YJ
Yolandi J

1 reviews | Active since Feb 2017

11 Jun 2018, 16:51

Discovery Health Cancelled

Very disappointed in Discovery Health: My full story! I was a member with Discovery Health for over 16 years. I hardly ever used the medical aid and if you add the 16 years total payments it adds to plus minus R 480 000.00 for the 16 years. In 2016 I went through a difficult financial time and had to give my medical aid up. In 2018 I joint finances with my mother to make our financial status much better and I app**** again for me and my mom to join Discovery Health as of 1 April 2018, as per forms I advised that I have seen a doctor for flue in the past 12 months and was given medication. No waiting period was given. My family does a yearly deworming and buys off the shelve deworming medication. But the chemist advised that we should consider visiting a doctor to get a yearly prescription deworming dosage as the chemist cannot supply you with that particular medication as you need a prescription. Reason why he advised this is because it is a small town and we all know each other well and he knows that we work with animals regular and we do buy the usual over the counter product twice a year. Apparently, these over the counter products does not work as well as the prescribed medication. Prevention is better than cure, so off we went in April 2018 to get the prescribed deworming product. Doctor advised that if we do have a worm problem then we should get tested for iron deficiency, I got tested and my son got tested (My son is on his father’s Discovery Medical aid, not mine). Came back that we have a iron deficiency so the doctor prescribed some iron tables for my 10 year old and iron IV treatment for my mom and myself. We went to the first iron IV session on 12 April 2018, I got extremely sick after the IV and on the 16th of April 2018 the second iron IV was scheduled. I was very reluctant to get this done and told the nurse at the doctor’s room that before she administers the 2nd one she must tell the doctor of my symptoms (Swollen tong, dizzy, extremely ill) I heard the doctor say, she must hang in there. We got the 2nd iron IV as you trust your doctor, and again I was extremely ill. There was a 3rd iron IV booked but I cancelled it via e-mail advising again my symptoms and I will not go for the 3rd one. The doctor will never see me again. Discovery paid for above with Dr Iron IV. On 14 May 2018 my mom was hospitalized as an emergency by another new doctor just after 6pm. The hospital admission advised that they will obtain authorization as it was an emergency. She was extremely weak and her stomach had been working over time since Sunday morning and she did not eat. On 15 May 2018, I receive a sms ‘Discovery Health Medical Scheme: We are reviewing your authorisation request. We asked Dr Iron IV for more information and will update you on the progress. They did quite a few tests and advised that she has a bile duct blockage and needs to go the UCT hospital asap and the doctor advised that this is an emergency and he will prebook her at UCT. Stressing my self into another world, seeing her so weak and ill, I took her to UCT hospital and admitted her on 21 May 2018 whereby I received another sms from Discovery Health’ We are reviewing your authorisation request. We asked Dr Iron IV for more information and will update you on the progress. A litter later that afternoon I received the following sms Discovery Health Member (Smily face?) please note that your authorisation has been declined. No Receipt fo PMA from Dr Iron IV. Thinking this was strange as Dr Iron IV was not the Doctor that admitted my mom, but tending to my mom’s needs and trying to get through the days, I receive a call from Discovery on 25 May 2018, which was a very bad emotional day for me. The lady was asking all kinds of questions and I kept referring to April 2018 and the iron IV’s and so on. I receive a letter from Discovery Health advising that my membership was cancelled due to non-disclosure, which I only saw the next night. This was apparently due to the fact that my mom visited this iron IV doctor in February 2018 for sore throat, sore muscles, stuffed sinus, according to any one flue like symptoms, he then advised her to go for iron IV and said she must get blood tests and if iron is low she must get iron IV. Which she did not go for as she got some vicks medinite and sinatabs at clicks and rested for 3 days, there after she was well again and went on with her daily duties. This visit I only found out about after I questioned her regarding the cancellation du to non-disclosure from Discovery and she advise that she gave me all the info correctly from her point of view and that she was not diagnosed with any condition and did not receive any treatment. Discovery also stated that if I have added her visit to Dr Iron IV in February 2018 there would have been a 3 month waiting period. BUT I advised my doctor visit and no waiting period was given? So why only when a hospitalization was requested then only Discovery tried to find problems? I wrote letters to Discovery Health and also appealed the decision, and advise that if Dr Iron IV has stated in February that he diagnosed her with Gal Bile blockage or had any reason to think that she might have a gul problem in the near future, then I would understand the non-disclosure part. Gal bile blockage has no symptoms of low iron or any symptoms which can be linked to any of the previous visits. So how could I have declared that she has a illness not diagnosed as of yet when I completed the application forms in March 2018? My main objection is that I cannot tell the future and I have no problem with Discovery Health turning down payments BUT what I do have a problem with is that they blatantly just cancel your medical aid and not give options to say, look we have a problem with your initial application but we will put your beneficiary on a waiting period due this issue which has come forward to further investigate. No they just cancel, not thinking that it would be better to keep the client on the medical aid and receive monthly payments of R 3 850.00 for the next 16 – 20 years instead of just cancelling. They have all my information on my 16 year at Discovery Health to see if I am a high risk client and illness record they also have my mom’s previous medical aid record of over 16 years to find out her health, if she visited a doctor 1 every 3 years then that would have been a lot. I might be looking at this incorrectly but this was my experience, very unpleasant and unprofessional for such a large company.

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Replies (2)
Discovery Health
Discovery Health's reply12 Jun 2018, 09:23
Official

Dear Y18olandi

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 reply13 Jun 2018, 13:46
Official

Dear Y18olandi

We have been in touch to answer your comments.

Regards
Discovery Health Servicing Team