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mishka O

1 reviews | Active since Nov 2012

30 Dec 2025, 21:14

Paying Monthly but No Cover: Repeated Billing Errors, Missing September Payment & Claims Denied

Title: Paying Monthly but No Cover: Repeated Billing Errors, Missing September Payment & Claims Denied

I am at my wits’ end with Discovery Medical Scheme and feel completely failed as a paying member.

I have been paying my medical aid premiums consistently throughout the year, yet my account is repeatedly marked as unpaid, my benefits are suspended, and my claims are denied. Each time I try to resolve this, I am given different and conflicting explanations, none of which actually fix the problem.

The main issue has been my September payment, which left my bank account months ago. I have submitted proofs of payment and full bank statements multiple times, yet Discovery still claims they “cannot find” this payment. This same September issue resurfaces over and over again, despite previous assurances that the matter was resolved.

To make matters worse: • I have now made 14 payments within a 12-month policy year, which does not make sense. • I am repeatedly told the problem relates to the debit order date, yet no one can explain how that justifies extra payments, suspended cover, or denied claims. • My Discovery and Vitality access is frequently inactive. • When I submit claims, they are rejected for multiple reasons, often because the account reflects as unpaid or inactive. • I feel like I am paying every month for absolutely nothing.

I have spent hours on calls trying to sort this out, including a recent call lasting nearly 2 hours, and I have requested management call-backs multiple times. No manager ever gets back to me. I only ever speak to consultants, each of whom gives a different explanation.

At this point, my trust in Discovery is completely broken. I am paying premiums, but I have no reliable cover and no confidence that claims will be honoured. I am seriously considering moving my medical aid elsewhere purely because this issue has dragged on for months without accountability or resolution.

I am posting this publicly because private emails and calls have achieved nothing.

All I am asking for is: • My payments to be correctly reflected • My benefits to remain active • My claims to stop being denied due to Discovery’s internal billing errors

Right now, none of that is happening.

0
Replies (33)
Discovery Health
Discovery Health's reply31 Dec 2025, 07:01
Official
Dear Mishka O

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
mO
mishka O's update31 Dec 2025, 11:57
Reviewer Update
Title: Manager Refused to Speak to Me While Account Remains Suspended

Adding to my ongoing complaint because the situation has worsened.

This morning I spoke to Zowta from KeyCare, who confirmed she cannot put me through to a manager. I was explicitly told that the manager refused to come to the line and instructed that I must “follow the process”.
This is while:
  • My membership is suspended
  • I am a paying customer
  • I have urgent claims pending
  • This same issue recurs every single month

I asked that my call from this morning be reviewed, as it clearly reflects that I attempted to escalate appropriately and was blocked from doing so. Being told to “follow the process” is meaningless when the process has failed repeatedly for months and leaves me without cover. Refusing managerial escalation while suspending a member’s benefits is unacceptable. Once again, I am left without assistance, without cover, and without accountability. I am documenting this publicly because Discovery’s internal channels continue to fail, and I am being actively prevented from escalating this matter despite ongoing financial prejudice.
mO
mishka O's update31 Dec 2025, 11:59
Reviewer Update
At one point, Discovery even attempted to terminate my membership entirely, claiming that they had not received three months of payments. This was despite the fact that I immediately submitted proofs of payment and full bank statements, including statements from Discovery Bank itself. Even after providing this documentation, the issue was not conclusively resolved and continues to resurface. Being threatened with termination after paying and submitting bank-issued proof is deeply concerning and has completely eroded my confidence in Discovery’s billing and escalation processes.


mO
mishka O's update31 Dec 2025, 12:01
Reviewer Update
I cannot continue being endlessly without medical cover while still paying premiums just to “satisfy” Discovery. Every month a new outstanding amount suddenly appears, I am told payment was “not received”, and my membership is suspended yet again. This cycle has been repeating for months and is never permanently resolved.
This is now critical. I am dealing with an urgent medical situation and I need access to cover immediately, which I am currently not receiving, despite being a paying member. Discovery is showing zero sense of urgency, and with public holidays approaching, I am being told to wait days while sitting without medical cover.
This is not acceptable. A medical scheme cannot repeatedly suspend a member, deny claims, and delay reinstatement while still accepting premiums. I need my membership reinstated immediately while Discovery resolves its internal billing issues. I cannot wait another 2–3 working days without cover.

