Menu
Login
COMPLAINT:
*Ref number: [protected] and Ref number: [protected]*
PLEASE NOTE THAT MY UNDERSTANDING IS THAT DISCOVERY MEDICAL AID INCREASES IS DONE 01 JANUARY EACH YEAR
I am using this platform to voice my dissatisfaction with Discovery Health Medical Scheme (Registration number : 1125) due to the fact that I could not found an E-Mail address for Discovery Health Medical Scheme complaints on any of the correspondence from Discovery Health Medical Scheme. (Payor of the medical aid).
My daughter in law started her Keycare Plus membership effective 01 June 2022 with an exclusion for Sinusitis for one year (Until 01 June 2023). Wonderful, thank you Discovery Health Medical Scheme.
Problem number 1:
01/09/2022 the premium was R1 279 and an increase R101 was done for October 2022 premium to R1 380.
Why the increase?
Was the Vitality benefit added?
What integrity is shown here, if this was the case?
What caliber sales people is used if everything, including cost is not explicitly explained?
Remember we are living is trying times not everyone can afford a premium hike out of the blue with NO correspondence pertaining this increase.
Call details can be obtain via myself for the 05/10/2022 where my daughter in law was informed that her pregnancy benefit was activated. Now reference number [protected] is the call confirming the activation of the pregnancy benefit on the 05/10/2022 at a R101 extra per month. I have an idea this the Vitality benefit was being activated. Please can this be investigated and refund the money of Vitality as we do not need nor can we afford the Vitality benefit.
Problem number 2:
Reference number : [protected]
The reception lady of the gynecologist call Discovery Health Medical Scheme today 11/11/2022. Discovery Health Medical Scheme inform her that my daughter in law's pregnancy will not be covered on the Scheme due to exclusion on her medical aid / Keycare Plus. My daughter in law went through a great length of trouble to get a Keycare Gynecologyist to assist her during her 1st pregnancy. The one provided in our area told her that is fully booked and con not take on more pregnancies.
According to our knowledge no exclusion was given on a pregnancy, she has a year exclusion for sinisitus.
I need to know why Discovery Health Medical Scheme wil not pay for the pregnancy of daughter in law?
There was no exclusion for pregnancy when the Keycare Plus was taken?
When enquiring was done to why Discovery Health Medical Scheme we were informed that there is an exclusion.
My problem here is really do not think a pregnancy and Sinusitis is the same thing?
Can Discovery Health Medical Scheme clarify this matter for us and ensure that we get the authorize number for the hospital to cover our new baby WITHOUT CAUSING FURTHER STRESS TO OUR ALREADY STRESSED MOMMY AND GRAND MOM.
We are preparing the matter to take it to the Ombudsman. This platform is our 1st step
Please contact us to resolve the matter.
Thank you
