AK
Andrea K

1 reviews | Active since Jul 2011

19 Nov 2021, 13:40

Useless Discovery Medical Aid

I'm on the smart classic plan with Discovery. On the 15th of November my husband and I were on our way to our holiday destination. Close to our destination, I started experiencing symptoms of a heart attack. He rushed me to the closest private hospital (Life West). They did several tests and found it was a major panic attack. Discovery is now refusing to pay any of the bills as it is not an "emergency" and because it's not the hospital in the smart network. Emergencies are covered on the smart plan, their definition of an emergency "an emergency, is the sudden and unexpected onset of a health condition that requires immediate medical and surgical treatment". This is exactly what happened to me. We treated the symptoms as that of a heart attack and acted quickly! After being on this plan from 2017, it's been useless. You truly know the worth of your medical plan when you try to claim for things you covered for. In my experience, Discovery will always try to find some sort of technicality not to cover claims. Besides all my monthly payments for the plan, I'm also liable for R3000+ in Drs bills.

0
Replies (4)
Discovery Health
Discovery Health's reply19 Nov 2021, 14:18
Official
Dear Andrea K 

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
Discovery Health's reply23 Nov 2021, 13:37
Official
Dear Andrea K

Please check your emails for final feedback from us.

Regards
Discovery Health Servicing Team

AK
Andrea K's update24 Nov 2021, 13:02
Reviewer Update
This has not been helpful. After submitting the pmb form the claims have been rejected again. I'm liable for R4000+ in payments because Discovery is using every code they can find to reject the claims. The point is that I have smart classic because it covers emergencies, apparently you can only have an emergency within close proximity to your network hospital which makes this useless! After several tests to rule out possible causes of my symptoms, only then was it revealed that it was a panic attack and not a heart attack. The emergency unit didn't treat me as someone that's having a panic attack. The symptoms were serious and cause for further investigation.
Discovery Health
Discovery Health's reply26 Nov 2021, 14:50
Official
Dear Andrea K

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team