1 reviews | Active since Nov 2014
The Optical benefits illusion
It is with a heavy heart filled with disappointment that I have to write this complaint. On Saturday I went for my optical bi-annual check up and spectacle upgrade. I did everything and the total was about R3.5k. According to my plan guide or schedule I have an Optical benefit of R3850.<br> To my surprise, shock and disbelief, the claim came through from my savings. I was never made aware of this possibility and I thought a claim for spectacles would come from the Optical benefit. Discovery paid R1.3k and I'm left to pay about R1.8k from my own pocket. There is an above Threshold benefit that I thought would kick in after my shocking discovery, but NO, I also didn't qualify for that.<br> I am just one member and Discovery won't miss me if I move to another medical aid. My day and week has been spoilt.
Thank you for your comment and patience while we attended to your query.
All day-to-day claims are funded from your Medical Savings Account which includes any out of hospital optical expense. This includes spectacles, lenses and their frames, contact lenses and refractive eye treatments.
This is indicated on your plan brochure which confirms that the dental limit is not a separate benefit and rather a limit.
In addition, the Above Threshold Benefit will only be available once your Self-Payment Gap has been closed.
Discovery Health attempts to be as transparent as possible. We always encourage our members to make use of a number of services should they require clarification on their benefits.
This can be done by contacting our Client Service on ***, by utilising the information available on our website and mobile app or by visiting one of our Walk-in Centres.
Regards
Keymira
Thank you for your comment and patience while we attended to your query.
All day-to-day claims are funded from your Medical Savings Account which includes any out of hospital optical expense. This includes spectacles, lenses and their frames, contact lenses and refractive eye treatments.
This is indicated on your plan brochure which confirms that the dental limit is not a separate benefit and rather a limit.
In addition, the Above Threshold Benefit will only be available once your Self-Payment Gap has been closed.
Discovery Health attempts to be as transparent as possible. We always encourage our members to make use of a number of services should they require clarification on their benefits.
This can be done by contacting our Client Service on ***, by utilising the information available on our website and mobile app or by visiting one of our Walk-in Centres.
Regards
Keymira