1 reviews | Active since Jul 2011
Discovery not willing to pay hospital account 100%!
We were members of our previous medical aid until the 30.06.21. On 3.06.21 I needed a semi-emergency surgery to remove my blocked LP Shunt. My previous medical aid paid for the expenses. During that time I’ve kept Discovery who will be our new medical aid from 01.07.21 up to date of my procedure via email and when I was discharged my husband called Discovery and told them I have to see my Neurosurgeon on the 7.7.21. Discovery confirmed they will pay for the consultation. Discovery was fully aware of my condition. Unfortunately this new shunt was rejected by my body. I went for tests on Tuesday which confirmed that the shunt pulled out and it’s now situated in my back. I’m currently very uncomfortable and in pain but my Neurosurgeon will only be able to do the surgery on Tuesday due to the occupation of theaters in hospital due to the Covid situation. Cape Gate Medi Clinic arranged for authorisation but Discovery will only cover 80% of the hospital account because we are still in a waiting period and I’m not going to Kuilsriver hospital. This is totally unacceptable! My surgeons is at Cape Gate Medi Clinic so I cannot go to Kuilsriver! Totally not negotiable! I thought Cape Gate is a Discovery service provider according to the list!!?? I’m based in Kraaifontein and not Kuilsriver! Why is this imposed? I’m very dissapointed in Discovery that I should pay 20% of the hospital account! I would really appreciate it if you can review this because I have kept Discovery up to date with my progress. This was really unforeseen circumstances and I really don’t have the money to pay the hospital account. I cannot wait another 3 months to get a new shunt, I’m in a lot of pain and very uncomfortable. The fluid collection gets bigger and bigger in my back. I actually feel this should be seen as an emergency because if they close the theaters now due to the rise of covid figures, I have to go in immediately. Unfortunately dr can only assist me on Tuesday, otherwise he would’ve done it earlier. I will really appreciate it if Discovery can figure something out to assist me in this difficult time?
