Discovery Health Medical Aid Complaints & Reviews

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Discovery Health Medical AidCould they at least answer their phones???

They do not even answer their phones! After 5 failed attempts, and 5 different phone no.s (all of whom, apparently, do not exist), I was put on hold, before being given some women complaining about being busy and asking me to leave a message. But the message box was full. So still no customer care or service. We pay you a damned fortune, Discovery, for very little benefit. So up your game!!!

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    Oct 26, 2020

    Discovery Health Medical Aid — Keycare / underwriting

    Good Morning I signed up with Discovery in September 2020, the underwriters diagnosed me with renal/ kidney...

    Discovery Health Medical AidSurgery authorization

    Hi

    My gp doctor has referred my daughter to a specialist he was monitoring a growth in her breast for the last 2 years unfortunately it has grown, which the specialist also agree that it needs to be removed discovery on the other hand does not believe it needs to be removed unless an biopsy says its cancerous and my medical plan does not cover this code what must we still do to convince these people that the patients health comes first she is 19 years old, if I was on a bigger plan then they would authorize should it not be the other way where the patients health and well being overrides these codes

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      Discovery Health Medical AidScheme

      Membership no [protected]
      Ref no [protected]

      I am beyond angry with the service received from your banking details department.

      I have been trying for a month to get my banking details changed.

      I, my partner noel whitehead and our h r department have sent through all the relevant documents... Not just once but half a dozen times, all I get is more and more emails requesting the documents.

      Do I have to get in my car and take a drive to the cape and give it to them in their hands.?

      Can someone in your organization please show these people how to download attachments from an email as they are obviously incapable.

      Please sort this out asap as it is already the 3rd today and the debit should have gone off on the 1st.

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        Discovery Health Medical AidFailing to pay towards therapy session, after writing to them

        HI
        to whom it may concern

        My wife Mrs S naidoo was in the car crash on the 08/03/2020 and taken to St Augustine's and was discharged on the 22/03/2020, as a result of the cv19 locked down at the hospital as they recorded cv 19 cases.
        The therapy sessions was not done after the surgery at the hospital and was required as per treating doctor
        I was informed by the treating Dr that, Mrs Naidoo must have the theraphy and that my medical should cover 24 sessions in this case and based on my policy, I then got my my Dr and therapist to write to my medical in this regard and this was rejected.

        I need help in this regard

        Failing to pay towards therapy session, after writing to them
        Failing to pay towards therapy session, after writing to them

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          Discovery Health Medical AidDebit order date change unfair business practices.

          We wish to change the date that our monthly premium debit order is paid out from the 1st of the month to the 10th. We are told that this is only possible if a double premium is paid for the month in question. We are also informed that we may not cancel the debit order in order to pay manually via eft. Another unfair business practise. Why may we not simply change the debit order payment date and for that change month just pay the pro rata difference between the 1st and the 10th of the month on the 10th of that month? What discovery health is demanding amounts to extortion as the month following the debit order date change again debits the full amount and keeps monthly debits going forward at the same rate. Member number [protected]. C rodel

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            Discovery Health Medical AidCancellation not done

            I requested cancellation on my discovery vitality in april already and was told i'll receive a call within 10 days in never happened I sent another complaint then was told 5 days still nothing all I want is to for you to cancel vitality and dont bill me this month I cant afford any luxuries since lockdown I need all the money I can get maybe I will reinstate after lockdown just like when I initially took it I was told I can cancel anytime, its surprising when I took vitality I was called the same day and it was activated now I want to cancel I must wait for how long

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              Apr 25, 2020

              Discovery Health Medical Aid — Deduction for new member and no feedback

              Hi I have lodged a complaint regarding a new dependent added end of March 2020 for which I indicated he must...

              Discovery Health Medical Aidvitality

              Firstly, there is zero useful vitality assistance for queries, beside a 'bot' which is useless. The helpline does not give the required options for queries.

