Discovery Health Medical Aid
Reviews and Complaints

Good morning .My name is merisha from ermelo. On the afternoon of the 25th july I noticed little bumps on my whole face wich where very itchy.So I went to my local pharmacy they gave me celestimine tablets and viocort ointment and said I have an skin allergy. Went home took the meds as prescribed applied the ointment.The morning of Friday 28th july no difference on my SKIN it was still very itchy and still all over my face .I then tried calling many dermatologists most of them only had appointments for me late August, middle september wich to me was impossible as I was suffering there n then for 3days taking meds n applying an ointment wich never made any difference.I called Dr Karen coch rooms she gave me an appointment for Friday 28th july at 16:00 wich I took the appointment as I'm worried what is happening to my face.I saw dr coch wich she said it looked like i had eitjer a bacterial or fungal infection on my FACE and that she had to take skin sample from my dace to send to the lab for testing to find out exactly whats wrong with my face.Today 11th AUGUST I receive an email from discovery claims stating my phatology account will not be paid as I needed a doctor's reference letter in order to see a specialist.what upsets me is that when you are faced with a situation what do you do?I for a fact know that if I went to the doctor I would have only seen a dermatologist within 2weeks of seeing the doctor. Who in their right mind will wait 1week or 2weeks to see a specialist when I was suffering with my skin so bad.its so sad that I am forced to have a useless medical aid like discovery, majority of the time i pay cash for a Lot of medication.When you have a problem why must we always wait, if I have a problem I want to been seen then there not when it suites a specialist.its sad doctor's and specialists are only in this medical field to make money it's not a passion and to help but it's us the patients have to be at there beck n call.You discovery need to review your do's and dont's when it comes to clients having a problem and need help ASAP.Very disappointing.I have a medical aid that I will go a year with out using any funds but the time i have a problem I still have to pay from my pocket.

Discovery Health does not contact me after a lengthy issue going on now for 5 months
They owe me R 750 that they have not paid out and they are causing me great amount of stress!
I have been a member for 18 plus years and the way they treat their clients is appalling! I am waiting for them to call me but they don't follow up or sort out my query

Claim no 1523893

The service received from Discovery Insure regarding a minor claim for an incident lodged on 22 May 2017 is pathetic to say the least. A lackadaisical approach is adopted when dealing with claims by consultants allocated claims and no feedback is forthcoming. The client has to chase the consultants for feedback instead of the consultants providing ongoing feedback to the client which is part of successful communication and client liaison of any organisation. Can someone from Discovery Insure please explain to me why a claims consultant is assigned to a claim and is never available for feedback on the progress of the claim? My interaction with the claims department has been disappointing and the claims queries have taken an unreasonable time to resolve and I wish to express my unhappiness on the manner in which the claim has been handled thusfar.

Eugene Nzama
[protected]

I got stuck at Devon after an incident on the 4th of May and i called discovery around 22h00. I kept on hearing that someone was coming till the 5th May at around 06h00. They towed my car to my place and left it there.I called discovery again about making claims, that's when they came back and towed my car to some storage which i wasn't made aware of storage fees .i waited for 3 weeks for the claim to be processed, only to have them terminate my policy today on the 26th May.I didn't mind because i wasn't happy with their services anyway...But when i wanted to retrieve my car today, i was told to pay R 3, 519 for storage fees, whereas this wasn't discussed with me. If i was made aware, i would have rather had my cay in my place than at some storage where discovery has to dump everything on me.

Membership number [protected]
: classic comprehensive plan
: mr daniel tebbutt
: 1968-11-13
: 0636304 k marszalek and partner inc
I was referred by my oncologist to have a follow up pet/ct scan done on the 3rd of march 2017 at tygerberg hospital. this after I was diagnosed with cancer last year. claim was submitted but discovery settle invoice from my medical savings and not oncology benefits. all claims for 2017 this far has been due to oncology treatment this includes doctors visits to dr marszalek, medication, pathology, radiology, pet scan etc. (excludes over counter medication and 1 visit to dentist dr de vries.
Request full recon on my medical savings. pmb application form was submitted on the 16th of may by dr marszalek to motivate treatment. received no outcome. numerous phone calls made without success. medical savings depleted.

