Discovery Health
4th month in a row that I am declined my meds

Health & Medicine

I have a prescription for chronic major depression which was approved by Discovery in March. For several months whenever I went to get it, the pharmacy system declined with a message: " We did not pay this claim because you have exceeded the quarterly or yearly limit for chronic medication/treatment."

I enquired and got a message that there was a mistake and it had been rectified. I was told to please call Discovery from the pharmacy should there be another problem, which I did. The problem persisted and still does. The explanations were:

- system error, will be fixed
- amount of tablets does not fit the approved amount
- 2 different brands gets the system confused
- there are high cost drugs which discovery blocks to manage the risk (whatever that means)

Fact is, I have been messed around, nobody knows why this is happening and everyone tries to find some reason, but even though I repeatedly ask for sorting this out permanently, today I am told this is not possible and I need to arrange for this every month, or my pharmacy has to.

This is unacceptable and I finally would like somebody to tell me how this will be fixed for good. Nothing else will do. It is ridiculous.


Company: Discovery Health
Country: South Africa
City: Chronic illness benefit
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