RR
Renier R
1 reviews | Active since Mar 2013
16 Apr 2024, 16:31
Stay away From Discovery Gap Cover
I have taken DIscovery Gap Cover 2023. I was made aware of a general 3 months waiting period and a 12 month Exclusions for pre-determined conditions. I was never made aware of a 12-month general waiting period for basically anything else you want done. Gap Cover pays for your CO-Payment on MRI Scans.
My wife was diagnosed with chondromalacia patella. To me that is a cartridge issue underneath the kneecap. No joint replacement.
Treatment of a "JOINT REPLACEMENT" is joint replacement. They won't under the Gap Cover Benefit cover the co-payment for MRI's as the MRI is relating to TREATMENT of a "JOINT REPLACEMENT" under there wording. My wife will not getting any joint replacements or being treated for a joint replacement. MRI is a diagnostic tool and not treatment!
Helpful (0)
Replies (12)0
Replies (12)RR
Renier R's updateReviewer Update
16 Apr 2024, 16:45There is an extract from there waiting period criteria for the general 12 months.
.
There is an automatic 12-month waiting period for any claims directly or indirectly related to the treatment of pregnancy and childbirth, endometrial ablations, hysterectomy, joint replacements, scopes (including minimally invasive scopes, endoscopies, hysteroscopies and arthroscopies), cataracts, cholecystectomy, wisdom teeth, orthognathic surgery, dental implants, tonsillectomy, grommets, adenoidectomy, nasal procedures, hernia procedures and reflux surgery
Not a single mention about MRI/CT scan's being excluded as a diagnostics tool or screening tool here!
Scopes and Scans*
Provides cover for co-payments and deductibles that apply to MRI and CT scans out-of-hospital, and for endoscopies performed in-hospital
GAP Cover Scopes and scans benefit.
.
There is an automatic 12-month waiting period for any claims directly or indirectly related to the treatment of pregnancy and childbirth, endometrial ablations, hysterectomy, joint replacements, scopes (including minimally invasive scopes, endoscopies, hysteroscopies and arthroscopies), cataracts, cholecystectomy, wisdom teeth, orthognathic surgery, dental implants, tonsillectomy, grommets, adenoidectomy, nasal procedures, hernia procedures and reflux surgery
Not a single mention about MRI/CT scan's being excluded as a diagnostics tool or screening tool here!
Scopes and Scans*
Provides cover for co-payments and deductibles that apply to MRI and CT scans out-of-hospital, and for endoscopies performed in-hospital
GAP Cover Scopes and scans benefit.
RR
Renier R's update16 Apr 2024, 16:45
Reviewer Update
There is an extract from there waiting period criteria for the general 12 months.
.
There is an automatic 12-month waiting period for any claims directly or indirectly related to the treatment of pregnancy and childbirth, endometrial ablations, hysterectomy, joint replacements, scopes (including minimally invasive scopes, endoscopies, hysteroscopies and arthroscopies), cataracts, cholecystectomy, wisdom teeth, orthognathic surgery, dental implants, tonsillectomy, grommets, adenoidectomy, nasal procedures, hernia procedures and reflux surgery
Not a single mention about MRI/CT scan's being excluded as a diagnostics tool or screening tool here!
Scopes and Scans*
Provides cover for co-payments and deductibles that apply to MRI and CT scans out-of-hospital, and for endoscopies performed in-hospital
GAP Cover Scopes and scans benefit.
.
There is an automatic 12-month waiting period for any claims directly or indirectly related to the treatment of pregnancy and childbirth, endometrial ablations, hysterectomy, joint replacements, scopes (including minimally invasive scopes, endoscopies, hysteroscopies and arthroscopies), cataracts, cholecystectomy, wisdom teeth, orthognathic surgery, dental implants, tonsillectomy, grommets, adenoidectomy, nasal procedures, hernia procedures and reflux surgery
Not a single mention about MRI/CT scan's being excluded as a diagnostics tool or screening tool here!
Scopes and Scans*
Provides cover for co-payments and deductibles that apply to MRI and CT scans out-of-hospital, and for endoscopies performed in-hospital
GAP Cover Scopes and scans benefit.
Discovery Health's replyOfficial
17 Apr 2024, 08:56Dear Renier V
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's reply17 Apr 2024, 08:56
Official
Dear Renier V
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's replyOfficial
17 Apr 2024, 15:32Dear Renier V
We have been in touch with you via email to answer your comments.
