LM
Lesley M

1 reviews | Active since Sept 2016

01 Nov 2021, 15:04

Discovery refuse to pay for PMB conditions and orthodontic work

My son had to go to accident and emergency for a bee sting that he was highly allergic to. This was the first time that we had to go to the hospital for this. I would expect that this would be a PMB condition, as they were getting the crash cart ready due to his response to the bee sting. I sent all the relevant information through to Discovery 2 weeks ago and they have not even bothered to reply to my email. So much for their 2-3day turnaround. This is not the first incident. He was diagnosed with several PMB conditions and the medical aid does not care, They just don't want to pay for anything. I even paid for a consultant to help us resolve this issue and Discovery gives them the runaround too. His orthodontic treatment gets fobbed off as an ordinary dental procedure so this gets paid out of the day-to-day savings which are depleted instead of coming out of the orthodontic funds which are plenty. I am highly disappointed in their service. They used to be so good, now they are money grabbing ******* that do not care about the member even though they say they do. They may talk the talk but they don't walk the walk.

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Replies (3)
Discovery Health
Discovery Health's reply02 Nov 2021, 07:09
Official
Dear Lesley 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
Discovery Health
Discovery Health's reply02 Nov 2021, 14:46
Official
Dear Lesley M
 
We have been in touch to address your concerns.
 
Regards
Discovery Health Servicing Team
LM
Lesley M's update18 Nov 2021, 14:44
Reviewer Update
It is futile trying to liaise with Discovery Health as they hide behind statements such as "we do not pay THAT provider" but it does not come off our self-payment gap because we have not Reached that level yet" or they say that "you cannot access the rest of your orthodontic funding as you have not completed your self-payment gap. Convenient ways in which they ***** your money and make you pay more. They have divided our savings into two sections and the second half you can only access after you have completed your self-payment gap. But they are not deducting the bills I send through as they are not even processing the bills, so I pay all the bills, and the self-payment gap and the monthly fees. I think its time to leave this medical aid as they have become as ******* as the ANC And frankly they must fall.