1 reviews | Active since May 2016

16 Nov 2021, 08:02

No assistance for valid chronic request

My husband was diagnosed with Epilepsy in April 2019. I was not aware that he could go on chronic for this condition and was never informed by Discovery. After speaking to someone in the field, I was advised I could claim under chronic as the scheme will pay for the doctor visits and medication. Lockdown happened and I could not get the forms printed and completed. During the year he was diagnosed, I ran out of funds and had to pay for his medication and doctor visits from my pocket. Please refer to your records as I asked the pharmacy to put in a claim every time I paid to have it on record for tax purposes at the time. I would therefore like to request that the chronic benefit is backdated on the policy. I am aware that it can be backdated for a period of 3 years according to the Council for Medical schemes. I sent this request to Discovery in June already and have still not heard anything from them to date. They continue to take the funds from my medical savings every month. As a leading medical aid, I expect more. My fees are not cheap but I pay it hoping to have the assistance I need when I need it. I don't intend to back down until this is resolved. Why do I have to go to this measure to be assisted?

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Replies (3)
Discovery Health
Discovery Health's reply16 Nov 2021, 10:19
Official
Dear Lynn B

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 reply16 Nov 2021, 12:30
Official
Dear Lynn B

We have contacted you regarding your query 
   
Regards Discovery Health Servicing Team
's update16 Nov 2021, 13:39
Reviewer Update
Your contact to me serves to confirm that I need to have the forms refilled in in submit again and you will only pay for the chronic from the time you receive the forms. Tell me if you believe this is treating me fairly. You advise you sent the forms to my husband to complete when I am the one that submitted the forms and I am the main member on this policy. Why would you not reply to the address you received the request from? When my husband was in hospital and waiting to be diagnosed, you were quick to call up to see if it was necessary for him to be hospitalised. If only you were this quick to advise me of my right to claim a chronic benefit. I had to struggle to get the Neurologist to complete the forms and he has since changed Neurologists too. Like I said, I will not be accepting this treatment from you. I have given you fair opportunity to correct this situation and this is how you consider it resolved.