Discovery Health - The Medical Scheme with Increased Premiums and Decreased Benefits

Discovery Health does not care!!!

Altaaf Adam ********** 901

They increase premiums annually and their clients pay these premiums without complain, however little do we realise that our premiums increase while out benefits decrease. I am one such member of the so called Discovery Health medical aid scheme who has realised there worth in my current situation. Last week Wednesday I had an appointment with an Orthopaedic Surgeon at Gatesville Medical Centre. The reason for my specialist visit was due to an uncomfortable pain in my left knee. After the specialist examined me he found that there was a loose piece of cartilage around my knee area that needs to be removed via a minor surgery. This condition is referred to as Osteochondral, anyway once the specialist was done examining me the loose piece of cartilage shifted from the side of my leg to the front of my knee cap. This causing me extreme pain and unable to walk because the piece of cartilage is preventing me from fully extending my left leg. Does Discovery Health care? No they don't! In fact they could not care less that I have been sitting in a wheelchair for 6 days unable to work. All that they care about is quoting medical jargon such as PMB and ICT codes and telling me that the minor operation is excluded from my medical aid plan, I am not a Doctor for crying out loud. I simply need my situation sorted. I have called Discovery Health 4 times over the 6 days period, in all my interactions on one very professional and endearing lady by the name of Nirvala seems to care, but I am mindful of the fact that she has little influence in her position, which I might add she is excellent in doing. Nirvala informed me about a review process where my Doctor can motivate for the operation to be covered. This review has been sitting with Discovery since Saturday the 9th and all this team can tell me is that the documents submitted are not sufficient. How convenient! I also logged a complaint on the 8th March 2019 at 9:33am reference number ********** 694, after which a automatic response thanks you for your query and promises feedback within 24 hours, still waiting....................

Now for some math, my medical aid monthly contribution for me and my family is R6500 but Discovery refuses to cover an operation that will cost them R5000? Sure that makes business sense.

I am the sole provider for my spouse and two kids and if my condition should escalate or become more serious Discovery Health will face legal consequences. Some advise for my fellow Discovery Health members, CHECK YOUR PLAN EXCLUSIONS and ensure that this company is not ripping you off.