1 reviews | Active since May 2020
Discovery Health-MSA Disaster putting our lives and well being of my family at risk
So i have been having numerous issues with Discovery recently. I will start from the beginning. I use to be a managing director of a my own private company. With businesses, usually having financial issues sometimes, giving the current circumstances as well. my account was not paid and has eventually lapsed. granted that is on me. HOWEVER, i did my part and got my discovery medical aid paid up-to date and re-instated. Upon re-activation, claims were resubmitted. My 4 month old son at the time being 2 months was admitted into hospital. He was released from hospital and this is where the problems started. Whomever the BRIGHT spark was, who resubmitted the claims, submitted all the in hospital claims as out of hospital. Draining our MSA instantly. The query was then launched by me (Whom had to tell them how to process their claims, i should add). The query was then eventually rectified after continuous calls made to discovery and a downgrade from Classic priority to Essential saver was initiated upon my request. Once the downgrade was processed our medical saving account went from being over R12000 available to having R0 available. When i called them while making an idiot off myself at the pharmacy. Discovery could not explain why my MSA has gone to R0. I had to pay for all the medications cash and had to except that they are looking into the situation. 3 days later, after more numerous calls made on my account (where they place you on hold for literally more than an hour) the MSA was then re-instated and the medical aid seemed to be rectified. With the current pandemic due to the Covid-19 we have had to cut costs wherever we could and came to the conclusion, that downgrading the medical aid from Essential saver to essential delta saver would be an option to cut cost, as its only the MSA which will become a bit less and the hospital we have to go to will have to be within their Delta network. I submitted the request to downgrade. At the time of request, we had a total of R12250 odd available in our MSA. And yes it happened once again. for some reason they adjusted our MSA to R0 again from R12250 with no claims being submitted. i received a call from their financial department requesting payment of R1400 which i now apparently owe them? Simple math - MSA for essential saver up until June for myself, wife and 2 dependants is R5000 in total accumulated. From beginning June to Dec 2020 the MSA will accumulate to R5586 for the 7 months (R798 X 7). We had 250 odd rand which was transferred from the previous year which concludes the amount i should have available should be R10800 give or take. To do this easy consolidation, which their accounting department cant seem to figure out, has been going on since the plan change took affect which was the 8th may 2020. today is the 20th of may with it still not being resolved. I Spoke to numerous consultants, with the same feedback being given, we will escalate it. just to add to this, the meds i paid for cash at the pharmacy was resubmitted for some reason and paid out by discovery to the service provider? taking even more out of our MSA which i ALREADY PAID CASH FOR. I am on schedule 5 and 6 medication which i need to take every single day. If i skip doses, i physically become very sick and literally cannot sleep or function due to the physical reaction and strain on my body. Discovery being a non profit company should save lives, where in our case they are not (not figuratively but literally) putting my life at risk as i now cannot get access to my medication. Im at wits end with this company and will be taking further action should this not be resolved latest COB 21 may 2020. If you are reading this review and thinking of taking out medical aid with Discovery, DONT, Its seems that not only the processes but staff are to *********** to resolve a simple issue like this. 2 weeks with no luck of rectification. The only persons being affected by their incompetence is myself and my family. They do NOT care what the outcome of our lives would be (dead or alive) due to their internal processes and staff. I am appalled with the service received. I have our legal representatives on speed dial should i not be able to get access to my medication by tomorrow, which i pay for through the medical aid. last note, i sent candice pillay at discovery an email immediately after i noticed the MSA ahs gone down to 0. I still have not received any feedback. note no Discovery, this woman is rude and a huge liability
Regards
Regards
Regards
Regards
