Hellopeter
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HV
Hendrik V

1 reviews | Active since Nov 2012

03 Dec 2025, 19:35

Concern Regarding PMB Coverage and AI Response

It is unfortunate that clients feel the need to resort to platforms like Hellopeter to receive attention or positive feedback.

I have logged a query regarding my PMBs to have my medication added to the chronic list, as it has not been approved to manage my medical condition. According to the Medical Schemes Act, this should be covered as part of the PMBs.

However, the response I received was an AI-generated letter with vague reasons, effectively shifting the responsibility onto the client rather than addressing Discovery’s obligation.

Adding to the frustration is the high cost of membership, which provides little value in return. Meanwhile, Discovery focuses on marketing additional products, such as Vitality, rather than addressing fundamental healthcare needs.

It is extremely frustrating to pay for a service that does not deliver value, while we, as clients, must manage our own medical expenses and responsibilities—unlike Discovery, which often fails to reimburse or support as required.

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Replies (6)
Discovery Health
Discovery Health's reply04 Dec 2025, 07:18
Official
Dear Hendrik D

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
Discovery Health
Discovery Health's reply04 Dec 2025, 17:49
Official
Dear Hendrik  

Please check your emails for feedback from us. Regards
Discovery Health Servicing Team

HV
Hendrik V's update04 Dec 2025, 18:20
Reviewer Update
Good day Discovery Health Servicing Team,

Thank you for your email. I acknowledge receipt of your feedback, and my dispute is currently under review by the Executive Team.
Kind regards,
Hendrik de Vos
Discovery Health
Discovery Health's reply05 Dec 2025, 07:08
Official
Dear Hendrik D

Thank you for taking time to give us your feedback. 
   
Regards Discovery Health Servicing Team
HV
Hendrik V's update05 Dec 2025, 19:58
Reviewer Update
Good day Discovery Executive Team,

I trust you are well.

Thank you for your feedback.

I wish to raise a concern that the clinical evidence submitted in support of my Prescribed Minimum Benefit (PMB) claims does not appear to have been correctly assessed. The motivation provided clearly outlines the complexity of ASD-related comorbid conditions; however, it seems this has not been adequately considered during the evaluation.

Additionally, the feedback provided includes no psychiatric or psychological specialist opinion, which raises concern that no qualified neurodiversity specialist reviewed the evidence.

Given the specialised nature of neurodiversity and its associated conditions, I will be requesting that recognised experts in this field participate in the upcoming dispute hearing.
Any costs associated with obtaining the necessary expert input will be directed to Discovery as part of the dispute process. I will contact them directly to arrange a suitable time and date.
Please also note that I have lodged a formal complaint with the Council for Medical Schemes regarding this matter, as I previously had to do in relation to the CPAP device issue arising from Discovery’s non-compliance with PMB regulations. I look forward to a fair and medically sound resolution.
Kind regards,
Hendrik de Vos
HV
Hendrik V's update09 Dec 2025, 10:38
Reviewer Update
Good day Discovery Management Team,

I trust you are all well.
Could you please provide me with the HPCSA registration numbers and BHF numbers for your psychologists and psychiatrists?

I need to confirm whether they are authorized to make determinations for individuals on the ASD spectrum with regard to PMB chronic medication.

If they are not properly registered or non-compliant, they are not legally permitted to make such determinations.
Thank you for your prompt attention to this matter.

Vriendelike groete/Kind Regards,
Hendrik de Vos