Discovery, the suffering

A 1/5 star rating is generous. I wish I could give a negative rating. They deserve a negative rating. On May 28 I phoned Discovery Health with the query of changing my plan from the Essential Smart to the Active Smart, but my wife is a REGISTERED CHRONIC patient for Ulcerative Colitis (which is also a PMB by the way) with an APPROVED chronic care basket. So of course my first instinct is to make sure that she does not lose any of her benefits with regards to her annual treatment that she receives. A part of this annual treatment is a yearly authorisation to 1 day in hospital for a scheduled follow up colonoscopy to review her recovery and adjust treatment is necessary. During this phone call on May 28 at 10h10 and 10h21, the customer care advisor assured me that my wife will still be allowed to go to Fourways Life Hospital because her CHRONIC condition is a PMB and therefor she will be allowed admission for her APPROVED anual check up. Naturally, I believed the word of someone who works for Discovery Health and I felt comfortable to make the switch from the Essential Smart to the Active Smart plan. Oh, how this came around to bite my in the ass. On July 3 we received notification from the doctor that Fourways Life denied my wifes admission for her colonoscopy because our plan does not cover admission to Fourways Life. And then the WHOLE can of worms was opened and spilled all over our lives. Upon further investigation I acknowledge that yes, the Active Smart plan only covers Dynamic Smart Network hospitals (which no one can provide me a list of) BUT that she can be allowed admission to Fourways Life for a PMB admission (WHICH IS WHAT SHE NEEDS TO GO TO HOSPITAL FOR BECAUSE OF HER CHRONIC CARE BASKET). But no, Discovery does not see this the same way. Oh no. They see my wifes Chronic Care Basket treatment as a pre-planned admission (not that she actually NEEDS this treatment) and therefor denied her admission to Fourways Life. Now, here is the deal with Fourways Life: This is the hospital where my wife was diagnosed this irreversible condition. This is where her specialist, diagnostician and treatment doctor practices. The only doctor that we would ever trust to treat my wife for this condition. I then phoned Discovery pre-authorisation for further clarity on this. The man I spoke to, Andre, was very nice and fully understood what we were going through. He advised that the treating doctor write a letter of motivation for why my wife needs to be admitted to Fourways Life that we can submit to the medical board. Which we did. The letter CLEARLY motivated why my wife needs to be admitted to Fourways Life and how TIME SENSITIVE her treatment is because of many complications that can development if she doesn't get in timely. It's July 30th and she still hasn't been treated. The only response we received on the letter of motivation are the following words: "May we have confirmation from the DSP that they cannot assist" And NO ONE can tell us what this actually means. Since then, my broker, bless this man, has been communicating with Discovery trying to sort out this issue for us. Does he not send me the entire email chain between him and his contact at Discovery for the past 2 WEEKS. And then I read something that completely sent me into a rage. 1 line of a few words: "We received confirmation that the client is not registered for any chronic benefit" WHAT THE ACTUAL F***!!! She has been registered and on chronic treatment since January 2024!!! HOW ON GOD'S GREEN EARTH does Discovery not communicate with their other departments? It took me 5 minutes to phone their Chronic department and get the letter of approval for Chronic for my wife received on January 12 2024!

I'm at a loss. I'm defeated.

My wife, with a registered Chronic condition, who requires PMB admission to hospital, for a Chronic Care treatment, with a letter of motivation from the SPECIALIST, is being denied access to hospital for a time sensitive treament.

Discovery would rather see their patients suffer than give them what they need. Thank you Discovery. For absolutely nothing.