Shame on you. Less benefits. More Profits.

Even though I thought that I had no issues with my medical aid in the past. I have come to realise in the last couple of months that was only because I wasn't the one working with them directly - the doctors were. I now realize why certain doctors simply refuse to work with medical aids and we are required to pay upfront only to claim back afterwards. WHAT AN EYE OPENER!

Not only have we all been complaining about how expensive certain medical aids have become and how they just simply do not cover certain necessities. I have come to realise these last couple of months fighting for a claim - which by the way was for a PMB (prescribed minimum benefit), look those up if you do not know what those are. It is certain minimum ICD-10 medical codes that we as South Africans have a legal right to as a bare minimum, it doesn't matter on which medical plan you are or aren't. These includes medical access to procedures like for example a pap smear at least once every 2-3 years, or certain chronic medication, or 15 outpatient psychiatric consultations or 21 inpatient days per year, etc. However medical aids do not advertise or tell you about these because they end up losing out on profits and even worse life insurance agencies tend to force you to disclose your chronic medications and use this against you to cap your life insurance policies in any way they can because in most cases like with Discovery they are both your medical aid provider as well as your insurance agency.

Back to my claim, I submitted a claim in January 2023. I have since cancelled my membership with Discovery. They still haven't paid my claim eventhough the claim was approved and I have the approval form, various emails, hours of phone calls and wasted energy to back it up. Absolutely nothing has happened since it was approved. Every time I receive a correspondence email stating it has been escalated to some or other department and I will get feedback within 3-5 working days. YEAH RIGHT! At this rate my grandkids might be able to buy a piece of bubble-gum with the claim someday!

Seriously Discovery is more worried about increasing their membership fees every year by 10% while everything else rises with only 6%, meanwhile they continue to remove ICD-10 and Z codes from their list, decreasing our benefits, so we are paying more for less. How do you explain this Discovery? How do you justify these increases? Shame on you.