BM
Barbara M

1 reviews | Active since Oct 2009

11 May 2015, 10:33

ALL GOOD UNTIL YOU NEED TO GO INTO HOSPITAL

Last week my daughter was diagnosed with severe anaemia after passing out at work. Her iron level is so low she requires an iron infusion which would resolve the problem in one day as oral medication will take six months. She's a chef and on her feet all day so needs to be healthy, not only that she is driving herself to and from work and cannot be at risk of fainting behind the wheel. The haemotologist explained the differences between oral medication and an iron infusion on Friday when we went to see him. He also said that although an iron infusion is the best remedy, DISCOVERY DO NOT LIKE TO PAY FOR IT !!! And they also take at least a week to make up their minds on whether they are going to pay for it or not. But mostly they come back and decline it !!! WHY ?? Because six months oral medication comes out of your medical savings doesn't it and doesn't cost them extra !!! So after I have been paying these #$%@ for Classic Comprehensive cover for years, when I eventually need it, they will do what they can to wriggle out of paying. I called them myself to confirm and found what he said was correct !! I wonder how they would feel if it was their child needing urgent treatment??

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Replies (1)
Discovery Health
Discovery Health's reply13 May 2015, 12:39
Official
Hello bm71,

Thank you for your comment.

Please be advised that when clinical requests are presented to us, the Scheme cannot blindly approve all requests. In some cases, there are clinical protocol to be followed in order to ensure that we approach all requests in a responsible manner taking into consideration affordability and sustainability of the scheme. If we were to make all these types of request available without ensuring that the clinical entry criteria is met, the impact on premiums could be astronomical.

I am sorry that the provider painted a different picture and will have one of your health Professional Managers contact him to discuss his concerns.

Her authorisation was approved and I have emailed you the details in this regards

Kind regards
Danita