mT
mpho T

1 reviews | Active since Aug 2016

27 Jan 2017, 09:17

medical aid not covering my pregnancy that i know about after i have joined and got a medical certificate

<p>on the 20/12/16 i joined and was approved by the discovery medical aid scheme which i had agreed to start payment on 01/02/17 </p> <p>on the 18/01/17 i got sick from work and find out i was pregnant which at the time i joined i did not know ,following that my doctor wrote a report which had proved that i did not know i was pregnant during the time i got my medical aid certificate .</p> <p>i than made the discovery aid know but to my surprise they will not cover the cost of pregnancy which am only due in AUGUST 2017 </p> <p>this are the certain pointer which i have in mind in terms of <br />1.having a condition and paying for a medical aid for duration of 2017 but not being able to get medical care <br />2.the right to better and quality medical care would be taken from me for my disclosure of the condition i did not know about when i signed up for the medical scheme on the 28/12/2017<br />3. my confidence to the discovery health care system <br />4.it is proven by my medical records that i did not know about my pregnancy before the 18/01/17 as i got sick from work and was sent home</p> <p>5.am an avarage south africa how will i afford to pay for my medical aid on a monthly basis and still afford to pay for my pregnancy costs </p> <p>6.what must i do cancel the medical aid so i can save that 2760 every month to afford to get me and myunborn baby the best medical care </p> <p>PLEASE HELP.</p>

0
Replies (5)
Discovery Health
Discovery Health's reply27 Jan 2017, 09:37
Official

Dear mphogtsotetsi

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.

Regards
Discovery Health Servicing Team

Discovery Health
Discovery Health's reply01 Feb 2017, 16:05
Official

Dear mphogtsotetsi

We can confirm that we have sent you final feedback by email.

Regards
Discovery Health Servicing Team

mT
mpho T's update02 Feb 2017, 10:34
Reviewer Update

Good day Miss M Tsotetsi

Your e-mail below has been referred to and reviewed, by the Risk Management Review Board, together with our file information.

You will note, as you have carefully perused the application form, that it is clearly stated that all pre-existing conditions including pregnancy, will be excluded for 12 months.

As required, you have informed us of your change in health prior to commencement of your membership. Due to this, we have now placed a condition specific exclusion on your membership.

The decision to apply the 12 month pregnancy exclusion, having been investigated and reviewed, is correct and confirmed.

Regards

Dr Theodore D Kretzmar

M.B. B Ch. Rand F.R.C.S. Eng F.R.C.S. Ed

Medical consultant

Clinical Risk Management

Discovery

Direct: +27 11 **********

E-mail: **********

http://www.discovery.co.za

good morning

i have received this repond i want to know being the the problem is i let discorvey know of my pregnancy prior to the 1st and apprently i should have kept quiet till the 01/02 would it have made any different

i have withdrwan my installement untill the matter has been finalised as am not rich and at this point i need to afford to pay my doctors visits ,i would understand a 3months waiting period and what inplication would this have on my unborn baby u**** delivery ,i need to know and this is an emegency so i see a way forward and start saving my monthly premiums and cancell my aid

Discovery Health
Discovery Health's reply02 Feb 2017, 13:00
Official

Dear mphogtsotetsi

Your concerns are important to us and we will be in touch soon with an answer to your comments.

Regards
Discovery Health Servicing Team

Discovery Health
Discovery Health's reply06 Feb 2017, 10:59
Official

Dear mphogtsotetsi

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team