Discovery Health
Oncology PMB not covering

Discovery's reason for not paying PMB for molemapping was:1.It is not offered in State hospitals. 2. Molemapping is outside the legislated PMB 3.Please note that we are not disputing that the procedure is necessary. However, the Scheme must always balance the needs of all our members with keeping contributions affordable in the long term. If we were to cover everything without carefully assessing their risk impact, we would place the whole scheme and its members at risk financially.
My Reply: 1. As indicated and proven to you this is no reason to disallow the PMB payment 2. As indicated and proven to you molemapping is not outside the legislated PMB. 3. Please explain this as to me it sounds like Discovery chooses that my procedure/traeatment, which you agree is necessary is not important enough, but other cancer treatments are. Melonoma is one of the fastest spreading cancers, which without molemapping is hard to detect early. I am shocked that Discovery in this way can pick and choose which treatments are covered, when the legislation prescribes that molemapping falls under PMB. I look forward to a positive response and hope to end this saga with Discovery admitting its mistake.

Company: Discovery Health
Country: South Africa
City: Cape Town

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