Regards
Discovery Health Servicing Team
Discovery Health's reply17 Apr 2024, 15:32
Official
Dear Renier V
We have been in touch with you via email to answer your comments.
Regards
Discovery Health Servicing Team
RR
Renier R's updateReviewer Update
17 Apr 2024, 15:59Wow what a cooperate nonsense reply!
Discovery changing this around from wording in the exclusions list to ICD codes!
Now Discovery claims exclusions is linked to ICD Codes. Please show me once how do we know what ICD codes will be excluded or not. Please show me the list of ICD codes that we are aware of that is excluded. It's not on a brochure or terms or any letter or in any commicnation . Please advise where have you provided this so called lists of ICD codes that we as public needs to be aware of on GAP COVER that will be excluded.
Please show me how is a MRI scan that is a diagnostic and screening benefit a "joint replacement". Please answer this simple question. Artificial joint replacement yes excluded, a cervical disc replacement yes excluded, a hip replacement yes excluded. That in layman terms would make sense! Does an MRI screening of the knee, NO, Is my wife getting any form of "joint replacement" NO!
Looks like Discovery employing AI to answer letters. Trying every trick in the book not to honor a valid claim.
For everyone's eyes this is the COMPREHENSIVE GAP CAP COVER ( There best option ) in which you pay a decent premium for this coverage. You failed me and probably get another AI Corporate reply on this.
Discovery changing this around from wording in the exclusions list to ICD codes!
Now Discovery claims exclusions is linked to ICD Codes. Please show me once how do we know what ICD codes will be excluded or not. Please show me the list of ICD codes that we are aware of that is excluded. It's not on a brochure or terms or any letter or in any commicnation . Please advise where have you provided this so called lists of ICD codes that we as public needs to be aware of on GAP COVER that will be excluded.
Please show me how is a MRI scan that is a diagnostic and screening benefit a "joint replacement". Please answer this simple question. Artificial joint replacement yes excluded, a cervical disc replacement yes excluded, a hip replacement yes excluded. That in layman terms would make sense! Does an MRI screening of the knee, NO, Is my wife getting any form of "joint replacement" NO!
Looks like Discovery employing AI to answer letters. Trying every trick in the book not to honor a valid claim.
For everyone's eyes this is the COMPREHENSIVE GAP CAP COVER ( There best option ) in which you pay a decent premium for this coverage. You failed me and probably get another AI Corporate reply on this.
RR
Renier R's update17 Apr 2024, 15:59
Reviewer Update
Wow what a cooperate nonsense reply!
Discovery changing this around from wording in the exclusions list to ICD codes!
Now Discovery claims exclusions is linked to ICD Codes. Please show me once how do we know what ICD codes will be excluded or not. Please show me the list of ICD codes that we are aware of that is excluded. It's not on a brochure or terms or any letter or in any commicnation . Please advise where have you provided this so called lists of ICD codes that we as public needs to be aware of on GAP COVER that will be excluded.
Please show me how is a MRI scan that is a diagnostic and screening benefit a "joint replacement". Please answer this simple question. Artificial joint replacement yes excluded, a cervical disc replacement yes excluded, a hip replacement yes excluded. That in layman terms would make sense! Does an MRI screening of the knee, NO, Is my wife getting any form of "joint replacement" NO!
Looks like Discovery employing AI to answer letters. Trying every trick in the book not to honor a valid claim.
For everyone's eyes this is the COMPREHENSIVE GAP CAP COVER ( There best option ) in which you pay a decent premium for this coverage. You failed me and probably get another AI Corporate reply on this.
Discovery changing this around from wording in the exclusions list to ICD codes!
Now Discovery claims exclusions is linked to ICD Codes. Please show me once how do we know what ICD codes will be excluded or not. Please show me the list of ICD codes that we are aware of that is excluded. It's not on a brochure or terms or any letter or in any commicnation . Please advise where have you provided this so called lists of ICD codes that we as public needs to be aware of on GAP COVER that will be excluded.
Please show me how is a MRI scan that is a diagnostic and screening benefit a "joint replacement". Please answer this simple question. Artificial joint replacement yes excluded, a cervical disc replacement yes excluded, a hip replacement yes excluded. That in layman terms would make sense! Does an MRI screening of the knee, NO, Is my wife getting any form of "joint replacement" NO!
