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Discovery Health Medical Aid
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Discovery Health Medical Aid
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www.discovery.co.za
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1.4 210 Reviews

Discovery Health Medical Aid Complaints Summary

19 Resolved
191 Unresolved
Our verdict: If considering services from Discovery Health Medical Aid with a critical resolution rate, extra caution is advised. Examine detailed customer feedback to understand the severity and nature of unresolved issues. Be prepared for the possibility of unsatisfactory responses and have contingency plans, including seeking assistance from consumer advocacy groups if necessary.
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Discovery Health Medical Aid reviews & complaints 210

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11:51 pm EDT

Discovery Health Medical Aid collections hand over

I have been a Discovery health client on and off for more than 10 years, and last year my wife went in for as her sugar was extremely low.Discovery then approved her hospital visit at Malbarton Hospital. This was in April 2015. I then lost my job at the end of that month which i was dealing with the CCMa. I told the Discovery health agent that i would pay for the medical savings portion and not the Reversed authorization. i was waiting on feedback and low and behold i was listed on ITC. This has now compromised me getting a job with a prominent bank. i am totally disappointed in Discovery and what they have done.

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9:07 pm EDT

Discovery Health Medical Aid hospital fees not paid

Please refer to email below regarding the claim for Parklands Hospital for MRs H Sukwa .

I called your call centre on 08 February 2016 and spoke to Nowazi and some other person who advised i do not need pre authorisation as this is a day procedure and if my mum needs to stay overnight the hospital will call for authorisation.
I was further informed that i only needed to pay the co payment.

Discovery has even made payments for the maxillofacial – Dr V Amaidas and the anesthetic – Dr Edington, this is beyond my understating that the claim for the hospital is rejected.

Please forward me recordings of my call to Discovery and i will also request the recordings from my IT department as our calls are also recorded.

No mention was made regarding the funding of this procedure. We were informed because it is considered ‘dentistry’ we are required to pay in the co-payment.

Very disappointing and unprofessional.
i have also emailed the recording of my call and no response

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9:32 am EDT
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Discovery Health Medical Aid discovery health

Discovery no longer seems to even bother to reply to email claims.

They just ignore claims.

If a claim does not meet their requirements, they do not supply the customer with feedback saying " your claim was rejected because xyz "...they just do not respond at all.

Discovery...come on man...shape up and let us know why our claims are being rejected.

Don't just ignore.

Why do we need to tell you this [censored] !

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11:42 pm EDT

Discovery Health Medical Aid authorisation claims

Discovery is the worst medical aid scheme i have ever come across.
Reading between the lines and fine print seems to be the ruling outcome with every health issue faced.
I am having a sensitive back op and had half the claim being authorised as suddenly one of the best neuro surgeons in south africa is not covered?

I pay almost r4000 pm for my medical aid on a comprehensive plan so why should i chose a lesser qualified surgeon who discovery does cover?

I cannot wait to change from this medical aid, they use any and every excuse not to pay a claim.

Pathetic service!

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2:05 am EDT
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Discovery Health Medical Aid discovery does not want to pay for anaesthetist

I am bitterly disappointed with discovery medical aid. I went into bedford gardens clinic on the 11 february 2016 for a double jaw procedure. Firstly i received authorization numbers and discovery land up paying for half the amount that they stipulated and secondly they depleted all my medical savings and all my dentistry as well so i lost both, in turn i phoned discovery only to be given the run around.
And now to add insult to injury they will not pay for anaesthetist as they say that they do not know what the account was for even though they paid for half the doc and hospital and gave me an authorization number?
I need someone to sort this situation out asap.
The anaesthetist is now charging me interest on the overdue account?

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manjuuuu
, IN
Mar 18, 2016 3:46 am EDT

you have to disappointed with Discovery Medical Aid. I went into Bedford Gardens Clinic on the 11 February 2016 for a double jaw procedure. Firstly I received Authorization numbers and Discovery land up paying for half the amount that they stipulated and secondly they depleted all my medical savings and all my dentistry as well so I lost both, in turn i phoned Discovery only to be given the run around we have take action on your complaint

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7:27 am EST

Discovery Health Medical Aid billing/customer service

I have been a member with discovery health since march 2011 via my company medical aid. I left my company in oct 2015 and naturally my company medical aid was cancelled.

