Discovery Health
Incosistency with oncology benfits

Why does Discovery not want to cover my preventive mole mapping from my PMB when I am on the oncology program (I had a melonoma removed 19 months ago). I have talked to numerous people at Discovery about this but no-one can give me an explanation. I took it to the Council for medical schemes and they referred to a letter from Discovery, where Discovery say that the mole mapping under RPL code 0287 is not part of the PMB scheme. I would like to know why, as this is preventive and necessary to detect further melonomas. It is not a cheap treatment and although it is preventative, so is a mammogram or a cat scan and PMB appears to cover for these. I ask Discovery Health to please consider covering my mole mapping under PMB as I am aware of a number of other medical scheme that cover this and it is as recognised by Discovery health and the Council for Medical schemes the treatment that is clinically appropriate. Why should I be in a worse financial position with a skin cancer than someone with eg breast cancer, where the scanning is paid for out of PMB? Thank you for your positive response.

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

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