Looks like Discovery employing AI to answer letters. Trying every trick in the book not to honor a valid claim.
For everyone's eyes this is the COMPREHENSIVE GAP CAP COVER ( There best option ) in which you pay a decent premium for this coverage. You failed me and probably get another AI Corporate reply on this.
RR
Renier R's updateReviewer Update
17 Apr 2024, 16:06Your EXLCUSIONS should have listed MUSCULOSKELETAL DISORDERS and any treatment, scans and screenings relating to the disorders and not " JOINT REPLACEMENT"
RR
Renier R's update17 Apr 2024, 16:06
Reviewer Update
Your EXLCUSIONS should have listed MUSCULOSKELETAL DISORDERS and any treatment, scans and screenings relating to the disorders and not " JOINT REPLACEMENT"
Discovery Health's replyOfficial
19 Apr 2024, 12:36Dear Renier V
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's reply19 Apr 2024, 12:36
Official
Dear Renier V
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's replyOfficial
22 Apr 2024, 14:05Dear Renier V
We have been in touch with you via email to answer your comments.
Regards
Discovery Health Servicing Team
Discovery Health's reply22 Apr 2024, 14:05
Official
Dear Renier V
We have been in touch with you via email to answer your comments.
Regards
Discovery Health Servicing Team
RR
Renier R's updateReviewer Update
22 Apr 2024, 15:29No email recieved as yet?
RR
Renier R's update22 Apr 2024, 15:29
Reviewer Update
No email recieved as yet?
RR
Renier R's updateReviewer Update
26 Apr 2024, 09:08HI All,
Just a note, Discovery has stopped all communications. When they are in the wrong they decide the best action is ignorance. Not leaving it here.
Just a note, Discovery has stopped all communications. When they are in the wrong they decide the best action is ignorance. Not leaving it here.
RR
Renier R's update26 Apr 2024, 09:08
Reviewer Update
HI All,
Just a note, Discovery has stopped all communications. When they are in the wrong they decide the best action is ignorance. Not leaving it here.
Just a note, Discovery has stopped all communications. When they are in the wrong they decide the best action is ignorance. Not leaving it here.
Discovery Health's replyOfficial
26 Apr 2024, 10:58Dear Renier V
We have been in touch with you via email to answer your comments.
Regards
Discovery Health Servicing Team
Discovery Health's reply26 Apr 2024, 10:58
Official
Dear Renier V
We have been in touch with you via email to answer your comments.
Regards
Discovery Health Servicing Team
RR
Renier R's updateReviewer Update
06 May 2024, 09:06Hi Everyone,
Discovery has stopped any comms via emails - Silence is admission of guilt. No worries, proceeding with OSTI as Discovery does not provide any answers, clarity, explanations, nothing! Fact is JOINT REPLACEMENT is a JOINT REPLACEMENT and a MRI is a screening benefit not treatment for a JOINT REPLACEMENT
Discovery has stopped any comms via emails - Silence is admission of guilt. No worries, proceeding with OSTI as Discovery does not provide any answers, clarity, explanations, nothing! Fact is JOINT REPLACEMENT is a JOINT REPLACEMENT and a MRI is a screening benefit not treatment for a JOINT REPLACEMENT
RR
Renier R's update06 May 2024, 09:06
Reviewer Update
Hi Everyone,
Discovery has stopped any comms via emails - Silence is admission of guilt. No worries, proceeding with OSTI as Discovery does not provide any answers, clarity, explanations, nothing! Fact is JOINT REPLACEMENT is a JOINT REPLACEMENT and a MRI is a screening benefit not treatment for a JOINT REPLACEMENT
Discovery has stopped any comms via emails - Silence is admission of guilt. No worries, proceeding with OSTI as Discovery does not provide any answers, clarity, explanations, nothing! Fact is JOINT REPLACEMENT is a JOINT REPLACEMENT and a MRI is a screening benefit not treatment for a JOINT REPLACEMENT
Discovery Health's replyOfficial
23 Oct 2024, 14:41Dear Renier V
We have been in contact with you.
Regards
Discovery Health Servicing Team
Discovery Health's reply23 Oct 2024, 14:41
Official
Dear Renier V
We have been in contact with you.
Regards
Discovery Health Servicing Team