BM
BM M

1 reviews | Active since Apr 2020

18 Nov 2021, 08:29

DISCOVERY MEDICAL AID - WHAT IS YOUR SPECIALITY? DEFINITELY NOT A MEDICAL AID???

I was diagnosed with SLE Lupus in 2019 and have been taking chronic medication DAILY for my condition. I have been treated by a rheumatologist for my condition since then. This illness has many many challenges and Discovery Medical Aid has now become one of them!!! What a huge hassle and disapointment!!! I had an acute and huge flare up in October and was admitted to hospital - Emoya Med. My rheumatologist l had no other choice but to admit me to hospital as this is a PMB condition which is honoured and recognised by Discovery. As my doctor and specialist he knows best. Blood tests a letter of motivation from the rheumatologist can motivate and prove this. On the day of my admission I probably waited 3 hours as the staff of EmoyaMed battled to get any feedback from Discovery. As I was in a really bad state and had terrible severe pain the hospital had no choice but to admit me and start treating me as soon as possible. I had to receive IVI cortisone and ivi pain therapy and other tests also had to be done to see what the reason for the flare up was. Shocking to me was that Discovery took their time and should actually after 3 years be fully aware of my condition and not be questioning it. Discovery did not give a **** and still don't! We have been members of Discovery since 2004 and this is how you treat loyal paying clients!?? I also just have to mention - it is also a challenge for my pharmacist to get feedback on chronic medication! One disapointment and hassle after the other with Discovery. It took Discovery over 3 weeks to give authorisation for my hospitalisatioin. First is was rejected twice!! Just imagine to stress they have put us through!!! This is totally ridiculous as all PMB conditions at Emoya Med is suppose to honoured and paid for by Discovery. Letters and blood tests have been e-mailed through. As if this was not enough and to add to all this we now suddenly get e-mails from Discovery about rejected claims and doctors phoning us for outstanding payments for in hospital treatments?? What an embarrasment. Without permission and or any notification Discovery used up all our savings - which was obviously not enough!!! All these tests were done and had to be done in hospital and should have been paid out of in hospital benefits (we are paying members for over 17 years and we are surely not newe members and this is a PMD condition): After investigation and very kind assistance I confirmed with EmoyaMed that according to their contract with Discovery treatment in hospital for PMB conditions MUST be paid and why use our savings??? Why has this been rejected??? Why is Discovery ignoring my condition? Surely now that authorisation has been obtained after a riduculous 3 weeks the amounts deducted from our savings will be paid in full by Discovery from In Hospital Benefits and the amounts reversed to our MSA? Why was this not done in the first place??

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Replies (3)
Discovery Health
Discovery Health's reply18 Nov 2021, 09:58
Official
Dear Bm M

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
BM
BM M's update19 Nov 2021, 17:08
Reviewer Update
Good day,

I am still waiting for an explanation on my original complaint, we are still receiving invoices for rejected in hospital treatments/ tests?
It is not just a concern, it is a huge dissapointment and terrible service received from Discovery Health. How can this just be dismissed and deducted from our savings after we waited over 3 weeks for authorisation ??? And then firstly authorisation was declined twice? According to the hospital this was never suppose to have happpened!? It is a huge issue for us as I have chronic conidtion which Discovery is defnitely aware of!!

Discovery Health
Discovery Health's reply26 Nov 2021, 15:55
Official
Dear Bm M

 Please check your emails for final feedback from us.
 
Regards 
Discovery Health Servicing Team