False Advertising

Good Morning

I have been hard at work trying to get a pre-authorisation approved by your medical aid in order to have a serious maxillofacial surgery performed as I have a retention cyst in my right maxillary sinus of over 8 cubic centimeters; that is affecting my sight, I have constant nose bleeds and sinusitis and am in constant pain.

I have been to a specialist in order to have the matter assessed. He has written a letter of motivation along with my X-ray and CT Scans. This was an out of network specialist who practices at one of your advertised in network day hospitals.

I am due for surgery on 29 September 2017. But to my shock, Discovery denied my authorization request. After many hours of research and several phone calls - it was confirmed by every maxillofacial oral surgeon advertised as an in network provider for KeyCare Plus, that NONE of them in fact are. Although they are listed on the website, KeyCare has denied every authorization request made by patients through these specialists. I have attached a screenshot of the page from Discovery's website. I was in contact with a representative from Discovery's client service department, who informed me that the website is updated monthly. How then is it possible that an entire list of specialists are advertised incorrectly?

I am currently awaiting Cure Day Clinic's reply in order to find out whether they are in fact a KeyCare Network Day Clinic or not.

So far, the operation will amount to R30,000.00 out of my own pocket. As an educator, how am I supposed to afford that? If I had put the thousands aside that I have paid to Discovery for medical cover, I would have been able to afford it. I am left with no other options and no assistance from Discovery's side.

Needless to say I am highly disappointed in the false advertising and the fact that my package does not include what is advertised, nor are the advertised specialist in fact affiliated with the scheme. It seems a serious violation of the Consumer Protection Act and will have to be taken further.

Regards Carla-Lene Cronje