Medscheme
Approved chronic medication not paid by scheme

I am a member of the Nedgroup Medical Aid and have approved chronic medication that is not paid by the chronic medication portion of my medical aid but out of my day to day benefit- the reason being that I am not using an "approved supplier" for I am getting the medication from my doctor. My question is the following I must get the script from my doctor but not the medication WHAT IS THE DIFFERENCE? my doctor charges the same rate. Are there ANY benefit for me or only for the scheme? The scheme hides behind "scheme rules" but it costs me money. An medical specialist prescribed some medication to my wife that was not paid by the scheme with the following reason "This medication is an exclusion and therefore not paid by your scheme" WHY, WHY, WHY the medication were prescribed by an SPESIALIST - now the doctor must submit reports to justify the script. it seems to me that the scheme is not using their funds (paying from the chronic) but my funds paying from the savings portion. I pay a lot of money to be on the top plan of the scheme but must now pay out of my own pocket for "This medication is an exclusion and therefore not paid by your scheme" medication and for my own chronic!!!

Company: Medscheme
Country: South Africa
City: South africa

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