Selective Discovery Maternity Benefits

It is a disgrace that a company takes your money on a monthly basis in return to promise that you have so called "medical aid cover" and they boast to be the best in the business, yet when you rely on them to cover your medical expenses, they just don't keep to their end of the deal. I've been a loyal client of Discovery Health for probably 7 years and have ever since not once claimed for something greater than GP visits, Gynaecologist visits and medications, yet now when I rely on Discovery to cover me during my pregnancy, they have all types of excuses for not covering certain items, tests and even partially covering my gynaecologist visits for which I am now forced to either pay from my Medical Savings account or directly out of pocket.

To date (and counting), I've had to pay a total of R2502,32 for everything included routine bloodtests, short-falls for my rountine gynae visits of which only the first three were paid in full by my "Maternity Benefit" 06 Aug 2018 was paid in full : R803,80, 16 Aug 2018 paid in full : R705,00 and 11 Sept 2018 paid in full : R948,80 and even a pretty much life vital injection to ensure my bloodtype and my baby's bloodtype does not attack eachother, Rhesugam IM, which was a cost of R754,52 on its own. When chatting to the pharmacist, what would be the case if I were to have been at a state hospital, would I have received this injection for free??? The answer was, yes? Why because you are a paying client, do you need to be squeezed for each and every single sent, yet somewhere else in the country you get this for free??? This, apparently, is an injection that I require AGAIN after delivery.... I am only 27 weeks pregnant and there is still a long way to go, lost of blood tests and checks that need to happen before baby's arrival, yet we have absolutely NO IDEA what the financial impact will be, because when contacting Discovery to confirm and even disputing the reasons as to why all these costs are not covered, you rather get an attitude from the consultant because they just keep answering you pretty much from a script and can't answer you directly according to your specific questions.

When speaking to the consultant and explaining to him that according to my Discovery Maternity Benefit profile, I have a certain list of cover which includes 12 Blood tests during pregnancy of which only 7 was used and asking him why only 7 was claimed and not the other tests with my first round, he stated that there are only a certain list of tests that are covered. NOW WHERE on my profile does it state that only a certain list of tests are covered and NOW WHERE am I able to view a list of tests that are covered, because when I asked the consultant how am I supposed to know which tests are covered or not, how I am I supposed to plan, he advised that they are not able to provide a list, I would need to call in with each code and check if it is covered or not.

My question now is, if my doctor sees it fit to have a certain list of blood tests run because of his expertise, his knowledge and his experience over the many many years that he has seen to pregnancies, and he orders a certain list of blood tests, how can Discovery decide which blood tests are vital for pregnancy and which tests are not? My doctor knows what my conditions are and what medical challenges I am to face, therefore a certain list of blood tests according to his experience to keep myself and my baby alive and well, yet when my Discovery Maternity Benefit Program is opened, I STILL today 20 Dec 2018, have 5 out of 12 blood tests available.....but no you don't.....

What is the point of a client paying almost R2000 a month for about 7 years (which adds up to an amount of R168 000 over the years, which I absolutely have not had this amount of medical expenses during the years) yet your service supplier lets you down?