Sunday, December 29, 2013

Don't be conned- Understand how a medical aid system works



It is quite unfortunate that many patients out there do not have the slightest idea on how a medical aid scheme works. Many patients arrive at the pharmacy with their card and expect miracles to happen. They expect to buy everything they require in the pharmacy on their medical aid. This is not possible. Unfortunately many unscrupulous health care professionals take advantage of these patients. Medical aids have a formulary and all drugs are capped at a certain price. The patient is liable to pay for the portion that the medical aid does not cover. What I find most shocking is that there are pharmacies out there who entice patients to buy from them based on the premise that " AT OUR PHARMACY YOU DO NOT PAY A LEVY." This is just not possible. At all pharmacies you will pay a levy unless your drugs are chronic and on the medical aid formulary and of course if you have a medical aid savings account. Be very careful if you frequenting a pharmacy where the pharmacist says you have a levy, but you don't need to pay in the levy. These unethical pharmacists usually cover up the levy shortfall by charging an over the counter product on the patients medical aid when the patient leaves the pharmcy. Hence, they score both ways. They claim for a product that the patient has not received plus they still have the item on the shelf. The poor patient is under the impression that they did not pay the levy so the pharmacist becomes well known and respected. Little do the patients know that these type of pharmacies are actually defrauding the medical aids by millions each year. The patient feels happy that they didn't pay a levy but at the end of the day money is still coming out of the patients medical aid savings. Patients often wonder why are their savings depleted so quickly. Many of them fail to read their statements from the medical aid and also assess if the correct medication has been given to them. There are pharmacies out there who allow patients to buy soaps, shampoos and other toiletries all on the medical aid. In other words the pharmacist claims drugs to the value of the toiletries. This is totally illegal and against the law. The other shocking practice is pharmacies issuing chronic medication to patients who have scripts that are dated from three years ago. This is so unethical and against the law as well. These type of pharmacies are not interested in the health of the patient, they are more interested in ringing up the cash register. The reason a chronic script is only valid for a maximum period of six months is because a patients disease state can change within six months. Blood pressure, blood sugar and other readings can change within a six month period. The doctor may decide to change medication or detect other health issues. As a country we have showed the world that we are sick and tired of corruption, so why then do we allow corruption and unethical medical practices to creep into our society. Break the cycle and do not support unethical medical practices. Eradicate corruption at grass root levels first then at a national level. As a patient I would be afraid to go to a pharmacy where anything and everything is dished out to the customer as though it is a candy store. These type of medical professionals have no respect for themselves and their profession, so why would they have any feeling or compassion towards you, the patient. At Medix pharmacy, we pride ourselves in providing our patients with the highest level of care. Hence, we will NOT be entertaining any patient that requests scheduled medication without a valid doctors prescription. We are the custodians of pharmaceuticals and we strongly believe in medical ethics, balancing the fine line between business matters and the well being of our patients. After all sustenance and provision comes from God Almighty alone. If we follow a straight path in life, success is guaranteed.