DJ
Doe J

1 reviews | Active since Jul 2011

12 Aug 2025, 08:12

Become a medical aid expert or they find a way not to pay you

Discovery seems to require members to become experts in medical aid. we must understand codes and processes. I thought my job was to pay premiums on time?

Saw the doctor on 16th July. It was a chronic condition diagnosis. Doctor activated the benefit later it seems - doctor said it was a bit of a process. Discovery sends a letter saying chronic benefit activated from 18th. So now they won't pay for the meds prescribed on the 16th. I also offered to send them the script I received that clearly shows it was chronic meds.

Why is it that your system cannot account for the scenario where the doctor does the admin later, but they can specify an effective date?

Now, I must go become an expert in your medical aid processes, I must go fight with the doctor to fix things because your system is inadequate.

Shame on you

0
Replies (3)
Discovery Health
Discovery Health's reply12 Aug 2025, 09:46
Official
Dear Doe J

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. 

Regards 
Discovery Health Servicing Team
DJ
Doe J's update26 Aug 2025, 11:08
Reviewer Update
Got the feedback. Terrible. Do I escalate to Ombud or you want to give it another shot?
Discovery Health
Discovery Health's reply10 Sept 2025, 11:51
Official
Dear Doe J 

We are busy investigating your query and will contact you soon.

Regards 
Discovery Health Servicing Team