NO financial assistance for a benefit urgently required!!

Pity there isn't a zero to select... We have been with Discovery Medical aid for nearly 12 years. Over the past few years their service has just gone from bad to worse…and I know I am not the first member to note that. We pay a fortune in premiums every month with no subsidy from our employer so the premiums are paid directly from our own pockets. I feel that Discovery medical aid is a medical aid that has lost all sense of compassion for helping its member with much needed claims payment assistance. My daughter has a learning disability and is in desperate need of speech therapy lessons. She has been attending lessons for 6 years now of which we have paid most of those costs and we are now at a stage where we are finding it difficult to afford these lessons which are vital for her. We tried to apply through the PMB benefit, with the necessary motivation etc but were told there is no cover for this under the PMB benefit. This even after one of your consultants spoke to the speech the****** herself and the speech the****** explain why these lessons are so vital for my daughter and how stopping the lessons would be to her detriment… Funny how depression, anxiety etc can get covered under this PMB benefit, but something as vital as support for learning disabilities isn’t. Strange but true story. We were then advised to try and claim through an ex gratia benefit, which we did and were given an email address to send all the necessary documentation through to. This was done on 5 September 2021. 5 days later after phoning in for about the 100th time…oh no you sent it to the wrong email address but that was the address I was given by Discovery….so I resubmitted to the ‘new’ email address given to me on 10 September. From mid September I start phoning in every second day, I kid you not and at times holding for up to an hour to find out if there has been any progress. Alas every time being pushed from pillar to post. After sending an email to *** finally someone makes contact with me. Promising to have an answer soon and saying they understand my frustration of no feedback etc…but I still wait and have to phone in again and again. After my phone call this past Tuesday 5 October and yet another rant….I was then told I should have an answer by Friday 8 October. After submitting all the relevant information that was required by Discovery including all our monthly expenses and showing Discovery how we are in the red (negative bank balance - because of these vital lessons) we received a letter from Discovery saying regrettably your request has been declined. I really this this is totally unfair. We pay so much in premiums every month and when it comes to the crunch of vital support and help that we so need from the medical aid….so help and support is forthcoming. There are so many things that are NOT covered so what is the point of actually having this medical aid??? Don’t let me get started on Covid tests that are covered in full if done at a Dischem outlet, but if done at another testing station are not covered in full. Really??? Even after the doctors rooms had to change their invoice 5 times - no sorry still not correct and won’t be paid in full!?!? I am just so over this all the time and effort one spends to try and get hold of someone at the call centre, being pushed from pillar to post and trying to get the help and assistance – it is actually just exhausting!!!!

Oh another thing when my oncologist requested blood tests to be done to check levels after I was Covid positive – ummm sorry those are not covered under your Covid or Oncology benefit….seriously?!?! You have got to be kidding me?!?!

I think the best thing to do is to look for another medical aid and soon as this is now beyond a joke!