Declining my Auth and not feeling the pain I'm feeling

I'm really disappointed with Discovery Health and would not advise anyone to take medical aid from them at all. For them it's just about the money and they don't care a bit about the person/client at all.

I went to see the Orthopedic Specialist on the 02nd of Nov and he confirmed that I have a tendon that is torn and one that is almost the same. They called for authorization to make a booking for the 28th of Nov to get it fix and it was declined because the Discovery Keycare option doesn't allow those procedures. I immediately called the Call Centre to find out what is going on as I'm the person sitting with pain in and out everyday. I spoke with Sabna and she advise me to email both the X-ray and Ultrasound to *** as they have a panel that will sits and see if it could be done via PMB.

Now today I receive and email advising that this was not successful and it's been declined as well. How the hell do you pay for medical aid but you can't use it as you need it???? This is really so unhuman from Discovery to do this to a person, we have been with you for so long and paid thousands towards our medical aid and what for??? To be declined????

I think that your process is doing more harm than good as you just collecting money from us and you don't cover anything and the below is just typical let's see how we can save money instead of helping our clients.

Some of the ways we achieve this is in our plan and benefit design and the application of funding policies and clinical protocols. These are developed using a rigorous, evidence-based decision-making process. Using this process helps us decide which procedures and treatments to completely exclude from cover and to develop funding policies for procedures and treatments that we have found to be clinically appropriate and cost-effective.

The below is also not true about the doctor as you would have listened to the doctor instead of having a panel to decide what to do.

We recognise that the doctor is in the best position to make medical decisions about your condition and treatment. In declining the funding, we have not questioned the diagnosis or the treatment the doctor recommended. As a healthcare funder, we decide about funding treatments to make sure the medical scheme can cover claims now and in the future.

Please note that the time is coming for us to change medical aid plans and I will definitely not be going with Discovery just due to them being so mean.........