1 reviews | Active since Feb 2015
Hospital Cover
I have just found out when getting an authorisation number, that I have waiting periods which have been implemented, date of signing with the medical aid I was unaware of being pregnant, now that I found out and its time for me to give birth, I will not be covered for the birth of my child. It is terrible that I have medical aid and now have to go to a government hospital. Surely discovery can work out some sort of concession just to cover the birth. The service I have received about helping me as I am the client and I pay for my services. I should just cancel with Discovery and move to another medical company. Trying to get a hold of the CEO is crazy, his never available. People were suppose to call me back but nothing! I have a good mind of calling Adrian Gore to deal with this situation as its giving Discovery a bad name, and they strive on customer service. Its not like I took out the medical aid just cause I was pregnant and I didnt intend on leaving the medical aid after the birth of the baby, but I might just leave before that.
Thank you for allowing me the opportunity to assist you.
As discussed, the Scheme is not disputing whether you knew you were pregnant at the time of the policy. We are merely applying the risk management rules. The rules state that if a member is more than 9 weeks pregnant at the time of accepting the policy, we will apply a condition specific waiting period.
When you apply to become a member on the Scheme, your application is subject to Underwriting. Underwriting is a risk management tool that assists medical schemes in maintaining their long-term sustainability. According to the Medical Schemes Act, a Scheme may not differentiate against members with their contributions based on their health status. The Act allows Schemes to implement waiting periods to contain risk and ensure the long-term sustainability of the Scheme. Discovery Health's role is to fund affordable and sustainable health care for our entire membership base.
I am sorry that we cannot offer you a different outcome to your query.
Kind regards
Danita
Thank you for allowing me the opportunity to assist you.
As discussed, the Scheme is not disputing whether you knew you were pregnant at the time of the policy. We are merely applying the risk management rules. The rules state that if a member is more than 9 weeks pregnant at the time of accepting the policy, we will apply a condition specific waiting period.
When you apply to become a member on the Scheme, your application is subject to Underwriting. Underwriting is a risk management tool that assists medical schemes in maintaining their long-term sustainability. According to the Medical Schemes Act, a Scheme may not differentiate against members with their contributions based on their health status. The Act allows Schemes to implement waiting periods to contain risk and ensure the long-term sustainability of the Scheme. Discovery Health's role is to fund affordable and sustainable health care for our entire membership base.
I am sorry that we cannot offer you a different outcome to your query.
Kind regards
Danita