Liberty Medical Scheme
Refusal to pay chronic medication

I joined Liberty Medical Scheme on 1 January 2013. On my app form I declared that I am on chronic medication for cholesterol. I was then put on a 3 month General Waiting period during which time I paid my chronic medication out of my pocket. My pharmacy contacted Liberty yesterday in order to get my medication loaded as a chronic condition and were told that it has been approved, only for me to receive an email from Liberty saying that it has been rejected "Since the patient does not meet the risk score criteria as set out by the gov algorithm that defines funding obligations for medical schemes". My grandmother on my father's side was in her late 20s when she already had her first triple heart bypass due to high cholesterol. My father was on chronic medication and both my sisters are also on chronic medication. When I first had mine tested I was 24 years old and my cholesterol was 7.1 as per lipogram given to Liberty. Do i first need to succumb to a heart attack before they will consider adding my medication as a chronic condition?? Why was I not told in January that I will not be covered for this, then I would have gone in search of another medical aid. THIS IS A PMB CONDITION!!!

Company: Liberty Medical Scheme
Country: South Africa
City: Head office

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