mO
mishka O's update31 Dec 2025, 12:10
Reviewer Update
I was further advised by Kiso Gqadu that he does not know when the billing department will get back to me, how long the process will take, or when (or if) my membership will be reinstated. I was explicitly told that my account will remain suspended in the meantime and that they “do not know what to do further.”
This is despite previous consultants repeatedly assuring both myself and my broker that the matter was “fully sorted.” I was told that beyond this point, he is not able to advise, and that there is no specific turnaround time that can be provided.
This exact process has been followed before, with the same promises and the same lack of outcome. It was not resolved then, and there is no confidence that it will be resolved now.
As it stands, I am left without medical cover, with no timeline, no accountability, and no escalation path.

This is not the first time in trying to sort this out this is months of this issue .
mO
mishka O's update31 Dec 2025, 12:11
Reviewer Update
5 January

• 26 February

• 10 March

• 7 April

• 19 May

• 28 June

• 25 July

• 25 August

• 30 September

• 24 October

• 20 November

• 25 November

• 6 December

• 22 December


Discovery Health
Discovery Health's reply31 Dec 2025, 12:36
Official
Dear Mishka O 

We are busy investigating your query and will contact you soon.

Regards 
Discovery Health Servicing Team
mO
mishka O's update31 Dec 2025, 12:49
Reviewer Update
This is unacceptable you guys have been investigating since October for the same query .
mO
mishka O's update31 Dec 2025, 12:49
Reviewer Update
TracelD
***FD0A7C***F906 Trace ID for September payment which was done by actioned debit order from discovery .
mO
mishka O's update31 Dec 2025, 12:50
Reviewer Update
I have been told the billing department is not working .
mO
mishka O's update31 Dec 2025, 12:50
Reviewer Update
Call with discovery yesterday 1 hour 49

Call with discovery today 1 hour 6 minutes and counting .

Previous calls - endless
mO
mishka O's update31 Dec 2025, 12:55
Reviewer Update
Through all this my account remains suspended . And no help for months from the billing department on the same issue
mO
mishka O's update31 Dec 2025, 13:13
Reviewer Update
I have been left on hold for the last 19 minutes .
mO
mishka O's update31 Dec 2025, 13:13
Reviewer Update
Sorry 29 minutes.
mO
mishka O's update31 Dec 2025, 13:24
Reviewer Update
Current call time 1 hour and 40 minutes . Hold time 40 minutes and counting .
mO
mishka O's update31 Dec 2025, 13:43
Reviewer Update
After 2 hours they cut the call . Now what do I do
mO
mishka O's update31 Dec 2025, 15:00
Reviewer Update
Kiso Gqadu Kept me on hold for an hour . The fall then cut from then to now - no call back. And I can’t get through to anyone
mO
mishka O's update31 Dec 2025, 15:07
Reviewer Update
I’ve been sitting on the phone since 10 am to now which is 15.06 with no help . No assistance . No call back . A suspended account and I’m tired . No one is is assisting . I have an urgent procedure to be done and NO one is bothered in the least .
mO
mishka O's update01 Jan 2026, 08:40
Reviewer Update
Title: Investigating Since October. 14 Payments Made. Still Suspended. Left on Hold for 48 Minutes With No Call-Back

I am posting yet again because Discovery Medical Scheme continues to suspend my membership despite months of investigation, repeated escalations, and full payment.

This issue has been under “investigation” since October, yet nothing has been resolved. I am exhausted, frustrated, and now without medical cover during an urgent medical situation.

I spent over 2 hours on the phone yesterday, dealing with the exact same query that has already been escalated multiple times with no outcome.

