Just another member...

Dear person if you care,

I am now a member for almost a month, after numerous emails send and calls, I still do not understand some of the values. One thing is said, “Your health is everything” but in my case, it feels like, another member who cares? Well I do. I have two small children without a break in coverage, born on my previous medical aid. Did choose the Classic Comp option so that they are covered. I asked if my pharmacy is on the network, the answer was yes. Now sitting with a R2500 bill, I was forced to move to a hospital plan because of a waiting period. Now I am being forced to move from a pharmacy that actually cares to just another patient from whoever? “Convenient medicine ordering service´ yes, my pharmacy is very convenient should you have wondered which I dealt. I had a trigger due to stress on my hand that it actually cracked open. Have photos to prove it. My youngest son is ok for now, but kids are kids and with the weather, I wanted to make sure that they are covered from the beginning. Now, my eldest which barely gets sick, is sick. And now? It is my problem as no one cares. On my previous medical aid, family took care of family but I am in the industry and shop around yearly on medical aids. Prevention is better than cure someone said to me from Discovery. I waited and ended up as a PMB. Waiting period and I know my children. I quote again “In a global study by Deloitte, Discovery Health Medical Scheme has been ranked among the top 3 health insurers in the world since 2008, based on financial security, contribution levels, membership and innovation.” To go further, the meaning of innovation, "innovation is crucial to the continuing success of any organization". Saying that, belonging to an organization, that do not care, I can willing leave. Should I? Maybe. If a member has a history of PMB’s, why be penalised? Did the member ask for it? No. Was is self-inflicted? No. Does the member want to be in the health situation? Obviously not by common sense. Saying that, common sense is not always common sense? Let me quote again “Access to wide ranging benefits, care programs and services that ensure you and your doctor can access the best healthcare available when you need it.” which by the way I just took out the spelling mistake. In black and white as a sales thing or do you live by it? In my case, dear member, your health is your problem. We do not care. You are just another member of the thousands of other members. Nice! “The very latest digital health technology that empowers you and your doctor to manage your health and your health plan, anywhere, anytime.” Funny, been struggling for a month. This new just another member which health is not anyone’s problem but the members own. Some of my queries ignored, some auto responses and some still unresolved. The only tools and services to improve my health at the moment is another cigarette combined with an Urbanol. Lekker man lekker. The only “Quality care in the comfort of your own home” I am getting is a stress level which increase my blood pressure. But who cares? When I decided to make the move, I asked about the waiting period because of value-added healthcare, the only value I got was hassles, drama and no answers. A waiting period applicable, a huge account at the pharmacy, a sick child and more stress. Dictated, challenged my knowledge with no answers as stated previously. All I asked was please do not add a waiting period. Who does that on a child? A child with a history of pneumonia which was admitted numerous times (PMB) and by avoiding it not to add. I declared my whole pedigree. Even non-existing conditions. We did not ask for conditions carried over born with a strong family history. We do not get to choose our parents history, just the way we cannot see into the future. As an honest person, should I have **** on my application? No, obviously not because I am not that kind of person. Did we ask to bury my sister and father and 12 other people we know the last 6 years? Obviously not. With that, a child with a strong lung history which is now 1 year and 9 months, another 5. We pay for the savings, of would have, but someone decided just another member. What would you do if you were in my shoes? If this was your family, your children? Did I ask to stop my dad’s resuscitation in October, no, but I had to. Did I ask for my sister’s body to be kept on the ground until my mom arrives, no, but I had to. Did I ask to call my dad to tell him his child is dead? No, yet I had to. Did I ask to wake up in a burning house, a gun to my head, car accidents many years ago, fell of a horse and only after pregnancy my back gave problems, break-in, attempted hi-jacking etc. No. But it happened. What I did ask, and pleaded by even begging (which I never do) to please wave the waiting period. What happened. Just another customer. Who cares? Yes, protect the risk pool. PMB’s get paid out of the risk pool, so why can I then not have access to savings? The one thing that is fascinating, I was asked to get a script for both my children for Sintair 4mg by a paediatrician. The one person told me, Discovery will cover, the other told me no? So, what is the answer? If I was asked for info, that was authorised on my previous medical aid, but not good enough for you, why should I cover the costs? If I was asked to complete the chronic application forms, why should I be charged if I have send the authorisation letters?

I wonder. Like I said. One says this, the other that. Do I need it, unfortunately? Do I want to need it? No ways! Now, I quote again;

“Discovery Health has eight core values:

Good business judgement. Optimism and Innovative practices. Exceptional Staff. Bringing out the best in people. Fairness integrity and honesty. Smart leadership. Urgency, drive and tenacity. The ability to amaze clients.”

Judgement made on what clinical principles? Non-existing conditions? Applications that had to be send over and over and over? Optimism, hopefulness and confidence about the future or the success of something. The only success in future I see is hopeless. After this past month? Unless proven otherwise. Ah, sorry, just another customer. Exceptional staff, some yes, some, I personally think should maybe, let me rather not say something bad. But, exceptional two people. They stand by the core values. Thank you. Then others. Bringing out the worst in me. Unfairness, dishonesty, empty promises and no integrity. Just another customer. A leader is supposed to inspire others, make sound decisions and not just passing the buck with an automated response or ignoring conflict but to resolve the issue? Where is the leadership communication in this? How can a mission and goal be reached if nothing is done? I am one customer with two dependents. How many other customers? A strong leader has to have passion in what they are doing. The only passion I see is maybe a holiday coming soon for the leader that I am referring to. Not the main leaders, but if the bottom leaders cannot resolve a simple issue, or ignore you, I cannot help but wonder. If a leader answers an email like this and I quote “I have taken note of your comprehensive e-mail. I must however refer it to Discovery Health as I cannot make any decision in this regard. My request is that you direct all enquiries to ********** and the response I get is automated. "To make people healthier and to enhance and protect their lives". Not so sure, well it definitely does not feel that way. The only urgency, quality and drive I see is blank. Not amazed at all! How can I? Amazed by two people so far out of how many? But even they get a smack on the hand for going the extra mile, no, more than the extra mile and being falsely accused of giving me information. Guess what, google is your friend. I have proven to the so called leader as referred to above where I got the information and that he falsely accused his own staff member of providing inside information. Is this called smart leadership?

Be smart, live healthier. Sure. Please do so that we do not have to help you dear customer as we do not care. This is how I experienced one of the top medical aids in South Africa out of how many? Now you probably wonder, women seriously, then change. You tell me. Should I? I don’t know. My previous medical will gladly take me back with open arms. I can be on any one, but out of how many open schemes, I made a choice to be part of you. How do you handle it? As if you do not want me? Talk about being special. We are not a risk, we are a small family, me a mom asking you, what would you do if you were in my shoes.

Please do not hesitate to answer me. Should you do not care, please confirm so that I can then go to someone that does. I you don’t care; my family is my everything and will not stand for this. Should you need my medical aid number, ask. But seeing that someone looked into my husband’s profile without giving any information, I am sure you can figure out who I am as the member. This just another one with two small children. You are more than welcome to contact the principal’s office as this was email to them as well.

Regards

Just another member.