              I have an apple watch, and am very it literate so don't need lessons on how to read, synchronise, capture, etc. I know how it all works.
              However, I received an email from discovery vitality to say that in january, I reached my goal only two of four weeks, and so will be billed. This is totally inaccurate. I completed all my goals for january.
              Secondly, this week, my 50 points due for 5000 to 9999 steps for thursday 6th, will not synch. This is the last 50 I need for my goal, and I am not getting the points due. There is a problem with the synching of apps in vitality, which must be addressed.
              Members who work very hard to attain their goals cannot be compromised by bad administration - it is not fair on the members - what are we paying the elevated vitality fee for after all???

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                Oct 29, 2019

                Discovery Health Medical Aid — chronic benefit

                I had no idea that some of my chronic meds were coming out of my savings until I had to pay for some of them...

                Aug 22, 2019

                Discovery Health Medical Aid — poor service

                I have been trying to apply for a medical aid with discovery for over a week now and still haven't received a...

                Discovery Health Medical Aidchronic benefits

                This is a condition in which the lining of the oeosphagus (the food pipe) changes from the usual oesophageal lining (squamous cells) to another (columnar cells) as a result of the damaging effect of the acid. Symptoms associated with Barrett's Oesophagus are those that are associated with acid reflux, namely heartburn and food/ fluid regurgitation.

                Barrett's Oesophagus is considered to be a pre-cancerous condition but not everyone with Barrett's Oesophagus is likely to develop cancer. The shift from Barrett's cells to cancer cells occurs along a sequence that consists of unstable (dysplasia) cells that are at risk of developing into cancerous cells. (Barrett's- dysplasia- cancer).

                However given the above Discovery Health Medical Aid, does not pay inf full for the scope examinations to detect or onset of cancer or the medication from day to day benefits and also refuse to provide the medication for chronic.

                Their actions will result in the on-sett of cancer from this pre-cancerous condition not being identified and ultimately resulting in the death of their member.

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                  • Ni
                    Ni-Shaat Ahjum Oct 15, 2019
                    This comment was posted by
                    a verified customer
                    Verified customer

                    Discovery Health would view the scopes as preventative and may review funding if it is related to a PMB condition provided that the treatment guidelines make provision for it. It would be best to discuss this this your treating doctor. All the best with your query

                    0 Votes
                  Jul 12, 2019

                  Discovery Health Medical Aid — poor maternity benefit

                  I am pregnant and not having the benefit of giving labour in a private hospital. I have been undergoing so...

                  May 06, 2019

                  Discovery Health Medical Aid — vitality

                  30 days — 6 emails and not a single reply from discovery. = Your reference number is [protected]. — it been...

                  Discovery Health Medical Aidvitality

                  22 March 2019.

                  [protected]

                  I was unable to log onto my Discovery app to use my rewards today. I asked around and others were unable to open the app. I think it was a general fault. The points are expiring and want to use them - but couldn't. I had to spend cash to purchase breakfast and a smoothie today as oppose to use my points at Kauai.

                  If I cannot get money back, or get more points, I would appreciate the points I have to have a longer validation period so I can spend them.

                  I will appreciate any feedback.

                  Thank you

                  Regards

                  Saul Bloch

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                    Discovery Health Medical AidMisinformed and mislead

                    I have been following up on a claim refund since the 06.03.2019 and after calling in almost every day until yesterday I was told that the money should be released and it wouldn't affect my clawback that I have made an arrangement for.

                    They lady that initially handled my call ensured me that this claim will be paid out and the money will not go to my clawback, after which I has used money that I needed to pay my bills. I am now in arrears due to the lack of knowledge of the discovery staff.

                    I was not settled about this and called in the next day and I was told the same, 1 agent I spoke to even told me that the clawback if a different plan and it will not affect my claim and I will be paid out.

                    I spoke to 6 different people whom all ensured me that the money will be paid via eft, the person I spoke to on Monday told me that if I don't get the money by next day I must call in and they will do a force EFT.