This was preceded by a separate 2-hour call the previous day with manager Sanele Tenza (reference number ***). During this call, Sanele Tenza stated that there was nothing he could do. I was once again taken through the same exercise of listing all payments made, only to be told yet again that September is outstanding, despite this being a 14th payment in a 12-month policy period.

I cannot understand how my account can remain suspended under these circumstances. Even if Discovery claims one payment has not been allocated, there are 13 other payments already made for a 12-month period, which should more than cover my premiums. Yet my membership remains suspended and I am left without medical cover.

During the most recent call, I was assisted by Kiso Gqadu, who:

  • Confirmed that my bank statements clearly show the September debit order left my account
  • Confirmed that the payment was not returned
  • Took down the debit order trace ID after I insisted that Discovery contact billing directly
  • Advised that he would contact billing and escalate the matter to a higher-level manager
After this, I was placed on hold for 48 minutes in one continuous hold, specifically while he stated he was contacting billing and escalating the matter. There were no updates or check-ins during this time. The call was eventually cut off, and Kiso Gqadu did not call me back. I am formally requesting that this call be reviewed, as this level of service is unacceptable. Being placed on hold for 48 minutes under the premise of escalation, only to be disconnected with no follow-up, is not reasonable and does not demonstrate any genuine attempt to resolve the issue. I was explicitly advised by Kiso Gqadu that:
  • He does not know when the billing department will get back to me
  • He does not know how long the process will take
  • He does not know when or if my membership will be reinstated
  • My account would remain suspended in the meantime
  • There is no turnaround time
  • Beyond this point, he is “not able to advise”
This is despite multiple previous consultants repeatedly assuring both myself and my broker that the matter was “fully sorted.” This exact process has been followed before. The same assurances were given. It was not resolved then, and there is no confidence that it will be resolved now. This is not a once-off issue. This has been happening for months. Every month:
  • A new outstanding amount suddenly appears
  • I am told a payment was “not received”
  • My membership is suspended again
  • Claims are denied
  • I am forced to repeat the same process from the beginning
I cannot continue being endlessly without medical cover while still paying premiums simply to “satisfy” Discovery. This situation is now critical. I am dealing with an urgent medical issue and need access to cover immediately, which I am currently not receiving, despite being a paying member. Discovery is showing zero sense of urgency, and with public holidays approaching, I am being told to wait days while sitting without medical cover. A medical scheme cannot repeatedly suspend a member, deny claims, and delay reinstatement while still accepting premiums. I need my membership reinstated immediately while Discovery resolves its internal billing failures. I cannot wait another 2–3 working days without cover. I am posting publicly because private channels have failed completely, and I am now being actively harmed by Discovery’s lack of urgency, accountability, and basic logic.
mO
mishka O's update01 Jan 2026, 08:41
Reviewer Update
Title: URGENT: Paying Member Left Without Medical Cover. 14 Payments Made. Still Suspended Since October

This complaint is now urgent and relates to a serious failure of duty of care by Discovery Medical Scheme.

My account has been under so-called “investigation” since October, yet I continue to be suspended month after month, despite having paid 14 premiums in a 12-month policy period. I am currently without medical cover during an urgent medical situation, while Discovery continues to delay, deflect, and hide behind internal processes.

Over the past two days alone, I have spent more than four hours on calls trying to resolve the same issue that has already been escalated multiple times with no outcome.

The day before yesterday, I was on a 2-hour call with manager Sanele Tenza (reference number ***). He stated plainly that there was nothing he could do. I was again taken through the same pointless exercise of listing all payments, only to be told yet again that September is “outstanding”, despite this being a 14th payment in a 12-month period.

This makes no sense. Even if Discovery claims one payment has not been allocated, there are 13 other payments already made, which fully cover a 12-month policy year. There is no logical or contractual basis for my membership to remain suspended.

