MJ
Michell J

1 reviews | Active since Sept 2025

02 Sept 2025, 13:46

Discovery Medical Aid - Good luck "Discovering" what they actually cover

I am absolutely seething.

Discovery is a bunch of snakes that hide behind a long list of criteria that change on a whim.

Just a warning: if you are over the age of 35 and pregnant, and you want to take the NIPT because the risk of chromosomal abnormalities—such as Down syndrome—begins to rise more noticeably after 35… well, not according to Discovery. No, according to Discovery, Advanced Maternal Age only starts at 40. Never mind all the scientific evidence indicating a significant risk increase from age 35. Discovery just ignores that—because, well, money?!

I was admitted to hospital for three days, and they didn’t cover my doctor’s visits in hospital. Why, you ask? Not a single clue. It’s just “Not covered by plan.” I still don’t know what my plan actually covers, and I suppose it will always be a mystery—because how dare I know what I’m paying for?

Try searching on the app under “What we cover” and what comes up? “Plan dependent.” I know—that’s why I’m using the search, to determine if my plan covers it or not. What’s the point of that search tool? It creates the illusion that they’re transparent about what you’re paying for, but in reality, you can never get a straight answer or guideline about what we’re paying thousands for.

I pay way more on Discovery than I ever have on any other medical aid in the past, and I’m getting by far the least benefits.

This is already a stressful time for a family, and Discovery does nothing to make it easier. They’re playing with people’s livelihoods and smiling all the way to the bank—and I am sick and tired of it.

They purposefully complicate the system so that it’s either too much effort for you to figure out what’s going on and you give up, or you simply don’t understand and just accept that they won’t pay.

We’re waiting on a new medical aid to come in as an option for the new year, and I am jumping the Discovery ship immediately!

0
Replies (4)
Discovery Health
Discovery Health's reply03 Sept 2025, 06:38
Official
Dear Michell J

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 reply03 Sept 2025, 16:29
Official
Dear Michell J

Please check your emails for final feedback from us.

Regards
Discovery Health Servicing Team
 
MJ
Michell J's update03 Sept 2025, 17:06
Reviewer Update
Email received, thank you.

Please can someone explain to the following excerpt from the response letter:
"For a member to be eligible for a review of prenatal screening coverage during pregnancy, they must submit the results obtained from the amniocentesis test. These results will determine whether the member meets the clinical entry criteria set by Discovery Health Medical Scheme for covering the NIPT (Non-Invasive Prenatal Testing) or Nuchal Translucency test."

So I need to do an invasive test to prove I need to do a non-invasive test? I need to put myself and my baby at risk of miscarriage (again) in order to do a simple blood test???? How about we start non-invasive to determine whether a more invasive test is needed.

I want to know the exact "clinical entry criteria" required by Discovery. Not a list of hogwash terms and conditions that are long winded and would take a law degree to decipher.
Simply:
1. Over the age of XX
2. History of miscarriage
3. Previous diagnosis off disease X
4. Family history of problem X
etc.

Such a list will not be made public because then Discovery has nothing to hide behind. These plans are designed to be misleading.

There has not been a single thing during pregnancy so far that Discovery has overed 100%. Every Doctor's visit, partially paid. In hospital, partially paid, medication, obviously not paid because MSA is used up because EVERY SINGLE THING is paid out of MSA even though I have PMB's that should cover those things.
Discovery Health
Discovery Health's reply16 Sept 2025, 16:30
Official
Dear Michell J

Please check your emails for final feedback from us.

Regards
Discovery Health Servicing Team