                    Called back on Tuesday and the guy I spoke to said that it's still within the 5 -7 day turnaround time and that I should call again by today and check if I still don't receive the money in my account.

                    Each person I spoke to requested me to confirm my account details to ensure the correct banking details are on the system for me to receive payment.

                    So today I call in and someone decides to do their Job efficiently or correctly ? telling me that I will not be getting paid

                    I have since spoken to 2 CRMS Michael which I was on the call for 35minutes and Priyan for another 35 minutes who escalated the query to senior management from whom I received an apology that was more of a about being sorry for the staff misinforming me and misleading me.

                    I was then called by SELWYN CHETTY a senior manager whom keeps on telling me that the staff will be dealt with and that they are new and don't have enough training (how lucky was I to go through untrained new staff every single call I made since my claim was put through) I told him that it is not my problem I honestly don't care as this is about me and he has the audacity to tell me ‘'well everything is about you''. He tells me that ‘'you do know you owe discovery the money ? '' when did I deny that? I have mentioned that from the onset to the staff of discovery upon which I was insured this will not affect anything as I have signed a debit order agreement for the clawback amount to be debited over 12 months which is attached.

                    Well it is about me right now I have been misled and wronged, due to the incorrect information provided to me by discovery I have utilised money that I knew I would be getting back.

                    I am now in a financial tuff because of the misinformation which is no problems of discovery ?

                    It is my consumer right to be Informed and given the facts needed to make an informed choice, to be protected against dishonest or misleading advertising and labelling. The Right to Choose To be able to select from a range of products and services, offered at competitive prices with an assurance of satisfactory quality.

                    I am totally appalled at the way I am being spoken to and forced to accept what has been done to me.

                    Very dissatisfied customer.

                    From: [protected]@discovery.co.za
                    Sent: 11 March 2019 11:42 AM
                    To: Jade Shanker
                    Cc: Jade Shanker
                    Subject: FW: Membership No : [protected] -WRefNo#[protected]#- -MailRef#[protected]#-

                    Dear Ms Shanker
                    Thank you for contacting us.
                    Claim for Mauff AC and Partners
                    We have received your query about the following claim:
                    Treatment date Amount claimed Amount paid Paid to Reason code Date of payment
                    2019/02/27 R904.00 R549.60 Member 263, 344 2019/03/07
                    Reason code 263: We have not paid this amount, as it is outside the scope of our cover. Unfortunately, medical proof doesn't support its effectiveness and long-term outcome. You are responsible for paying this amount.
                    Reason code 344: We have paid this service at our agreed rates. You do not need to pay this amount.
                    I have contacted the Account Department at the pathologist to query the reason for the surplus charges.
                    They have requested a copy of the remittance to be sent to them for further review.
                    I have emailed the remittance to them for the claim to be reviewed further and await a response from them. Their turnaround time is 5-7 working days.
                    The account details we have on record for claim reinbursements are as follows:
                    Name of bank First National Bank
                    Branch name Remote Banking Service
                    Branch code 250655
                    Account type Cheque
                    Account holder Jade Shanker
                    Account Number ******0770
                    If you have any more questions, please call us on [protected], email [protected]@discovery.co.za or visit www.discovery.co.za
                    Regards
                    Mohammad Patel
                    Discovery Health (Pty) Ltd
                    On behalf of Discovery Health Medical Scheme
                    ________________________________________
                    FW: Membership No : [protected] -MailRef#[protected]#-
                    ________________________________________
                    • To: "[protected]@discovery.co.za"
                    • Subject: FW: Membership No : [protected] -MailRef#[protected]#-
                    • From: Jade Shanker
                    • Date: Wed, 6 Mar 2019 13:41:06 +0200 (CAT)
                    • Accept-language: en-US
                    • Authentication-results: za-mx.discovery.co.za; spf=Pass smtp.mailfrom=[protected]@gaap.co.za; spf=Pass smtp.helo=[protected]@EUR01-VE1-obe.outbound.protection.outlook.com
                    • Cc: Jade Shanker
                    • Delivered-to: [protected]@discoverylink.co.za
                    • Disposition-notification-to: Jade Shanker
                    • Dkim-signature: v=1; a=rsa-sha256; c=relaxed/relaxed; d=gaap.co.za; s=selector1; h=From:Date:Subject:Message-ID:Content-Type:MIME-Version:X-MS-Exchange-SenderADCheck; bh=KOLELAgzSvys8ee8/DDiK44mx5/1xRgy520NiKWb7cQ=; b=Kv01t1pOhIuB6OI/RUDhqQjqCHMZhZUYcq5lpMTQwekYWWGrlTB/MsZBTQsnFDOKpZewcn9IR0sesQj5qMyy9TekyNzCaXRlBGxbteLeSrhX6F4F442Ozlq5AXuDJ5XJT1gxcz2OGogu8pDRPKAdAgPwbxOoEVXLfVAQIAG5frQ=
                    • In-reply-to:
                    • Ironport-phdr: 9a23:m1rtMh3xCCRmeqLMsmDT+D5fVm0co7zxezUtxN8igrNKfL6k+s24bkPW7O0rh1iPT4yJsqsZ2dqTiLjpXCk72bjEsH0Gd8ATBTI4s51P2jINWYuCA0C9K+P2ZSsnGsgETEVi43ywLUlSHoD5ekHWpXqxqzUVH0emOA==
                    • References:
                    • Thread-index: AQHU0mptDEluRaS0hESmp5nu8XG0TKX+eaSg
                    • Thread-topic: Membership No : [protected] -MailRef#[protected]#-
                    ________________________________________
                    Good Day

