HV
Hendrik V

1 reviews | Active since Nov 2012

15 Sept 2025, 22:47

Refusal to pay claim for CPAP machine

I was diagnosed with Obstructive Sleep Apnea (OSA), a serious condition that poses significant health risks, including severe cardiovascular disease. Discovery Health covered the diagnostic tests, and following medical advice, I was prescribed a CPAP machine due to the severity of my OSA.

Given the seriousness of this condition, I had hoped that Discovery would cover the cost of the device. However, my claim was declined, and I was forced to pay for the CPAP machine out of my own pocket. I lodged a dispute regarding this matter, but as the feedback was not positive, I have now escalated the case to the Medical Aid Schemes Board.

It is deeply concerning that Discovery appears unwilling to invest in the essential healthcare of its members, while prioritising add-on products such as Vitality. As a loyal member for many years, I feel let down by this lack of support. I am now seriously considering withdrawing my membership.

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Replies (8)
Discovery Health
Discovery Health's reply16 Sept 2025, 07:26
Official
Dear Hendrik D
 
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 Sept 2025, 11:31
Official
Dear Hendrik D
 
We’ve contacted you to discuss your concern.  Regards Discovery Health Servicing Team
HV
Hendrik V's update25 Oct 2025, 12:04
Reviewer Update
Good day,

I trust that you are well. Thank you for your feedback regarding Query *** – MailRef#***. While I appreciate the response, I must express my disappointment with how this matter has been handled. As a long-standing Discovery member, I am concerned by the lack of empathy and support in a situation that directly affects my health and quality of life.
A CPAP device is not a luxury item—it is a medically necessary device used to prevent serious and potentially life-threatening conditions. Given the contributions paid to the medical aid, it is reasonable to expect full reimbur*****t for essential, life-preserving equipment. Offering only R17,000 toward a device that directly impacts a member’s wellbeing is deeply concerning. Adding to this frustration is the perception that Discovery prioritises executive compensation over service delivery and patient care.

For reference, the article below highlights significant executive earnings, which raises fair questions about priorities when basic member support falls short: https://businesstech.co.za/news/banking/840719/discovery-bank-ceo-scores-r60-million-payday-over-r20-million-more-than-his-boss It is also sad to hear that the medical practitioners are being paid below par while the executives receive increases. While executives earn substantial salaries, clients and staff appear to struggle to receive adequate support. This sentiment is reflected publicly, with Discovery currently receiving low customer satisfaction ratings on platforms such as HelloPeter. At this stage, I am already in the process of exploring alternative medical aid options for myself—and recommending that others do the same—based on the lack of empathy and unwillingness to fully support essential medical needs. I am, however, still hopeful that Discovery will resolve this matter in good faith.
I am requesting that Discovery settle the full outstanding amount for the CPAP device. Should this matter be resolved appropriately, I will gladly remove my public complaint and continue my membership with confidence.
I truly hope to see positive and constructive feedback, and a resolution that reflects the values Discovery claims to stand for.

Kind Regards
Hendrik de Vos
Discovery Health
Discovery Health's reply27 Oct 2025, 11:56
Official
Dear Hendrik V 

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

Regards Discovery Health Servicing Team
Discovery Health
Discovery Health's reply31 Oct 2025, 17:19
Official
Dear Hendrik D
 
We have been in touch with you to answer your comments.  Regards Discovery Health Servicing Team
HV
Hendrik V's update07 Nov 2025, 12:06
Reviewer Update
Good day Discovery Team,

I trust you are well. Could you please provide an update on this matter?

Kind regards,
Hendrik de Vos
Discovery Health
Discovery Health's reply07 Nov 2025, 12:48
Official
Dear Hendrik D

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

Regards Discovery Health Servicing Team
Discovery Health
Discovery Health's reply11 Nov 2025, 16:47
Official
Dear Hendrik D

Please check your emails for final feedback from us. 

Regards Discovery Health Servicing Team