PB
Pauline B

1 reviews | Active since Mar 2019

24 Nov 2025, 14:19

SPECIALIST VIST DENIED - BECAUSE "THE PANEL" DECIDED!! WHO HAVE NO IDEA OF HER HISTORY - EVEN THOUGH ITS STATED ON HER REFFERAL REQUEST BY HER GP - WHO IS NOT TREATING HER

Specialist visit denied - Because you want an additional scan - EVEN though the scans are conducted by the specialist, who is seen every 6 Months - and my daughter has been seeing the specialist for more then 2 years - with a condition that has been monitored by the SPECIALIST - because she was referred by her GP!!! Now new "policies" have been implemented, that a person has to fork out money for more scans to be approved for a specialist which are not covered by the medical aid - and then IF she goes for her visit - there will be another scan conducted. What is a person actually paying medical aid for? Why does Discovery want to keep as many treatments under a GP? Because those additional things are not cover by the medical and the person has to pay for it out of pocket - MEANING DISCOVERY MAKES MORE MONEY - They do not care about the People who are paying for their medical aid. If the specialist benefit runs out, then it should come out of the members pocket - why should a person not have access to their benefit that they are paying for every month. I am actually disgusted. Needless to say, I will be looking for other medical aid options - this is really not on.

0
Replies (5)
Discovery Health
Discovery Health's reply25 Nov 2025, 06:47
Official
Dear Pauline B 

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 reply26 Nov 2025, 10:33
Official
Dear Pauline B 

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

Regards 
Discovery Health Servicing Team
PB
Pauline B's update26 Nov 2025, 11:00
Reviewer Update
I was contacted - Unfortunately, this has NOT BEEN RESOLVED. I kept being told that I need to provide proof BEFORE "SPECIALIST INTERVENTION" takes place. However, What Discovery and "THE MEDICAL PANEL" do NOT WANT understand, that this is not NEW "specialist intervention" this is check up which she is required to do every six months as per her SPECIALIST WHO SHE HAS BEEN SEEING FOR 3 YEARS. The GP did all the medical tests and blood work 3 years ago, and then she was referred to a SPECIALIST. The GP is supposed to be used to "treat her to the best of their ability - before a specialist visit is approved", Which was done 3 YEARS AGO. The SPECIALIST is treating her, the GP did his part 3 YEARS AGO - The SPECIALIST requests that she sees him every six months. Its just shows that its all about the money - Its has got nothing to do with the Welfare of the people who pay their medical aid, expecting to have services and benefits, but then you get told - OH YOU ARE NOT ALLOWED TO USE THEM. I will be taking this further.
Discovery Health
Discovery Health's reply28 Nov 2025, 12:06
Official
Dear Pauline B 

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

Regards 
Discovery Health Servicing Team
Discovery Health
Discovery Health's reply02 Dec 2025, 11:49
Official
Dear Pauline B 

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

Regards 
Discovery Health Servicing Team