1 reviews | Active since Nov 2022
Utterly pathetic service
I am very disillusioned. I pride myself for not abusing my medical aid, for which I pay an astronomical amount per month. After an incident with my heart, I also took out Gap Cover to pay for the things Discovery suddenly doesn't pay when you submit claims. I don't know why I have to pay this money just to be able to say I have a medical aid, because that is all I can say. I can't say that they really care much about my health.
My doctor referred me to hospital and wrote 3 different diagnoses he wanted investigated. I got turned away by the Discovery Case Manager on duty at the hospital, stating I must follow the out-patient route by going to casualties so that they can narrow the diagnoses down to one - for which I have to pay to the tune of R3K+. The condition the doctor wanted me admitted for is actually linked to no less than 2 PMB Conditions I am registered for with Discovery.
I am seriously considering ending my road with Discovery because it appears to me they are so hell-bent on saving money that their client care flew out of window three moons ago. They make me feel unsafe. On paper, they are the best. But in practice - far from it. And by the number of negative reviews they have on here, I am wondering why.
Phoning in to their call centre is also a waste of time. Sometimes you hold 30 minutes, just for the call to be dropped. Then you have to start ALL over again. In my eyes Discovery is nothing else but a bunch of bullies. They know they hold the market in South Africa and now they think they can treat their clients like "a word I can't use here"
Thank you Discovery, for failing me, yet again.
"this request has been reviewed and declined. we have reviewed and declined your request for funding because we have been informed that confirmation of benefits for this procedure is no longer needed. We cannot confirm benefits."
But then in the very next point it says:
"As a member of a medical scheme, you may be entitled to funding for Prescribed Minimum Benefit (PMB) conditions"
Now I AM registered for TWO PMB conditions of which the Diagnosis codes are CO-MORBIDITIES of, which mean I DO qualify for funding.
So in essence you say to me "you may be ill, you can just not confirm that you are ill - first have a major crisis, then we will (possibly) fund you."
I fail to understand this warped logic. Well done Discovery.
"this request has been reviewed and declined. we have reviewed and declined your request for funding because we have been informed that confirmation of benefits for this procedure is no longer needed. We cannot confirm benefits."
But then in the very next point it says:
"As a member of a medical scheme, you may be entitled to funding for Prescribed Minimum Benefit (PMB) conditions"
Now I AM registered for TWO PMB conditions of which the Diagnosis codes are CO-MORBIDITIES of, which mean I DO qualify for funding.
So in essence you say to me "you may be ill, you can just not confirm that you are ill - first have a major crisis, then we will (possibly) fund you."
I fail to understand this warped logic. Well done Discovery.
For the one diagnosis the doctor had on his list, heart failure, the treatment component applicable to that condition is medical treatment. Medical treatment includes, inter alia, Medications, Lifestyle Modifications, Monitoring and Follow-up care Therapies and diagnostic procedures.
If i take into consideration that I have been diagnosed with Hypertension as a registered PMB, under that would fall Hypertensive Heart Disease with (congestive) Heart failure, and the treatment component for that includes Medical and Surgical Management. This will include, inter alia, diagnostic procedures, medications, Lifestyle modifications and follow-up care. The goal of management is to:
Diagnose and treat the underlying condition, manage symptoms and prevent complications, improve quality of life and restore function and mobility, amongst others.
Interesting.
For the one diagnosis the doctor had on his list, heart failure, the treatment component applicable to that condition is medical treatment. Medical treatment includes, inter alia, Medications, Lifestyle Modifications, Monitoring and Follow-up care Therapies and diagnostic procedures.
If i take into consideration that I have been diagnosed with Hypertension as a registered PMB, under that would fall Hypertensive Heart Disease with (congestive) Heart failure, and the treatment component for that includes Medical and Surgical Management. This will include, inter alia, diagnostic procedures, medications, Lifestyle modifications and follow-up care. The goal of management is to:
Diagnose and treat the underlying condition, manage symptoms and prevent complications, improve quality of life and restore function and mobility, amongst others.
Interesting.