Stay away from The Smart Classic Plan !

I am horrified at the treatment I have received from Discovery, my story follows

I was with Discovery medical aid for a few years with my old employers. I then re-joined this year and I went onto the Smart Classic Plan. I have had kidney stones twice a few years ago, whilst on the previous plan – resulting in a surgical procedure, where I was treated with utmost respect and help from Discovery. Now that I am on a lower plan, I have been treated with anything but respect.

When signing up for the new plan, I was upfront and honest in regards to my previous kidney stones. I have had Kidney stones twice in my life which resulted in the most painful experience of my life. Therefore I felt it imperative that I enquire if my new plan was going to cover Kidney stones. A very logical question in my opinion. I was then answered yes to my question. Either way, I was with Discovery previously, therefore there would not be any chance of ever trying to get away with being dishonest about my previous kidney stones as this was all on record.

I have since been having other health issues that have required medical attention. My symptoms have been extreme headaches, dizziness and tingles down my whole body. I sought medical assistance through my GP, she was convinced that this was stress related. The stress medication did not work in anyway so went back for a consult with the GP, she then suggested that I see a Neurologist. I saw a neurologist. He suggested I get an MRI on my brain to rule out any tumours as well as a MRI on my lower back in order to make sure that there were no nerve problems which could be resulting in these tingles I continue to experience. I then received the all clear on both MRIS. I went for a follow up consult with the neurologist where he explained that everything is normal, except my blood sugar levels, in the blood tests and MRIs and that I should consult with an endocrinologist. He referred me to an endocrinologist. I then had another episode where I did not feel well at all, so I made another appointment with a GP , who informed me that I might have a magnesium deficiency and ordered me to start taken magnesium immediately. Which I have been and I am still experiencing the same symptoms therefore there is further investigations needed in order to diagnose me. I have been having dizzy spells, vomiting, tingles and severe headaches for a few months now. It got so severe at once stage that I went to emergency. This was before I saw the endocrinologist, as I was still waiting for my appointment date. The emergency department then contacted the neurologist, who informed them that I would have to see the endocrinologist in order to find out what is wrong with me and that all they could do for me were treat my symptoms of nausea, headaches and dizziness. I was given some medication, went home and waited for my endocrinologist appointment.

I then saw the endocrinologist and she ordered me to go get more blood tests taken and then see her again for a follow up on the 26th of September. She says she is testing my thyroid, my liver and my Vitamin B.

I then started peeing pure blood over the weekend, I was worried I was experiencing another kidney stone, I decided to flush my system by drinking immense amounts of water and citrosoda and hope for the best.

By Monday morning, I was still peeing pure blood but I now had localised pain in my back in the region of my kidneys, not feeling well and starting to get extremely worried, I went back to the emergency. They asked me many questions with regards to my medical history and decided that my recent poor health did not have anything to do with my current kidney stone symptoms and therefore took a urine sample, which came back with no signs of infections, only blood was present in the urine. As this is not normal, they ordered a CT scan, which I proceeded with and the results of this was that I had a kidney stone. The emergency department contacted the urologist on call. He decided I need to be admitted and the kidney stone must be removed the next day. I was then informed that, that hospital was not in the network of hospitals under my plan and therefore would have to pay an R8800 co-payment. If I did not want to pay this co-payment, I would need to be transferred to Morningside Clinic. I decided to go to Morningside Clinic, where I had to meet with a new Urologist. I was authorized to stay the night at the Morningside Clinic and was awaiting my procedure the next day. The next morning, I was then informed by Morningside that Discovery has decided to put my authorisation under pending due to an investigation regarding mu kidney stones.

I then had to leave the hospital (not knowing if I am financially liable for this stay or not) I was told I need to meet my new Urologist at the Donald Gordon the next day to remove the kidney stone. I tried to get authorisation from Discovery regarding this procedure, but I was told that this is still pending.

Discovery has sent through am assessment form to my GPs in order to evaluate if my visits had anything to do with me kidney stones or not. My GP sent back this assessment form and still, I waited to receive word back from Discovery.

I have been on countless phone calls with regards to this and still cannot get an answer. I had a conversation with an extremely rude person who works in Discovery, by the name of Rosanna Kinloch. This woman has countless complaints against her, all having simi**** content - rude from the get go, cancelling people's medic aids without notice, telling people they are *****. I can not understand how on earth she is still working with Discoverys' customers as there are countless people who feel the same as I do regarding this woman. Things like this will scare potential clients off as she seems to find any reason under the sun to cancel your medical aid. How does one even feel safe and secure regarding their medical aids.

She then proceeded to tell me that, because I asked if the medical aid plan covers kidney stones, I knew all along that I had a kidney stone and imp**** that I am a ****. This made me extremely frustrated and I feel like I am being treated like a ******** because I have now got a kidney stone.

I had a meeting at the Discovery offices in Sandton on the 21st of September 2018 and the treatment received by Ms Kinloch was seriously disrespectful. She was demeaning and rude from the start, she over talked me and she has convinced herself that I am a ****. I feel that Ms Kinloch and I have gotten off on the wrong footing and therefore she has a vendetta against me and this is why I would like to request someone else to be assigned to this case.

From the start of the meeting Ms Kinloch had a very bad attitude and made me as the customer feel as if my word meant nothing.

I was upfront about my previous kidney stones and obviously wanted to know if the plan covered any kidney stones that may arise in the future, of course I am making sure I am looking after my health and well-being. I was informed that my medical aid plan covers kidney stones and now I am not receiving cover in regards to this. I have listened to this on voice recording, where it is clearly stated that the plan covers kidney stones and therefore this makes Discovery dishonest.

I will be contacting the medical board in regards to this despicable treatment that I have received and I will also be contacting the ombudsman, I will also be taking this to social media explaining how terrible this plan is and how in my opinion, I seriously advise against going onto this plan.

If my kidney stone starts to pass and I need emergency treatment and I need to be admitted, I feel I will not get the assistance I need from Discovery, which is not ethical due to the fact that on telephone recording there is proof stating that my kidney stones will be covered.