Discovery Falsely Marketing Baby Benefits

I am the principal member on the Discovery Medical Aid, Essential Delta Core Plan. As part of the benefits of the plan, it details that my baby is covered for 2 visits to a GP, paediatrician, or ENT specialist within their first 2 years. This was part of the reason as to why I joined the plan.

When I attempted to use my first covered visit, as offered in the benefits, the Discovery website didn’t have a single paediatrician offering full cover in the entire network of Johannesburg AND Sandton. They simply told me that they cannot force providers (doctors) to sign up and charge according to their scheme rate. While I understand that not all paediatricians will be covered, I expected at least ONE that offers cover since Discovery’s own benefit guide states that 2 visits are fully covered.

I feel that Discovery has falsely advertised and marketed their benefits under this plan and I, as the customer have to pay out of my pocket because of their false advertising. I searched the Discovery website and each brochure kept referring to another guide/website to view the full benefit guide. This was very difficult to follow as each guide stated that I am covered for 2 visits.

By the end of it, I was charged R1350 from the paediaitrician that I paid out of my own pocket, and Discovery reimbursed me about R650 of that amount.

I feel extremely betrayed by this medical scheme that bills me R3621 a month, yet misleads me with the benefits that they offer me.