To my surprise i received a call from shapiro shaik defries & associates (Attorneys) on the 09/02/2016 about an outstanding amount of r4162 owing to discovery health. I was never informed either by telephone, e-mail, sms, or postal by discovery that i owe them any money. The collection attorneys (Shapiro shaik) have placed a letter of demand against my name on itc on request by discovery health. This has caused me great embarrassment in looking for new employment.

I am disgusted that discovery health can treat one of their members like disposable toilet paper and not even have the common decency to try and contact me as per professional health service provider.

I will also be cancelling the following products i currently hold with discovery due to their shambolic service and embarrassment they have caused me.
-discovery credit card
-discovery invest
-discovery life insurance

Regards
Willie kruger
Membership number [protected]

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8:27 am EST

Discovery Health Medical Aid not honouring written hospital authorisation

After 5 years of irregular menstruation and trying different pills, my gynae recommended i try the mirena iud. I bought the device from the chemist and it was covered out of my msa. I then went for the procedure to have it inserted in the doctor's rooms. Unfortunately i am one of the rare people they mention in the indemnity form and i had a vasovagal attack with a seizure. My doctor was unable to complete the insertion and advised that it is impossible for it to be done in her rooms as this will happen again. It is extremely dangerous and the only way for the procedure to be done is under general anesthetic.

I sent the letter of motivation i received from the doctor to discovery to apply for hospital authorisation. They declined it. I understand if they won't cover the device or doctor as its a contraceptive, but the fact is that the procedure has to be done in hospital. As my medical aid provider, the hospital should be covered by discovery. I complained and my application was then escalated and i received authorisation by email. I went to the hospital and booked the procedure for 15 feb.

I called discovery to change the date on the auth letter and was advised the auth was sent by the system in error and should have been declined. I have it in writing from discovery. How can they now go back on a written authorisation? As a consumer, surely i am protected by the fact that i received the authorisation in writing?

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8:21 am EST

Discovery Health Medical Aid incorrect billing and threats

Good day,

We are having huge issues with our administrator, Anna-Maria Aires. We are consistently having disputes about the amounts being deducted my means of debit order and have now cancelled the debit order as our company cannot keep paying for services/members we should not. We have now been told, tough, we cannot cancel the debit order and will have to sort out the disputes after the fact. How is this possible? We have been asking weeks in advance when/how can we make the eft payment and are just being stonewalled and threatened. Is this discovery's level of service. Please advise.

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4:34 am EST
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Discovery Health Medical Aid account was handed over for collection. cancelled medical aid

How the hell do you hand over my account to debt collectors if you have not responded to emails or even tried making contact with regards to the outstanding monies owed. I cannot believe this poor service. Then they ask why I cancelled my membership. Do you think it is acceptable to mess up my credit record because of your crap service. Come on wake up pick up a phone or email your client(Ex-Client) first before doing something as stupid. [protected]

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11:27 pm EST

Discovery Health Medical Aid medical rates

For discovery, as a classic priority member paying r2478, 00 a month, i am appalled that discovery as my health service provider is not able to cover me properly on my pregnancy. I was equally shocked to see that they only have two gynecologist in the johannesburg area charging their medical scheme rates... So much for providing choice combined with affordability. Thus i am forced to go to a doctor that does not cover your rates, only to find out from the breakdown how shockingly low their rates actually are! Do theyreally expect a respected and professional doctor to charge r340 per consultation and less than r262 for a baby scan?... I am utterly speechless and beyond shocked. You know what they say, you truly only realise how decent your provider is when you are faced with a health situation different from your norm, discovery is anything but decent. It is a sad day when my company chose them as a health provider. Please make them wake up, they are exploiting people with their rates. At the very least, they must put in place a pregnancy program to acknowledge that this is a unique heath situation which does require a little bit more assistance than a person who is not pregnant. Or increase choices of medical doctors who charge their rates. Something must be done. Brigitte monvoisin

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6:55 am EST
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Discovery Health Medical Aid claims not being paid

Hi i am truly upset, you are quick to take our money every month and when i submit a claim it is always a costly lengthy expense on my part, the hours of phone calls following up on claims that was submitted, explaining everything from the beginning every time, the last claims i made to this day has never been paid in full, and i have truly have given up i submitted another claim today, and in the 8 odd years that i have been with discovery i have always been the one that calls and resolves issues as my husband who is the principle member is on the road and does not have access to a phone line, and as i have explained before this is never a quick 5 minute call. I was told today that i cant get my claim paid in full, even though i have given an instruction to do so, because the principle member has to give that authority, really? Can you not give better service then to send me from pillar to post every time i call your call centre, i am truly fed up. I want the claim that i sent through today to be processed in full immediately, there is plenty of savings funds available for you to do so i spoke with farah sharmar – her reporting line is claire cosby.

