Discovery doesn't cover casualty or emergency room visits.

I recently went to an Emergency Room at a hospital with symptoms of a heart attack. Discovery's plan documentation clearly states that "all medical schemes have to cover the costs related to the diagnosis, treatment and care of: An emergency medical condition". Sure seems like an emergency medical condition to me, but no - Discovery would rather have you walk it off, and if you get hospitalised at that point, they might consider covering it. Might.

Discovery paid for nothing. I have disputed the claims, and despite highlighting the sections from the documentation, they insist that "casualty visits are not covered". In my experience, Discovery basically pays for GP visits (with a copayment from you, of course) and nothing else.

When I'm visiting Casualties, the last thing I want to worry about is bills - I pay for medical aid, I have an emergency, I would like to assume that this is covered. The tests are not exactly elective, I'm not asking for a nose job, I'm asking you to diagnose something that couldn't wait for a GP visit, I want to know how serious it is, I want to know if I will still be alive tomorrow.

Oh - they'll cover the casualty visit from your Medical Savings Account, which is marketing doublespeak for "pay us upfront so we can draw interest on your money, and then we'll see if we feel like giving some of it back to you when you need it."

Discovery is not a good company. Despite their marketing, despite their messages of "we want you to live a healthy life and we'll help you do it", despite them telling you to "be proactive about your health", make no mistake - this is marketing magic, nothing more.

You will get fewer false promises, more value and a straighter answer when you deal with the ANC, the Post Office or Eskom. Discovery is not your friend, they do not have your back, and the only thing you can count on is that they will weasel their way out of paying every single cent they can manage.

Trust me, you are better off waiting for NHI than you are relying on Discovery.

Oh, and don't count on feedback forms or even something as simple as the "have we resolved your query" survey working - you'll see nothing but error messages every time you try.

Lastly, they try to call you once, and only once - before fobbing you off via email. Had a meeting? Didn't answer because their number was - understandably - marked as spam? Tough luck.

Out of interest, here are the applicable sections from their documentation, which goes out of its way to make you sound covered, with no asterisks or qualifications, until you actually need their services:

"In terms of the Medical Schemes Act 131 of 1998 and its Regulations, all medical schemes have to cover the costs related to the diagnosis, treatment and care of: An emergency medical condition"

"An emergency medical condition may be referred to, simply, as an emergency. It is the sudden and unexpected onset of a health condition that requires immediate medical or surgical treatment. Failure to provide this medical or surgical treatment would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or it would place the person’s life in serious jeopardy. An emergency does not necessarily require you to be admitted to a hospital and may be treated in casualty. We may ask you or your treating provider for information to confirm the emergency."

Sounds good, right? You'll be safe in an emergency, right? Think again.

If you're looking for medical aid, Discovery ain't it. Try someone else - anyone else - but avoid Discovery like the plague. Which they won't cover if you get it, of course.