Discovery Health Medical Aid
reviews and complaints

My wife was hospitalised which obviously means that all doctors bills must be paid out from the medical scheme, which has not been done. I, ve been battling for a month now to get all the bills sorted out, but no luck yet. i, ve made numerous phone calls (duration of calls 45 to 90 minutes) they keep transferring you to the next department which means you have to explain the whole issue to 5 different people. almost have more reference numbers on my phone than contacts. and guess what? still not sorted out! But when You owe them money they are quick to deduct or phone for payment. This is the worst service I have ever seen in my entire life and this is supposed to be the best medical aid. So if you have any queries dont even waste your time by sending email's or making millions of phone calls, because it wont help. You're simply just wasting your time and money.

Hi, Today I recieved a call from ITC saying that I am listed on ITC by Discovery. I called Discovery regarding this query and they explained to me why I was owing R2700. I have no problem with paying the R2700 but I do have a problem regarding the extra cost on the ITC board. I was not contacted regarding this query and I do not understand how, if one does not respond to letters why are they not called. the lady that I spoke to Viloshnee Kisten told me that it was not part of the policy to call clients in June-the policy became active in August. My question to Discovery is in August, why was I not called!? Handing someone over before you have exhausted all contacts is not legal! I would like to be taken off ITC and pay the outstanding R2700. Please may I have this matter resolved with the outmost urgency.

I have been a member of Discovery Health since 2002 and have always been happy with their service until I went onto their Oncology program in 2007. The oncology department is a 'law unto themselves' and do not respond to queries. I sent my query regarding unpaid bills by e-mail on 3 June, 7 July & 16 July 09. I also faxed the query to the oncology department on 12th June 09. I followed up with phone calls to Sandra Alexander but, to date, I am still awaiting a response. There is no area on their web site where one can lodge a complaint and their call centre does not handle oncology queries. I am very disappointed with the lack of service from Discovery's oncology department.

Discovery are paying me for my claim for my gp submitted for service dates 14 September, 15 September and 26 September, but HOW can I possibly have the following:

Reason Code 42: You are responsible to pay the balance of this line as you have run out of funds in your Medical Savings Account.

I AM IN MY THRESHHOLD so how can this be? You have paid the rest of this account from threshhold?! Please correct this immediately and PAY me what you owe me, i.e. the injection for the amount of R194.31 on service date 14 September. I need to pay this amount to my doctor asap.

My wife has been diagnosed with Hyperthyroidism which is not covered by the Chronic Illness Benefit, while Hypothyroidism is. Both are life threatening conditions, one disease is for an overactive Thyroid gland (Hyperthyroidism) while the other is for a under-active (Hypothyroidism) Thyroid gland. It pains me to understand how one can be covered while the other is not! Hyperthyroidism can also lead to a number of conditions, such as heart problems which are covered by the scheme where as the cause of the condition is not! Its like only covering conditions effecting your right leg and not your left!This is shocking and it is just spelling out the problem I have with medical aid, you never know what you are really covered for. Just now you get some strange new disease and they tell you its not covered because its never been diagnosed before! Its like your motor insurance company only insuring you against accidents between Audi and BMW and if a Opel hits you, you're not covered!

Having paid money to both Virgin Active and Discovery Vitality in April, I was highly embarrased to find out last Friday that my membership to both organisations had been cancelled. The cancellation dates back to February 09, despite contracts being concluded in April 09. Calling both call centres has proven to be an nightmare, with Virgin Active blaming Vitality. Vitality on the other hand have promised on 3 occasions to get someone to call me back. The last promise was yesterday (81009) where I was promised that a manager would call me within the hour - A day later I am still waiting.

I tried to add my partner onto to my existing Discovery Medical Aid account now that we are living together by submitting an 'Additional Dependant Form' to them on the 25th August. As of today, I heard nothing, nearly a month later! I call their help centre and I am told that the application has been denied due to their 'rule' that I cannot add a dependant onto my account if they are coming from a lower Discovery medical scheme. Now, no where on the application form does it mention this and neither did ANYONE inform me that the application had been denied...eventhough I had cancelled my partners medical aid already! They also did not inform my partner when she cancelled her account that she could not be moved onto my account!

This is totally unacceptable. How can I be denied adding a dependant to my account...it will effectively be doubling my contribution to Discovery Medical Aid...but I guess they dont want my business?!? It is also unacceptable to not infrom me about this. Goodness knows how long my partner would not have been on medical aid!

If you enjoy being dictated to by Discovery as to what you can and cannot do on your account, then by all means become a member...

To whom it may concern

My husband had undergone heart bypass surgery on the 8th of april 2009 at st augustines hospital. The surgeon who performed the operation on him was mr m. K. Odayan.
On recovery we were faced with unpaid bills amounting to r25 064, 24 which were not covered by medical aid due to a billing problem they are experiencing with the above surgeon. The doctor had bypassed five arteries. He billed on code 1348 as well as using a modifier code and code 1275. What is not making sense to me is that the medical aid paid for one bypass and did not pay for the other four. How did they expect a surgeon to open my husband up and do one bypass?

