Questionable communication and Rules
I have a Classic Comprehensive health plan with Discovery. The claims were, and still are, unlimited above threshold benefits. Now, out of the blue, with absolutely no notification whatsoeve, they will only pay 50% of my medication unless I buy the cheapest possible generic (no matter how awful my doctor and pharmacist know them to be) and I have to buy from Clicks or Dischem. Since when and when did you notify us? I bet it was in the small print on page 67 of 100 page document explaining plan rules annd benefits and which even someone with a Doctorate Degree could not understand. If you phone their “help” desk the agent will read a litany of rules at breakneck speed which becomes impossible to decipher especially when they start explaining rules about diseases you don’t have and are not calling about.
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Replies (3)
Discovery Health's replyOfficial
09 Oct 2023, 05:19Dear Alun A
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
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's reply09 Oct 2023, 05:19
Official
Dear Alun A
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
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's replyOfficial
10 Oct 2023, 15:09Dear Alun A
We have been in touch with you to answer your comments.
Regards Discovery Health Servicing Team
We have been in touch with you to answer your comments.
Regards Discovery Health Servicing Team
Discovery Health's reply10 Oct 2023, 15:09
Official
Dear Alun A
We have been in touch with you to answer your comments.
Regards Discovery Health Servicing Team
We have been in touch with you to answer your comments.
Regards Discovery Health Servicing Team
's updateReviewer Update
11 Oct 2023, 07:25You have indeed been in touch with an individual who was defensive, blaming me for not using their App every month to double check a what they will and will not pay for and rattled off at machine gun speed the different rearing of medications Discovery have (I think it goes from 1 to 7 but I don’t know if this is a Discovery rating or the official schedule of the drug. We ended up shouting each other down as he wanted to get his point across and I wanted to get mine. It ended up being a pointless unpleasant “discussion” and I’m still not certain he understood that my Hellopeter complaint stemmed from a phone call to their support desk when I was categorically informed that only 50% was paid as I don’t use Medexpress and am buying my medication action from the wrong pharmacy (one I’ve been buying from for 25 years!). I stopped the discussion as it was pointless and unpleasant and, anyway, it’ll be much easier to pay for hospital cover only with Gap cover so I don’t have this mystery about what they will and won’t pay. Interestingly Morningside Clinic is one of their Network hospitals it even on the Classic Comprehensive we had to pay a R6000 co-payment. Overall I still claim that people talking at you reading lists of rules at breakneck speed is worse than no help at all….
's update11 Oct 2023, 07:25
Reviewer Update
You have indeed been in touch with an individual who was defensive, blaming me for not using their App every month to double check a what they will and will not pay for and rattled off at machine gun speed the different rearing of medications Discovery have (I think it goes from 1 to 7 but I don’t know if this is a Discovery rating or the official schedule of the drug. We ended up shouting each other down as he wanted to get his point across and I wanted to get mine. It ended up being a pointless unpleasant “discussion” and I’m still not certain he understood that my Hellopeter complaint stemmed from a phone call to their support desk when I was categorically informed that only 50% was paid as I don’t use Medexpress and am buying my medication action from the wrong pharmacy (one I’ve been buying from for 25 years!). I stopped the discussion as it was pointless and unpleasant and, anyway, it’ll be much easier to pay for hospital cover only with Gap cover so I don’t have this mystery about what they will and won’t pay. Interestingly Morningside Clinic is one of their Network hospitals it even on the Classic Comprehensive we had to pay a R6000 co-payment. Overall I still claim that people talking at you reading lists of rules at breakneck speed is worse than no help at all….