                    I was referred to get blood tests done by Br B Bishop (Gynaecologist) on the 26.02.2019, he gave me a lancet form with my Auth number on it to do my bloods.

                    The gynae said that they only deal with Lancet when I queried as I know there are way cheaper pathologists available, nevertheless I went to lancet at eThekwini heart centre on the 27/02/2019 as I knew that the tests will be paid out from my specialist benefit as I has a specialist referral with an auth number.

                    When I went to Lancet the lady that saw to me insisted that I pay cash as the system does not take the codes for my key care plan, I tried to explain to her that the specialist benefit will pay out as there is and auth number but she wasnât able to assist me as they do not phone discovery from there offices and if the system said it doesnât cover it doesnât (well too bad for me I have no option)

                    She told me that I can pay cash and claim from discovery, which I did.

                    They now have charged me out of discovery rates for the blood tests R226 instead of R183.50

                    I do not see that this is fair me being charged R42.50 extra per test.

                    This is R170 extra in total that I need to pay because I was charged out of network rates, I am not sending this mail because I am being petty and I do not expect things for free. I do not expect to be ripped off and charged exorbitantly for tests that should be charged a specific amount.

                    I would like this matter to be addressed with the mentioned pathologist as soon as possible.

                    Thanks,

                    From: [protected]@discovery.co.za
                    Sent: 04 March 2019 11:12 AM
                    To: Jade Shanker
                    Subject: Membership No : [protected] -MailRef#[protected]#-

                    Dear Member
                    Thank you for your email.
                    This is an automated response to acknowledge receipt of your claim(s). Your request will be processed within 2-3 working days.
                    Your reference number is [protected], and the details of these claims will reflect on your next claims statement or notification.
                    Please do not reply to this email.

                    Jade Shanker
                    Licensing and Debtors Unit 18 Origin Industrial Park, 14 Riverhorse Close, Riverhorse Valley Business Estate
                    Durban

                    Tel: +[protected] Ext: 513
                    [protected]@gaap.co.za
                    Fax:
                    www.gaap.co.za
                    Mobile:

                    Confidentiality Notice:
                    This e-mail and any attachments are confidential and/or privileged, and remain the property of GAAP Point of Sale (Pty) Ltd. If you are not the intended recipient, any review, retransmission, dissemination, copy or other use of, or taking of any action in reliance upon this information by persons or entities other than the intended recipient is prohibited. If you received this message in error, please notify the sender immediately by e-mail, facsimile or telephone and thereafter delete the material from your computer. Any views expressed in this message are those of the individual sender. GAAP Point of Sale (Pty) Ltd hereby distances itself from and accepts no liability in respect of the unauthorised use of its e-mail facility or the sending of e-mail communications.