Yesterday, I then spent over two more hours on the phone with Kiso Gqadu. During this call:

  • He confirmed that my bank statements clearly show the September debit order left my account
  • He confirmed the payment was not reversed or returned
  • He took down the debit order trace ID
  • He stated he would contact billing and escalate the matter to a higher-level manager
After this, I was placed on hold for 48 minutes in one continuous hold, specifically while he claimed to be contacting billing and escalating the issue. There were no updates, no check-ins, and no urgency shown. The call was then cut off, and Kiso Gqadu never called me back. I am formally requesting that this call be reviewed, because this level of service is completely unacceptable. Placing a paying member on hold for 48 minutes under the pretence of escalation and then disconnecting the call with no follow-up is indefensible. I was explicitly told by Kiso Gqadu that:
  • He does not know when billing will respond
  • He does not know how long the process will take
  • He does not know when or if my membership will be reinstated
  • My account will remain suspended in the meantime
  • There is no turnaround time
  • Beyond this, he is “not able to advise”
This is despite previous consultants repeatedly assuring both myself and my broker that the matter was “fully sorted.” This is not a once-off mistake. This has been happening for months. Every month:
  • A new outstanding balance suddenly appears
  • I am told Discovery has “not received payment”
  • My membership is suspended again
  • Claims are denied
  • I am left without cover
  • I am forced to start from scratch
I cannot and will not continue being endlessly without medical cover while still paying premiums just to “satisfy” Discovery. This situation is now critical. I have an urgent medical matter that requires cover immediately. Instead, I am being told to wait days, over public holidays, while Discovery shows zero urgency and keeps my account suspended. A medical scheme cannot lawfully continue accepting premiums while repeatedly suspending a member, denying claims, and offering no reinstatement timeline. I am demanding immediate reinstatement of my membership while Discovery resolves its internal billing failures. I cannot wait another 2–3 working days without medical cover. I am posting publicly because every internal channel has failed, and Discovery’s lack of urgency, accountability, and basic logic is now placing me at real medical and financial risk.

Friday will be two working days since sanele said he needs 2-3 working days ( an excuse I’m hearing since October from different consultants )
mO
mishka O's update01 Jan 2026, 08:45
Reviewer Update
Please note I did try dialing back and remained on hold with no response from ANYONE
mO
mishka O's update01 Jan 2026, 11:18
Reviewer Update
What is it that I need to do to get my medical aid on? I can’t be sitting without a medical aid .
mO
mishka O's update01 Jan 2026, 11:28
Reviewer Update
I have done an additional payment of 2000 - to make sure my medical aid is not suspended which means I have done 14 payments and a further R2000 whilst this is investigated .

Thanks, I've sent your documents to the correct team. Your reference number is ****.*

It takes up to 3 days to process them and we’ll let you know once we're done.
mO
mishka O's update01 Jan 2026, 11:42
Reviewer Update
Further update and correction, which makes this situation even more unacceptable:

Today, in an attempt to prevent yet another suspension and to protect myself from being left without cover, I made additional payments as follows:

  • R2 000
  • R156 (medical aid)
  • R514 (Vitality)
This is on top of the existing premium already reflected for January (R2 957). This means that for January alone, I have now paid a total of: R2 957 + R2 000 + R156 + R514 = R5 627 As a result, I have now made 15 payments within a 12-month policy period. Despite this, Discovery still claims that my September debit order payment remains unallocated on their system, even though:
  • The funds left my bank account
  • The payment was not reversed
  • Bank statements and proof have been submitted multiple times
  • A debit order trace ID was provided
  • Discovery has had months to resolve this
At this point, there is absolutely no justification for my account to be suspended. Even if Discovery insists on disputing one payment, there are more than enough payments on record to fully cover a 12-month policy period. Continuing to suspend my membership under these circumstances is illogical, unreasonable, and unacceptable. I am a paying member who has now significantly overpaid, yet I am still being left without medical cover and with claims being denied. My account should NOT be suspended under any circumstances while Discovery resolves its internal billing failures. This situation has gone far beyond an administrative error. It is now a case of a medical scheme accepting money while withholding cover, and it needs to be addressed immediately.
mO
mishka O's update01 Jan 2026, 11:49
Reviewer Update
Further update and correction, which makes this situation even more unacceptable:
Today, in an attempt to prevent yet another suspension and to protect myself from being left without cover, I made additional payments as follows:
  • R2 000
  • R156 (medical aid)
  • R514 (Vitality)
This is on top of the existing premium already reflected for January (R2 957). This means that for January alone, I have now paid a total of: R2 957 + R2 000 + R156 + R514 = R5 627 As a result, I have now made 15 payments within a 12-month policy period. Despite this, Discovery still claims that my September debit order payment remains unallocated on their system, even though:
  • The funds left my bank account
  • The payment was not reversed
  • Bank statements and proof have been submitted multiple times
  • A debit order trace ID was provided
  • Discovery has had months to resolve this
At this point, there is absolutely no justification for my account to be suspended. Even if Discovery insists on disputing one payment, there are more than enough payments on record to fully cover a 12-month policy period. Continuing to suspend my membership under these circumstances is illogical, unreasonable, and unacceptable. I am a paying member who has now significantly overpaid, yet I am still being left without medical cover and with claims being denied. My account should NOT be suspended under any circumstances while Discovery resolves its internal billing failures. This situation has gone far beyond an administrative error. It is now a case of a medical scheme accepting money while withholding cover, and it needs to be addressed immediately.
mO
mishka O's update01 Jan 2026, 11:51
Reviewer Update
Dear Client

This is an automated response to confirm that we have received your request.

Your reference number is ***

One of our Client Relationship Managers will attend to your request and respond by email or contact you telephonically.

Kind regards
Discovery Health
mO
mishka O's update01 Jan 2026, 12:00
Reviewer Update

Dear Client

This is an automated response to confirm that we have received your request.

Your reference number is ***

One of our Client Relationship Managers will attend to your request and respond by email or contact you telephonically.

Kind regards
Discovery Health
mO
mishka O's update02 Jan 2026, 10:23
Reviewer Update
As per my call this morning, I was advised that no one could assist me at the time.

Jayden took my call under reference number *** and informed me that someone would call me back to investigate what is happening.

To date, nothing has been done and I have received no follow-up.

I urgently require assistance with the following unresolved issues:

1. My debit order date has still not been moved to the 25th as requested. Despite making double payments, this has not been corrected. I was charged twice in November on two separate dates and twice again in December.

2. There is currently no debit order coming through, and I have not been given any explanation for this.

3. My additional payments are unaccounted for. Based on the payments made, my account should be in credit. Please confirm where this money has been allocated.

4. The September payment is still missing. I have already provided the trace ID, bank statements, and proof of payment. Billing has had this information since October, yet the payment has still not been allocated.

This situation has been ongoing for months and is unacceptable. I require a clear written response confirming what actions will be taken and when this will be resolved.

Please treat this matter as urgent.

Kind regards,
Mishaka
mO
mishka O's update02 Jan 2026, 16:06
Reviewer Update
I have called in with no help. I was promised 2 call backs . It’s 16.06 - this was at 10am and still NO CALL BACK
Discovery Health
Discovery Health's reply07 Jan 2026, 10:36
Official
Dear Mishka O

Please check your emails for feedback from us.

Regards 
Discovery Health Servicing Team
mO
mishka O's update07 Jan 2026, 11:54
Reviewer Update
Hi the feedback is holly insufficient, I paid 2957- it says 2100 in credit to my account .
Was my vitality 857????
Further it doesn’t say September was now allocated .
Further it’s not saying why I’m not being debited on the 25th? When I paid double premiums 2 months in a row.

Further agents keep calling me not knowing what’s going on
mO
mishka O's update07 Jan 2026, 13:42
Reviewer Update
There’s no way to contact you guys
Discovery Health
Discovery Health's reply15 Jan 2026, 10:42
Official
Dear Mishka O

Please check your emails for feedback from us.

Regards 
Discovery Health Servicing Team