KD
Karen D

1 reviews | Active since Mar 2014

13 Aug 2015, 14:55

Terms of Medical Aid Plan not adhered to!

On 11 August I was advised by my GP that I had Pneumonia. I needed urgent medical care in hospital. My GP called the Psychian, notified him, who in turned arranged for my admittance to Durbanville Medi Clinic. I told my GP that I was on Classic Comprehensive Delta Plan, he advised that this was a medical emergency so it was not necessary to go to one of the Delta Hospitals. On arriving at Durbanville & booking in, the clerk advised that he needed to get authorization. He called Discovery and told me that I was liable to pay a penalty of R5980 because the hospital was not on the Delta network. I was horrified, as when upgrading to Classic Comprehensive Delta I was informed that this only pertained to PLANNED procedures. Pneumonia is not planned! I spoke to the consultant who insisted that the penalty was due. Being an emergency I paid the penalty so that I could be admitted. My pulse rate was 130!! I am disgusted in Discovery Health and the fact that I have been taken for a ride. Nowhere does it state that Pneumonia is a planned procedure. I want my money back as this was an emergency! I will also be looking at cancelling my Med Aid with Discovery! I pay R3800 pm for what? No faith!

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Replies (1)
Discovery Health
Discovery Health's reply17 Aug 2015, 08:51
Official
Hello Gabiswa1@,

Thank you for your comment.

We confirmed that we are in the process of addressing your concerns and will be in contact with feedback.

Regards
Annelize