1 reviews | Active since Jul 2014
Discovery Refusing to Pay Claims for Specialist
i am a keycare member. I pay R4700 a month for medical aid for me and my family. Keycare plus is the lowest plan on discovery but the cover itself is not bad, but limited. I was diagnosed with Graves Disease in January this year by my GP. I had to cover the cost of my blood tests myself. Keycare does not have an Endocrinoligist on their specialists panel but I was given the go ahead to see one at Christiaan Barnard Hospital. My GP followed procedure and app**** for the specialist benefit. each member is given a R3000 annual limit for specialist visits. I went to see my specialist for my first visit in March at a cost of R1400 which I had to pay and then claim back. Discovery sent me an email advising they will cover only R300 of the claim I have yet to receive that refund. I had my follow up appointment in May at a cost of R700, Discovery advised they will not pay but will look into it if I paid a shortfall of R80 that was reflecting on my account, which I paid. they are now saying I did not follow procedure and they will not cover any of the costs, and the specialist benefit i app**** for expired on 22/04. only after my first visit but they didnt even cover that. how is this okay?
Thank you for your comment.
We are investigating your concerns and will be in contact to assist.
Regards
Rishana
Thank you for your comment.
We are investigating your concerns and will be in contact to assist.
Regards
Rishana
