on and on pages and pages as I said write a book about their appaling attitude towards their members. I am currently fighting with them with regard to one of my cholesterol medications to get on chronic.

I didnt know there was an ombdsmn for medical aids. I would be interested I think also in contact details - maybe I might then finally get somewhere with my genuine complaints!

Reply to anxious | 1 comment (hide)
Posted by: Anonymous | 2014/01/12

Hi, Read your comment which was made in 2008. Hope you got some relief. Did they ever accept your lymphodema as a pmb ??

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