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Update by renejason
Dec 28, 2015 3:42 am EST

still no response from anyone!

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6:02 am EST

Discovery Health Medical Aid discovery health claims department

I have put in claims to discovery from march this year 2015 and have never received the money i've claimed. I phoned discovery numerous time the most recent being 02 december 2015. From i was promised by consultant charldene koen whom assured me that she would get back to me with feedback on action she has taken and when i would get my money. Which she hasn't to date. I was on the phone with her for more than 50min. Subsequent to that i spent yet another hour (01h05) to be exact today using my work landline trying to follow up with another consultant abi chetty who also started the process from scratch which i assume had never been resolved by the previous consultant. Who also gave my multiple and differing reasons why i had not received a cent from discovery. I was further advised that the reason the claims were not paid to my account was because the my details were never which was not true because when i went to the discovery website and logged to my profile my banking details were there already. So this means that i was lied to me. I have been with discovery for the past 5years, never missed or delayed a single payment and the least they can do is pay me r2000 worth of claims back. The claims are for:

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12:39 am EST

Discovery Health Medical Aid hospital payout

I went into hospital on the 9th November and my admission was approved by Discovery. My policy covers 100% hospital and a portion of doctors bills, hence, why I have Gap cover. My hospital bill was not paid in full and according to the administrator, Ethekwini does not fall under Coastal This was not told to me when I was given admission approval. EThekwini have already handed my account over and it is the first invoice I have received in the post. I have then had contact with the doctors rooms to find out if they have been paid as I need to submit the balance to my Gap cover. I was informed by the doctors that Discovery have tried to contact me because they have paid the money into my account. Not once has Discovery called to ask me for my details nor have they contacted my husband. When I called to complain the administrator told me EThekwini does not fall under coastal and they need to pay me for the doctors. He dis not ask me for my bank details and to this day no one from Discovery has called me for my bank details. The last time I went into hospital (2yrs ago) Discovery paid the doctors directly. Why the change? NO one at Discovery has replied to my emails sent 30th November 2015. Seriously need to look at a medical aid that keeps to their word!

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6:44 pm EST
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Discovery Health Medical Aid refund not being processed.

My wife received the necessary authorisation from Discovery Medical Aid prior to purchasing her prosthesis which needed to be bought by ourselves and later claimed from them, the claim was submitted to them and 2 weeks later we still wait for the refund, nothing that all relevant documentation was received by themselves, they seem to have exhaustive excuses every time, it's either that it's with a manager, or the managers are in a workshop, bad, worst customer service skills I have ever encountered in the service industry, and what makes it most frustrating is that every time you call you end up speaking to a different person and you are required to give them the entire story to be told the same excuses, and also there is no indivual person that you make contact, their service is pathetic, I wish and will be investigating my options if changing my medical aid in the new year .

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5:47 am EDT
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Discovery Health Medical Aid refusal to pay hospital when previous payment was made.

I was admitted to to bay view hospital in mossel bay on the the 20/09/2015 for a peptic ulcer related to medication taken for pancreatitus. Only after i was discharged i was informed by the hospital that i owe them r18000 because discovery refuses to pay. I have repeatedly tried to contact them and they do not give me any information. I was admitted in march of the same year for pancreatitus and everything was paid in full. Why not now. The doctor admitted that the ulcer and pancreatitus was related. I was again admitted on the 10/10/2015 for a bleeding ulcer but was told yesterday to leave the hospital due to the fact that discovery refuses to pay but at the same time yesterday i recieved an authorization number. Attached is a pasting of the mail and number. "dear sean we have received the preauthorisation request for your hospital stay. We realise there is a lot to arrange before any treatment. This letter will help you to prepare. The authorisation number is [protected]. " can someone tell me what is going on. I will be forced to go to the ombudsman or seek legal assistance. Why would they kick me out of hospital when i recieve an autherisation number? My id [protected]

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3:03 am EDT

Discovery Health Medical Aid refund not processed

Discovery is very quick when it comes to collecting debit orders... If only they were as quick in refunding monies. Submitted a claim for a refund, a discovery consultant approved it 2 weeks ago... Still the money is not in my account. If discovery is to open a retail bank.. They wont see me on their doors!

