MD
Michelle D

1 reviews | Active since Oct 2013

10 Sept 2026, 16:10

Discovery Keycare Plus limitations

I cannot tell you how angry I am. I have been with Discovery Health for 21 years now. I began on one of the higher platforms but due to life's unpredictability, I have had to drop down to Keycare Plus and with that the limitations imposed. About 6 weeks ago my daughter (16 y/o) was admitted to a preferred provider hospital and saw a preferred provider doctor at the facility for gastrointestinal problems as well as anxiety. The gastroenterologist diagnosed her and prescribed specific medications which would help manage her condition - his rooms submitted the prescription to Discovery with the ICD 10 codes as chronic meds and the come back was declined. The doctor then wrote a motivation as to why the meds were necessary and again - they were declined. I then wrote to the council of medical aids for intervention and am still awaiting the final decision. However, Discovery will pay unlimited amounts for hospitalization but not for medication ... that doesn't make sense at all! But here is where my frustration (true) comes in again ... my daughter was referred to see a psychiatrist for her condition. Again - we saw a preferred provider psychiatrist at a preferred provider facility - he then prescribed meds for her condition, accompanied with ICD 10 codes that were submitted to Discovery as being chronic meds - again we have been declined. I called Discovery yesterday and was advised that because of the plan I am on, we are not covered for conditions like depression, anxiety or anything related. This is blatant ************** (as far as I am concerned). The consultant I chatted to said only the elite plans allow coverage for such conditions. So, in effect what is being said is - poorer people don't get anxious or depressed. Poorer people (by poorer I mean those who can't afford to be on the higher plans) don't deserve the same benefits that the richer people do. Here's how things sit ... my medical aid costs R2645 +/- (for my daughter and I) and the out of pocket expenses for her 'chronic meds' costs an additional R1600 per month. This is so unfair. And, please (Discovery) don't tell me you are going to look into it and get back to me - because the answer will always be the same. It's your way! I know that Discovery is a financial institution that makes its money through providing medical aid for people - but there surely needs to be a balance between the shareholders profits and the members benefits. Discovery you can do better than this.

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Replies (2)
Discovery Health
Discovery Health's reply11 Sept 2026, 06:56
Official
Dear Michelle D 

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 reply15 Sept 2026, 14:00
Official
Dear Michelle D 

Please check your emails for feedback from us.

Regards Discovery Health Servicing Team