                    ________________________________________

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                      Discovery Health Medical Aidthe service and procedures

                      I have been calling in for the past 6days because i am not able to use my Optometry benefits as i was told that the Isoleso department needs to wait for my membership gile to be submitted by Discovery and still no feedback.

                      I am a new member of your service and if this is the only way I'll be heard and asdisyed than would take step because this is not gonna get resolved neither will i be able to use my Optometry benefits.

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                        Discovery Health Medical Aidunethical behavior

                        I was at westville hospital for admission on 26/02/19 around 15h00 coming from the DR's room. There was a lady by reception from discovery who refused for me to be admitted. She said she will not authorise my admission. She said Dr is not suppose to admit me, I must go to casualty and I must go for x-rays, she made me go around .I asked who must pay for double charge now that she says I must go to casualty, then she asked me who then must pay.
                        I was in severe pain with my knees and I had to go up and down because of that lady from discovery.

                        Im so unhappy with the way I was treated .
                        She's asking me who is gonna pay.
                        My question is why must we pay discovery if then they don't wanna pay for our hospitalisation when we are in need.
                        No respect, no confidentiality for discovery to discuss me in reception like that.
                        And I feel that my DR's knowledge/intelligence was undermined for her to say I'm not suppose to be admitted.

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                          Feb 15, 2019

                          Discovery Health Medical Aid — terrible advice and bad customer services

                          How does two consultants confirm telephonically that my wife and daughter can be moved from their own policy...

                          Discovery Health Medical AidMedical aid

                          Good day,

                          I have been a Discovery client for more than 4 years and now I have had enough of your pathetic customer service. Every time we submit a claim your system responds with some vague or cryptic error message and I have to try and figure out what it means. No effort is made from Discovery's side.

                          We have been trying to get a claim processed for almost a month now.

                          My wife phoned discovery on the 18th of January 2019 to get pre-approval for a range of tests. She spent almost an hour on the phone to going through all the codes on the quotation and the Discovery agent ensured her that Discovery would pay for everything in full.

                          On 29 Jan 2019 my wife submitted the claim with all the necessary information and documentation via the Discovery app

                          On 30 Jan we received an email stating the the claim was unclear - refno: [protected]
                          On 30 Jan we received another email stating the only a receipt was received - refno: [protected]
                          On 30 Jan we resubmitted everything via email to [protected]@discovery.co.za

                          On 4 February 2019 we received an email stating that they only received a receipt of payment. This statement was obviously false as we send 3 different documents containing all practice details and codes.

                          On 4 Feb a had to phone Discovery to try and figure out what was going on. It turns out in the world of Discovery "only received a receipt of payment" means "membership number incorrect".

                          On that same they we resubmitted everything with the correct membership numbers.

                          On 5 Feb we received and email with the same message

                          On 6 Feb we received an email stating again that the claim was unclear

                          We then received payment for first amount on the invoice. We are still waiting for the second amount of ~ R 2800

                          11 Feb we received another email stating that the practice details were missing on the submitted documentation - Again a false statement as both invoices that we submitted contained all practice info including practice codes

                          11 Feb We resubmitted everything again

                          At this point we are extremely frustrated with Discovery. Every time you send one of these message we now have to try and figure out what went wrong. The message that your are sending to your customers with this level of service is "We just don't care". How about when there is a problem on a claim you phone the client. How about you put in some effort to get the claims processed. We are paying a lot of money every year to Discovery. Every year prices go up but your customer service goes down.

                          Today I received a statement stating that Discovery is not paying for the second half.

                          We have had several reference numbers during this process: [protected], [protected], [protected], [protected], [protected].

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