1 reviews | Active since May 2018
Discovery moneymaking business
Last week Monday my son was admitted in Lesedi Hospital. He fractured his wrist in two places and needed an operation. He went under operation at 23h00 Monday night and was discharged the following morning. Doctor prescribed a sling and some pain medication. While getting ready to leave the hospital, the nurse informed us that the medical aid doesn't cover the sling. We asked how much does the sling costs, we were told R400 and that he needed the sling immediately in order to heal properly. So we paid cash for the sling, thinking that I was going to claim it back from Discovery, thinking that because my son was admitted, it will fall under the in-hospital benefit. When we went to the pharmacy, we were again told that the medical aid doesn't cover the medicine. We again then paid cash. My son was booked off for two weeks, so I took a week's leave to stay with him. So today when I got to work, I phoned Discovery and spoke to Junaid. He informed me that I am, unfortunately unable to claim back the R400, because I was supposed to purchase the sling from one of their providers. He gave me a list of 3 providers which I first needed to call to enquire about the available item, then the provider will then send me a list with all available items, if I select an item on the list, then the provider will send me a form to fill in, which I send back to provider, who will then send to Discovery for authorization. After approval, Discovery will then send payment to provider, who will then deliver item to me. Now tell me, how was I supposed to know all that? I assumed that if one is admitted to hospital, everything will automatically will be covered which the doctor prescribes. So if I had followed above process, how long was my son gonna wait for the sling? Such a long process for something that we needed urgently? - First of all, why are we not aware of all this? The hospital knows under what plan you fall, and everything that it covers and not, so why can't they advise us on such things? No one told me about the process I needed to follow, so now we paid cash for something that was supposed to be covered by the medical aid. I am totally flabbergasted with the service from such a big provider. I mean, we pay exorbitant fees every month, but you still needs to pay cash for emergencies. The sling was a necessity for my son, so why couldn't it fall under in-hospital cover? When one have an emergency, you must always have cash on you, especially with Key Care Plus, because hardly anything is covered. And the most annoying thing is, the hospitals knows exactly which plan covers what, but still we are not informed properly. May I suggest, that all your hospitals please have a section for Key Care Plus members only, where we will be able to fully enjoy our benefits. Where we will be informed immediately about everything that we need to do and how to do it. If I was to take my son to a public hospital and the doctor said he needed a sling immediately, they would have provided him with one. But with Discovery, you have to pay cash to be able to get the best medical care. I can just imagine what was gonna happen if I didn't have the money to pay for the sling, but I have medical aid:-( So what is the use of having medical aid at the end of the day, because one still have to pay cash for the one or other? I feel if patient is admitted in hospital, everything the patient needs must be covered by medical aid, irrespective of the plan.