However on admission, authorization was given by medical aid but I was not informed of any problems or liabilities I would have had to cover personally. The day before my husband surgery, we asked the surgeon before signing the consent form of any shortfalls that we would be liable for, he mentioned that he charges up to 200% of medical aid rates and we were covered for 200%. However medical had paid full for all codes the surgeon had charged except the 4 grafts. This does not tell me that the surgeon had charged over medical aid rates, so why am I left with this bill of r25064-24. Had discovery health or the surgeon informed me of this problem before the operation, I would have got another surgeon whose billing is in line with discovery to operate on my husband.

Discovery medical aid does not return calls neither do that keep you informed of the progress of your complaint. I am now waiting for four months.

Although I am liable as the member, I will not take responsibility for someone else’s mistake or a simple problem such as billing problem between discovery and the cardiothoracic surgeons board. Please can someone help me, as I am now prepared to go public (To the media) with my problem so that other discovery members are not faced with the similar situation. Time is now of essence.

I moved to Australia with my family on 13 August 2008. I contated the Customer Services department at Discovery Health to inform them of my cancellation of my medical aid as well as new contact details of myself (including e-mail address and my mothers' postal address details in Gauteng, South Africa). I still have the e-mail from the Customer Services Consultant where he cc'ed me on an e-mail to the department who were supposed to update my details on 1 August 2008, specifically stating that we were moving to Australia.

2 weeks ago we were informed by my father-in-law in Bloemfontein, South Africa, that I debt collector had turned up at his business (which was my previous work address), stating that we were listed on ITC and had to pay R2500.00 outstanding to Discovery Health. He paid the amount.

I have copied the e-mail correspondence between myself and a consultant at Discovery Health after her reply to my request as to why they never contacted me was that that had indeed tried to contact me. Sent me 4 letters (which to this day has not arrived at the postal address I supplied on cancellation - my mother will confirm this) and tried to contact me on our South African contact numbers. No attempt was made to contact me on my e-mail address or the new postal address that I supplied.

My last e-mail to her, has gone unanswered. In there I wanted her to supply me proof of the fact that these letters were sent to the postal address which I supplied as well as why my husband was listed on ITC while I was the principle member. There could be proof or explanations for this, but Discovery has decided to ignore me.

I feel (as per my comment below) that with so many people leaving the country, they should have something in place in their system to be able to contact people who have moved overseas.

I do not dispute the amount we had to pay. I dispute the fact that they placed us on ITC and caused major embaressment with my husband's parents because of their lack of professionality.

Ps c the copied correspondence below.

Thank you,
Gillian Willemse

RE: Discovery Health account‏
From: Johann and Gillian Willemse (jos.[protected]@hotmail.com)
Sent: 13 May 2009 01:33:24 AM
To: [protected]@discovery.co.za; [protected]@discovery.co.za; [protected]@hotmail.com ([protected]@hotmail.com)

Good Day Pamela,

I don't understand. The last e-mail I referred to (and attached) in my previous e-mail, I received confirmation that the operator confirmed my LEAVING SOUTH AFRICA and moving to AUSTRALIA. How is it possible Discovery would think it possible to CONTACT me by sending letters to a POSTAL ADDRESS in SOUTH AFRICA and by trying to phone me on a SOUTH AFRICAN number? What about my e-mail address?

The second thing I don't understand is your statement: "Since the amount is now paid, we have sent a request for your name to be cleared off ITC. Please note that our banking details are included in the document attached. Please email me the proof of payment in order for this to be done." What do you mean?

I want confirmation of the postal address where these letters were sent to AND I want to know, why if I am the principle member, my husband's details appear on the attached letter? Does this mean all the letters and the ITC listing was in his name?

I would appreciate your speedy response to a matter that could have been sorted without any problems if someone at Discovery Debt Collection had just taken the time to understand the situasion and handled it appropriately. With so many people leaving the country, is there no other way for Discovery to make sure that they can be contacted after they've left the country other than to send the debt collector if the SOUTH AFRICAN details don't produce results? This is obviously part of the customer service department. I would appreciate feedback from them as how they handle situasions like this.

Thank you,
Mrs. Gillian Willemse

"Do not let the past dictate who you are, but let it become part of who you will be."

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Subject: Discovery Health account
Date: Tue, 12 May 2009 10:54:40 +0200
From: [protected]@discovery.co.za
To: jos.[protected]@hotmail.com

Goodday Mr Willemse

We have received your query regarding the amount of R2228.00 that was outstanding to Discovery Health. I have attached an account of this amount.

Also, please note that we sent you 4 letters informing you about this debt; on the 5th September 2008, the 7th October 2008, the 14th November 2008 and the 16th January 2009 respectively. We did not receive any response; after which we attempted to contact you by telephone, to no avail.

After a certain time has passed and the debt is not paid, our system will automatically list a member on ITC or hand over the account to an external debt collection agency; as it happened in your case Mr Willemse. Since the amount is now paid, we have sent a request for your name to be cleared off ITC.

Please note that our banking details are included in the document attached. Please email me the proof of payment in order for this to be done.

Thank you very much for your query.

Pamela Buthelezi

Member Debt Administrator

Settlement Solutions

tel: +[protected]
fax: +[protected]
email to:[protected]@discovery.co.za

URL: http://www.discovery.co.za

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Registration number: 1999/007789/06
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