Discovery has told me that I am not on the right medical aid plan to receive treatment for Crohns disease (which is on the PMB list) I was told I need to upgrade to a higher plan to fund the drug called Humira. I told them that I am happy to do so but they said I have to wait until the end of the year as that is the only time that they allow members to upgrade.
Unfortunately for me, my doctor says I cannot wait that long as the rate at which my health is deteriorating might force me to have a permanent ileostomy performed. I am 32.
They have refused to do any more for me until I upgrade at the end of the year. Myself and my doctor sent off an Ex Gratia application and they still said no. They said I must fund it myself (after looking at my bank statements and seeing that I obviously can't afford it) or try other medication. My doctor says my only options are a permanent ileostomy or Humira.
Now, it is my understanding that as a PMB, this disease and its treatment should be funded by my medical aid, whom I have been with since 1995, regardless of what medical aid plan a person is on.
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Please help me if you can
Regards
Graham
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