GL
Gareth L

1 reviews | Active since Jun 2013

16 Nov 2017, 15:54

No cover for more modern, safer and less invasive procedures

I was admitted to hospital on 30 September 2017 with severe appendicitis. I was operated on and had my appendix removed on the same day only a few hours after admission. Shortly before being wheeled into theatre the surgeon asked me what type of surgery I would prefer, open surgery, which is more dangerous, invasive and takes longer to recover from, or laparoscopic surgery which is basically two key hole incisions, is faster, safer, less invasive, is recommended and preferred by the surgeon and allows for faster recovery, i.e. a shorter hospital stay post-operation.

Fortunately I was conscious enough, despite having been given Morphine, and aware of how Discovery Health always try to cover as little as possible, so I said I would prefer laparoscopic surgery if my medical aid would cover, so the surgeons assistant made a quick phone call to check.

Not surprisingly, but to my disgust, Discovery Health does not cover laparoscopic surgery, and I had to have open surgery. This resulted in a 3 hour operation and 4 days in hospital to recover. Please can someone at Discovery Health explain the logic to me? You are a premium medical aid provider and charge premium rates, but when one of your clients needs emergency medical care, you cover only the older, more dangerous, more invasive medical procedure?

This makes no sense to me and adds to the feeling that Discovery Health cares very little for people's health and only really cares about their own profits. I have no problem with Discovery being profitable, even very profitable. I have a problem when there is a high personal cost being incurred by people, so that Discovery Health is profitable.

Regards, Gareth

0
Replies (3)
Discovery Health
Discovery Health's reply16 Nov 2017, 16:32
Official

Dear garethlawson

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 reply20 Nov 2017, 12:42
Official

Dear garethlawson

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

Regards
Discovery Health Servicing Team

GL
Gareth L's update20 Nov 2017, 14:41
Reviewer Update
While I do appreciate that someone phoned me and was quite understanding and helpful, all my kudos goes to that person who has this tireless job. To Umiksha who was tasked with phoning me as a complainant, you get 5 stars from me for the way you approached the phone call. Discovery, you are lucky to have employees/contractors like Umiksha working for you! Maybe I will submit another review giving the relevant department a good rating. As for the rating on this post, I still don't feel compelled to change it. It is noted that the information I received was not 100% correct and that Discovery Health will partially cover laparoscopic surgery. Ultimately, this was still a really bad experience for me, and the fact that I would have probably had a R7000.00+ co-payment to deal with had the surgeon's assistant not checked, makes it even more alarming. The surgeon seemed to think I would be fully covered.