unaware of activation on app

Below is the email I send to Discovery Medical Aid after I was told today that if the pregnancy was not activated through discovery application by one of the manager tell no. ********** - M/Ship no. ********** 00 nothing was going to be paid on the Scheme benefit and everything would be taken from Saving – I was with Bonitas before joining was not aware of the activation of pregnancy through discount application which you must download on your cell phone, please assist

Good day All

May you please find the 06-04-2019 ultrasound scans for 20 weeks attached and pay from the Scheme benefit not from savings?

Scheme benefit below:

Eight antenatal consultations with the gynaecologist, GP or midwife. – I have attached two invoices which need to be paid from Scheme benefits not savings as per the Saver plan option selected

Rectify below and correct from your side:

1.

Eight antenatal consultations with the gynaecologist, GP or midwife. – We are now half way to the pregnancy all consultation has been taken from Savings? Please explain why they were not refunded from scheme benefit and attached them so that you can re-look at them and advise accordingly? – May you please refund the two-consultation taken saving back and be taken from Scheme Benefit

Five pre- or postnatal classes or consultations with a registered nurse. – We haven’t used the benefit for any pre- or postnatal classes yet

Two ultrasound scans. - On the 06-04-2019 will be visiting the doctor for 20 weeks consultations with our Gynaecologist for ultrasound big scan – which two consultations do you cover and at what weeks of pregnancy? Invoice attached for this week consultation.

One nuchal translucency or non-invasive prenatal test (NIPT) subject to clinical entry criteria. – We haven’t used the

A defined basket of blood tests. – May you please refund test conducted at Linksfield for pregnancy confirmation as is part of the scheme benefit back to savings account

On Fri, Apr 5, 2019 at 6:26 PM Ndivhuwo Zacharia ****eledzha ********** wrote: Good day All May you please clarify the following concerned unanswered from first email I send to discovery to advise on what I am covered for on my benefit selected with the medial aid. As a member on a Saver plan, you will have access to the following during your pregnancy, once the benefit has been activated on the Discovery website or app: 1. • Eight antenatal consultations with the gynaecologist, GP or midwife. – We are now half way to the pregnancy all consultation has been taken from Savings? Please explain why they were not refunded from scheme benefit and attached them so that you can re-look at them and advise accordingly? • Five pre- or postnatal classes or consultations with a registered nurse. – We haven’t used the benefit for any pre- or postnatal classes yet • Two ultrasound scans. - On the 06-04-2019 will be visiting the doctor for 20 weeks consultations with our Gynaecologist for ultrasound big scan – which two consultations do you cover and at what weeks of pregnancy? • One nuchal translucency or non-invasive prenatal test (NIPT) subject to clinical entry criteria. – We haven’t used the • A defined basket of blood tests. – at week 12 my wife did test which were also taken from my saving as well the abnormality on the baby and aids test as is a routine for pregnancy woman at certain level of pregnancy 2. Before you are admitted to hospital for the birth, please contact us so that we can approve your admission. You can contact our Discovery Care department on ***. Please have the following information available: - Please advise once the information below have been captured on the system? • The estimated date of the birth of your baby. – expected date of birth 15-08-2019 • Your gynaecologist’s details (including practice number). – DR Nyaoke Practice number. ********** 31342 • Details of your hospital. – Linksfields hospital Thanks a lot.

Regards;

Zacharia ****eledzha

Cell no. **********

On Mon, Feb 18, 2019 at 9:39 AM ********** wrote:

Dear Mr. ****eledzha Thank you for contacting us. Referred - Claims We have referred your email to our Claims division. They will attend to your query and get back to you. Your reference number is ********** 753. If you have any further queries, please contact us on ***or email us at ********** Maternity Benefit Congratulations on your pregnancy. We wish you health and happiness during this precious time. We understand that your main focus is staying healthy and having a safe birth. To help you keep all the important information together, we want to let you know how you are covered for antenatal care and for the birth. Before you are admitted to hospital for the birth, please contact us so that we can approve your admission. You can contact our DiscoveryCare department on ***. Please have the following information available: • The estimated date of the birth of your baby. • Your gynaecologist’s details (including practice number). • Details of your hospital. How you are covered • We cover you for three days and two nights for a natural birth. • We cover you for four days and three nights for a caesarean. The day of your delivery or caesarean is the first day of your hospital stay. • If you need to stay in hospital longer for medical reasons, please ask your doctor to send us a letter confirming the reasons. We cover claims for treatment received during your hospital stay from your Hospital Benefit, according to the rules of the health plan you are on. Discovery Health Medical Scheme members on all plans will have access to comprehensive maternity and post-birth benefits. This will be covered from the Maternity Benefit at the Discovery Health Rate and will not affect your day-to-day benefits. The benefit is activated once you create a pregnancy profile on the Discovery app or website, when you get pre-authorision for the delivery, or when your baby is registered on the Scheme. As a member on a Saver plan, you will have access to the following during your pregnancy, once the benefit has been activated on the Discovery website or app: • Eight antenatal consultations with the gynaecologist, GP or midwife. • Five pre- or postnatal classes or consultations with a registered nurse. • Two ultrasound scans. • One nuchal translucency or non-invasive prenatal test (NIPT) subject to clinical entry criteria. • A defined basket of blood tests. Further cover after your pregnancy For up to two years after your pregnancy, the Maternity Benefit offers you the following: • Your baby is covered for up to two visits with a GP, paediatrician or an ENT. • You will be covered for the following: o One six-week post-birth consultation with a midwife, GP or gynaecologist o One nutrition assessment with a dietitian o Two mental health consultations with a counsellor or psychologist o One lactation consultation with a registered nurse or lactation specialist. Cover for newborns A newborn baby receives a period of free cover during their first month, from the date of the baby’s birth up to the last day of the calendar month in which he or she is born, if the mother or both parents are on Discovery Health Medical Scheme. If only the father is a Discovery Health Medical Scheme member, and the mother does not belong to a medical scheme, the baby still receives a period of free cover, from the date of the baby’s birth up to the last day of the calendar month in which he or she is born. Only the main member, authorised financial adviser or hospital liaison manager can register a newborn on a Discovery Health Medical Scheme Plan. A spouse may add a newborn (telephonically) if he or she is the biological parent and is registered as a Discovery Health Medical Scheme member. The newborn will be added to the membership free of underwriting if you notify us within 30 days of the birth of the baby. Cover for a midwife You still need to get approval for the birth even if the baby is delivered at home or in a birthing unit. Once we have approved the event, Discovery Health Medical Scheme will pay for the midwife’s accounts up to 300% of the Discovery Health Rate on the Executive Plan, up to 200% of the Discovery Health Rate on Classic plans, and up to the Discovery Health Rate on Essential, Coastal and KeyCare plans, as long as the midwife is part of the network They will be paid directly and may not bill our members. Please note: • Discovery Health Medical Scheme does not cover costs related to a mother staying in the hospital to nurse her child. • The Maternity Benefit does not cover the baby packs you receive from the hospital. Cover for a doulas A doula is a woman who gives support, help and advice to another woman during pregnancy as well as during and after birth. Currently only Woman Offering Mothers Birth Support (WOMBS) are the accredited doulas who will be invited to join the network for Discovery Health Medical Scheme. If you would like the assistance of a doula, their cover will come from the available funds in your Medical Savings Account (MSA). If the funds in your MSA have been used up, you will have to pay for this service yourself. If your plan does not have a Medical Savings Account, you will be responsible for the cost. Did you know? If you are registered on the Discovery website, you can check the status of your claims online by going to Your Health Plan and then to Claims. You can also get certain documents online such as your membership certificate, tax certificate and proof of International Travel Benefit. You are also able to update certain information, as well as check your benefits and request certain forms and statements via the Discovery App which is available on both Android and Apple devices. To register on the website, please go to www.discovery.co.za If you have any more questions, please call us on ***, email ********** or visit www.discovery.co.za Regards Zakkiya Ganesh Discovery Health (Pty) Ltd On behalf of Discovery Health Medical Scheme ________________________________________ Medical Aid no. ********** 00 ________________________________________ • To: ********** • Subject: Medical Aid no. ********** 00 • From: Ndivhuwo Zacharia ****eledzha ********** • Date: Mon, 18 Feb 2019 06:51:43 +0200 (CAT) • Cc: ********** • Delivered-to: ********** • Dkim-signature: v=1; a=rsa-sha256; c=relaxed/relaxed; d=gmail.com; s= ********** 5; h=mime-version:references:in-reply-to:from:date:message-id:subject:to :cc; bh=YxJuGUSzNkJAAatB9RTwOvcKAUk61tBpo1rTPJCNncw=; b=kPkrdr6O2GSv9ItNX12WSJyNWgaHMulKQie3FNaVk797hq/NIcSCtXuTx8p7DLIFTT abQKm16GpWa64co7klbaZUUYctsUw0OL/6uXIMey05KMUTkXHT2J+q8mCuA41apf3f/+ mCAQhmTMtz24ee9zAy8Qewv9/+c2/mdt9tb3pW4wuXHy0lJVYVt99toFffTuqZ3VIjuu pxlujvuvlX8EgnL6rbS6PJzojXgZL6VWM/PNr3kRpX5obz06Igcv53GsFCCk5ma7zIpy tnfyz7G5kM9dGTR23ibELnpV6E95gyrXOnhEuv1+YaOVy7uY5SGJ1VB36iD8gjwAe6Cr auMQ== • In-reply-to: ********** • References: ********** • Resent-from: ********** ________________________________________ Good morning Please find claim attached for visiting our doctors office which have been paid and need to be reimbursed for the Invoice. May you please advise with the questions below: 1. My Wife she is pregnant 2. Please advise which consultation you will be covering and at what weeks which does not get covered from saving? 3.Âbased on my Âbenefits would you please breakdown the benefits when a spouse is expecting? Thanks a lot.