AP
Avani P

1 reviews | Active since Jul 2016

09 Sept 2019, 15:13

Discovery members, do you know what your benefits are, because Discovery does not!

I bought and paid cash for a breastpump that was purchased on my husband's name. According to my personal plan benefits page, each member is allowed 1 device. I submitted the claim only to be rejected. So on Fri, 6 Sept I call Discovery and explain that it is one of my benefits, the lady says no problem, she will send it for reprocessing. Today, I get another call saying that the claims department insists that a breastpump device is only allowed to be taken on the female members name, I am to provide proof that it is one allowed per family member. She asked me to take a screenshot and email it to her, which I've done and did not receive a call back as promised. We are paying R9064 per month out of pocket for medical aid, 1) why do I need to provide proof that I am allowed this device? Shouldn't Discovery know what they members are allowed? 2) This device has been allowed, 1 per member since I can remember, which is 2013, why all the hassle now? 3) If the breastpump device is taken off each members name, shouldn't my premium decrease? Being allowed 1 breastpump for my family of 4 is a total of +-R18640, if only 1 breastpump per year is allowed at an amount of R4660, then my premium should also decrease by R13980 for the 3 taken off for the year.

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Replies (1)
Discovery Health
Discovery Health's reply10 Sept 2019, 07:21
Official
Dear Avani Pillay

Your concerns are important to us. We will contact you soon to answer your comments.

Kind regards
Discovery Health Servicing Team