DH
Dylan H

1 reviews | Active since Mar 2023

22 Jul 2024, 16:55

Discovery Gap Cover

My daughter was born with a heart defect (one of her heart valves was not functioning properly) that we were unaware of. My partner and I are on the essential delta saver plan at discovery with gap cover. She had to undergo a balloon procedure in order to open up her valve and restore proper blood flow to her lungs. We were advised by our specialist to do this procedure and that our medical aid and gap cover will cover the cost and short falls. A couple of days after the procedure we received an email from discovery stating that we are still in the waiting period of our gap cover and that they are not going to pay the outstanding balance. This heart defect was explained to us by our pediatric cardiologist as severe pulmonary valve stenosis and needed urgent care. On Discovery's booklet it explains that there is an automatic waiting period of 3 months for gap cover except if there is an emergency hospital admission. We are now sitting with a hefty medical bill. I am going to dispute this decision as the diagnosis was explained to us as an emergency procedure. We bought gap cover with the idea that if we ever got in a situation where there are any outstanding medical bills/ short falls, that it will be covered. Especially an emergency for a 2 month old baby. We also received a PMB form from our specialist stating the urgency of this emergency procedure. This was sent through to Discovery Medical Aid. Can Discovery please explain.

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Replies (2)
Discovery Health
Discovery Health's reply23 Jul 2024, 06:29
Official
Dear Dylan H

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 reply25 Jul 2024, 15:18
Official
Dear Dylan H

We have been in touch with you to answer your comments.

Regards 
Discovery Health Servicing Team