DISCOVERY HEALTH - DISCOUNTINUED THE ESSENTIAL DELTA COMPREHENSIVE PLAN AND REFUSE TO FOLLOW THROUGH IN CARRYING EXCEPTIONS OVER.

Discovery Health discontinued the Essential Delta Comprehensive Plan as off the 01st January 2024 without informing us about it. The monthly instalment of the plan was R5600 After cancelling the plan , they defaulted my mum to the Classic Comprehensive which is R8400 per month without our knowledge. My mum is a Chronic patient with an illness called Ulcerative Colitis.

On the Essential Delta plan she was had being going for treatment which an infusion every 8 weeks to control her illness. The treatment , required no copayment on our part due to an exclusion/exception on the plan based on motivation provided by her Specialist.

Due to the fact that my mum is a pensioner, she could not afford the Classic Comprehensive which was going to cost her R8400 a month and after much deliberation with Discovery we dropped the plan to Classic Priority which costs her R5200 a month. The Classic Priority covers the infusion , however Discovery health and their Clinical advisors have been dragging their feet to carry of the Exception/Exclusion of NO COPAYMENT for this treatment from the Old plan to the New Plan Since the 05 January 2024 , I have had 80+ interactions with the general and Chronic department on this issue, and sadly still nothing has been resolved

We were requested on the 20th February 2024 to obtain a new motivation from my mums specialist ( which we had to pay for as a normal consultation of R950 ) to and submit this to the Chronic Department in order for the Exception/Exclusion on the Copayment to be added on the plan.

Sadly once again , Discovery didn't seem to have urgency. 8days later , I was then requested to ask my mums Specialist for Disease Scores. A document that should have been requested and asked off us on the initial request on the 20th February 2024.

I am continuously calling in for feedback to only be told that the case is with the ''external committee'' for review and no feedback is on the system yet

MY MUM IS NOW CURRENTLY ILL , DUE TO THE INCOMPETNENCE AND LACK OF COMMUNICATION FROM DISCOVERY ON THE DISCOUNTUNATION OF A PLAN WHICH SHOULD HAVE BEEN COMMUINCATED IN ADVANCE.

I HAVE DEALT WITH DISCOVERY FOR MANY YEARS , HOWEVER THEIR LACK OF CARE AND URGENCY ON THIS MATTER IS EXTREMELY APPALING FOR A COMPANY WHOSE MISSION STATEMENT ENTAILS ''MANAGED CARE SERVICES''

THEY ARE JUST DRAGGING THEIR FEET ON THIS MATTER AND WHILST A LIFE IS ON THE LINE.

Its extremely to sad to see that , we work extremely hard to pay for medical aid to receive this kind of service from a company who holds the highest standard in the industry.

This is unacceptable and I will be reporting Discovery to the Council of Medical Schemes.

DISCOVERY - THIS WAS YOUR FAULT FOR CANCELLING A PLAN AND NOT MADE AWARE OF IT.