LB
Lindy B

1 reviews | Active since Oct 2018

29 Oct 2018, 15:20

Should i be moving to a new Medical Aid?

This is my experience i had with one of the "best" medical aid schemes out there. The only medical aid i have ever been with (Just saying). on Sunday the 21/09/2018 i had the worst pain i have very experienced in my life in my stomach so my boyfriend then rushes me to one of our NETWORK hospitals, (where the doctors and nurses where outstanding!) i then find out i had to pay in R900.00 just to see the doctor??? why am i going to to my network hospital if i need to pay this when our scheme states a R50.00 co payment with network doctors? Which i assumed they would be as i am in the emergency rooms in my NETWORK hospital. I then get a drip to control the pain and they take Bloods. I then (Keeping in mind that i am at a network hospital where i assumed NETWORK Doctors worked, especially in the ER) get a script from the Doctor who saw me and prescribed me quite a lot of medication. I get released so off to the pharmacy we go just to find out that i need to pay in a further R1300.00 to get my prescribed medication (from the Doctor at the emergency rooms at my NETWORK hospital) i then asked for genetic versions of my medication as it was too expensive but still ended up paying R1100.00 or so because the Doctor who prescribed me my medication was not part of my network who works at the NETWORK hospital the one i specifically went to for help!! On Wednesday the 24/9/2018 i then return to see the same doctor who then sent me for an Ultrasound (which they did not pay for R1200.00, which i understand is not paid for in my medical aid scheme). .....meaning at this stage if i had just gone to my GP i would have properly saved money..... so to recap 1. i had to pay R900.00 to see a Doctor at our NETWORK hospital where our medical aid should pay for it with a R50.00 co-payment as our scheme specifies especially considering i was at the emergency rooms, expecting to see a NETWORK doctor. 2. R1300.00 for medication prescribed by the doctor (who is not part of Discovery NETWORK plan) but works in the emergency rooms at my NETWORK hospital!!!! 3. R1200.00 for an ultrasound. 4. Still in tremendous pain, I am too scared to go back to the hospital for help as i cant afford more expenses at this point in time! Personally i think that Discovery should start focusing a little less on the free stuff and all the glorious rewards they offer and refocus on the actual service they meant provide!

0
Replies (4)
Discovery Health
Discovery Health's reply29 Oct 2018, 15:33
Official

Dear Lindy Blom

We received your complaint and we’re looking into the matter.

Kind regards
Discovery Health Servicing Team

Discovery Health
Discovery Health's reply31 Oct 2018, 13:52
Official

Dear Lindy Blom

We have been in touch with you to answer your comments.

Kind regards
Discovery Health Servicing Team

LB
Lindy B's update31 Oct 2018, 13:58
Reviewer Update
The Response i got from Discovery was utterly useless, i am so angry !!! The guy who called me told me that the doctor i saw when i went to the ER was part of our network but the practice that he was under was not therefore they did not pay! Please can someone explain how that even makes sense!
Discovery Health
Discovery Health's reply02 Nov 2018, 13:26
Official

Dear Lindy Blom

We have been in touch with you to answer your comments. An email was sent to you with a possible solution to this matter.

Kind regards
Discovery Health Servicing Team