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Kuben Pillay
, ZA
Nov 03, 2015 6:29 pm EST
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I fully agree as I'm in a similar predicament, my wife got the necessary authorisation in writing from Discovery for the purchase of a prosthesis, the claim was submitted and acknowledged yet it still needs to be authorised by management who is either in a meeting, you end up calling numerous occasions speaking to different consultants who in turn promise to call you back and tells you the same story that it's being referred to a manager .
Their service is pathethic, they seem to or try to frustrate you in dropping your claim, it's the worst company that I have dealt with, they need to be educated with regard to customer service, looking at the complaints on this site is shocking .
Mr Kuben Pillay [protected]

V
V
vina de barros
, US
Oct 01, 2015 2:12 am EDT
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I'm just having the same problem here - they took money out of my account without my consent - and from my cheque account on top o it which i NEVER gave them before - whenever there is a co payment i use my credit card - and they say they dont keep record of our credit cards? really ! this is just unceptable and to get to talk to someone to clear this mess is just as bad - no supervisor no manager no wonder!

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2:32 am EDT

Discovery Health Medical Aid authorisations number

Joined 1st january was accepted in may i notify them about an operation i was going to having august refuse authorisation number because of the agents zaarik yoosub which i was told this month is as agent told him all about my pre-existing condition no waiting period his profile is not what i was told, my membership was cancelled via email can get my telephonic conversion that i had with zaarik yoosub. Please advise me what to do. Thank you.

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7:59 am EDT
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Discovery Health Medical Aid refusing to refund full payment

My son is 22 months old and has been revered to Paediatrician Neurologist who recently diagnosed him with Epilepsy. She does request cash upfront which you as the member need to get back from Discovery. After a month we have still not received our refund. After 5 email and 20 phone calls they have at least processed they claim but still awaiting for payment. We were NOW also informed Discovery does not have a PAYMENT ARRRANGMENT with the doctor therefore they are only willing to refund us half our money. I as the member feel whatever arrangement they have with the doctor should have nothing to do with me as the member. That money I have in MY SAVINGS is my money the member not Discovery’s money. They would pay a normal paediatrician who does not specialise in a child’s brain R 719-00 because they have a payment arrangement with that doctor. A paediatrician neurologist which specialise in a child’s brain they are willing to refund R 489-10 according to the agreed amount. Agree amount according to whom! How does is make sense? Surety the C.E.O. of Discovery does not receive the same salary as the staff in the claims department. I even gone so far as to call discovery held on for 10 minutes asking them to refer me to a Paediatrician Neurologist they have a payment arrangement with. They came back and said they have NONE. They have no payment arrangement with any Neurologist Paediatrician what does that tell you. I expect a full refund on my money !

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9:41 pm EDT

Discovery Health Medical Aid recruitment process

I really had high regards for discovery health once upon a time. Not anymore. I do hope "adrian gore" (Ceo of discovery) has time to read all the negative responses and really does something about it. I applied for a pre-authorisation position and when i went for the cognitive test in centurion branch, i noticed that certain individuals where very content with there selves, as if they new what to expect to come out, i even over heard them make a statement after the test, which clearly indicates that they hand the upper hand and was given material to give them the edge to get ahead in the process. It is really sad because when i reported this matter to the guy that was the hr representative, his response was " i will definitely take it into account" but his body language said other wise. He didn't even seem shocked at what i had reported to him, as if he was aware of this and was quit content with it. I now truly believe that discovery employs people via connection calls and clear not by there widths. There poor service comments from customer all over speaks volumes of the pathetic employees. The name discovery is a thing of the past, a name that has been dragged through the trenchers.

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6:27 am EDT

Discovery Health Medical Aid giving birth through midwives

Dear Sir/Madam.

I find it very strange that Discovery rates for Midwives are so ridiculous low when a member chooses to go through midwives as compared to hospital rates.

On average giving birth through a hospital would easily cost more than R60 000 and discovery medical aid pays in full. But through Midwives it costs maximum R20 000 but discovery rates only refund about 20% of the costs, which is unfair because not all people prefer hospitals for birth.

I would like to urge Discovery to really consider us as well as the are loosing nothing but saving a lot of money through midwives births. I recently lost a lot of money while I pay a lot to Discovery.

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Update by Zam1172
Aug 17, 2015 6:29 am EDT

It's not fair

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Phone numbers

+27 115 292 888 +27 315 086 444 More phone numbers

Website

www.discovery.co.za

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