Discovery wrongly taking Money out of my MSA

Dear Anybody from Discovery who cares enough

It has been FIVE months of me telling DISCOVERY that you incorrectly took money out of my savings account. R9 000 rand is what you took from me. I want to say ***** from me, but was advised not. So ill just say took.

Long story short - i have been approved for a kidney transplant. Discovery approved it as part of the Transplant Benefits. I was sent to do bloodtests, and BOOM R9 000 gets taken out of my MSA. No prior warning, no headsup, not even a quote so that i can financially prepare myself for this... just take take take.

DOnt think i can PHONE anyone to clear this up... no no no. No phoning. So its emails....5 months worth of emails. Of Discovery not really knowing or caring what is going on. And this morning i get an email (from a sender i cannot reply to) saying that:

The claim has been part-paid from the Medical Savings Account (MSA) because the claim has been processed according to the attached approval.

WOW - really!? This is EXACTLY what me and my husband are trying to tell you... for FIVE MONTHS now?

What i have been TRYING to say to you is that DISCOVERY approved my TRANSPLANT in Feb according to the TRANSPLANT BENEFITS. YOU SENT me to do bloodtests and never was I informed that I need to pay R9 000 out of my own pocket. How can you think its right to just TAKE money without asking or explaining?! We were told by the transplant coordinator that we won't be paying for these tests and that Discovery gave approval in going ahead.

And now you dont want to pay for it......after you APPROVED it?! Tests that YOU need in order to go ahead with MY transplant. Why are you not understanding this?!

Can you understand that you are causing a SICK person a lot of unnecessary stress in trying to figure this out for FIVE months now? Is this how all of your clients are treated? I have been a client of this medical Aid for more that 15 YEARS.... monthly paying my premium - NEVER EVER have i skipped. Now that the going gets tough and i need a transplant - you fail me.

What i dont understand is that Kidney transplants are happening all the time? The way that discovery is dealing with my situation really looks like you have never ever dealt with something like this before? As if this is new to you? Don't you do this the whole time - approve a transplant, send people for bloodworks, pay for it according to what is approved? Why were tests performed that were not approved according to you now? Why has tests been done that were not covered. Who requested these tests that were not part of the approval? Why were we not informed of the co-payment prior to the tests being performed?

What went wrong here? Why is this SO HARD for you and your team to figure out? Or do you normally take R9 000 from people that is just too sick to fight it?

I havent been supp**** a quote for the tests - no one told me that I will be responsible for R9 000 personally. That is ALOT of money. How must i know what is approved and what not? I received a transplant approval from discovery and was sent for tests. I was also told Discovery covers everything?

Stop telling me that: The claim has been part-paid from the Medical Savings Account (MSA) because the claim has been processed according to the attached approval....what does that even mean?

Then your mail states: This means that if the procedure and diagnosis code do not match an approved code, or if the frequency limit has been reached, the claim is funded from available MSA... i KNOW THAT - that is what i have been TELLING YOU this past five months. So now you basically just sent me an email to say what i have been saying??? I have been saying that you SHOULD NOT have taken it out of my MSA. because YOU approved these tests before i went for it, that is why you should pay for the ENTIRE AMOUNT. YOU ASKED FOR THESE TESTS TO BE DONE IN ORDER FOR ME TO CONTINUE WITH A TRANSPLANT.

ALL you are doing in sending this email ....is just stating the obvious and not coming to a solution. You basically told me nothing changed?

You also have a cheek to ask my doctor to write appeal letters or to even ask me to APPEAL for something that you clearly *****ed up. My doctor is busy fighting the third covid wave. He is exhausted, tired and not LUS for this admin. I am also exhausted, tired and not LUS for this admin - im a sick person and it really seems like Discovery couldn't care less?

And 'conveniently" i cannot phone or email any of you.... as you are sending emails from generic addresses or the only number available is a useless call centre.

This is not on. And this is not how you treat sick people or your loyal clients of the past 15 years. Nikki