I registered my baby for the Vitality Baby program on the 20th of April 2017. I received a letter in the post with the Vitality Baby discount card.
As per the Vitality website, I am entitled to receive a 25 % Healthy Care benefit, a 10 % Toys-R-Us discount card and a gift bag from Babies-R-Us.
My wife and I went to Toys-R-Us on Saturday, 5 May to collect the gift bag. I took my ID along and was told in the store that I needed to bring in both my ID and the card. The next day I returned with my card and was told that I did not need my card or my ID but instead I needed to bring the letter. I went back to the store with my letter, card and ID and was told that the letter did not have the reference number which was required by the store.
Upon phoning Vitality today I was told that the letter which I received did not contain the reference number because my baby is over 3 months old (she turned 4 months on Wednesday). This information was not communicated to me at any point. I went onto the Vitality website and there is no mention anywhere on the website that your baby must be under 3 months to receive the gift bag. In fact, the only way to find out the information is by clicking on the Vitality Baby benefits guide tab and then reading through the attached document which has a paragraph where it stipulates this clause.
This amounts to false advertising because Vitality led me to believe that my baby would receive a gift bag once I registered. If you go to the Vitality Baby website it clearly indicates that you will receive all 3 benefits.
The fact that crucial information such as the 3 month cut off period is not stated anywhere on the Vitality Baby webpage is very disappointing.
Moreover my wife and I were made to look like fools for going to the store so many times, only to find that we were wasting our time.
It is also very disappointing that once I registered my baby for the Vitality Baby program, I received several emails from Vitality, one welcoming us to the program, and follow up emails as well. But NONE of those emails bothered to mention that we would be denied the gift bag because of the hidden clause.
I actually had to phone into the Vitality call centre and then find out over the phone.

I had a car accident on the 17 April. Here i am almost 3 weeks later and they have not even completed the assessment on the car. I have no idea what is is going on with the claim because no one bothers to inform me. I call in daily and there is no progress. I spoke to a manager who also failed to assist me. My request was clear, kindly allocate my claim to someone else seeing that the current consultant is unable or lacks interest in doing any form of work. Yesterday I called the dealership where they claimed to have sent my car and they had no record of the car. I had to call them to inform them that the car is not there. This is after almost 3 weeks of them lying about the assessment. If the car was booked in for the 4th of may how on earth did they not know that the car had not reached its destination. I am completely shocked and dismayed by the level of incompetence displayed by discovery insure. I informed them yesterday that the car is MIA and they did not even bother to contact me after. An entire reputable entity fails to complete an assessment in almost 3 weeks and then loses a car!

I have used my TomTom sports watch for exercising and if you exercise for more than 30 minutes with an average heart rate of over 80% of your age you must get awarded with 300 points which at the end will pay for your gym fees if your goal was reached. In this case 900 points.

Vitality have not now for the first time take random exercises, that has been send through by Tomtom, and classify them as "Unverified" .
This resulted that the goal for that week is not reached and the discount to the gym fees is then not rewarded.

This is a scam to let everybody believe that as long as they gym and reach their goal they will gym for free. This is not true and is theft and fraudulent.

Vitality can not send any proof to justify their actions taken.
I believe that they must have proof to justify their actions and if not the points should be awarded otherwise it can be classified as fraudulent.

My vehicle got stolen on 29 March. I have registered this claim with Discovery Insure. They have provided me with a claims administrator, Lerato Ntsala. I haven't received any feedback or communication on the progress of the claim from her at all.

She e-mailed me more than a week later (6 April at 18:56) to confirm the full description of the vehicle, to which I was told was the last request as the claim is with management (Bianca Manaka) for authorisation. I have provided them with the detail at 20:03 (an hour later). By this date she has told me that the claim would be settled before Friday, 7 April. I have been phoning on Friday whereas I have been told that Lerato is busy on the line. I have phoned numerous times after that, with no prevail, only to find out that Lerato wasn't in on Friday. I have left a dozen messages and requested a call back.

On Monday, I have been informed that the vehicle value is R10, 000 less than the amount I have insured it for (insurance was based on a nominated amount and NOT retail). They are now refusing to pay the nominated amount and are still trying to confirm the value (which I have done three times with three different dealerships in a turnaround time of 6 minutes).

After it took them the whole of Monday and Tuesday to confirm the value (note that the value is now confirmed - also the same amount I have confirmed with three different dealerships - which was supposedly the last to do before authorisation), they now want the tracking report from Tracker. Two weeks later? Seriously, two weeks after the vehicle got stolen? This will now delay the claim further as it takes up to 72 hours to retrieve this report.

I would like this claim to please be settled today as it seems they are using every possible excuse to either delay or reduce the amount.

Next... Ombudsman.

For over five years being a member of the medical aid, I have never been contacted by anyone regarding the medical aid's fees increases or the various schemes one can change to in case of affordability. Every year I am advised of a visit by a consultant who never shows up while there is always a report that the visit was done. I am now thinking of looking for another medical scheme which cannot lie to me and give a better service. Other offices are attended to and get whatever advice and information they need but I'm treated like an outcast while paying the fees every month. I demand an answer why I don't get the same service like others but lied to instead.

I called Discovery to jion a medical aid plan. The consultant told me that the Coastal saver plan was good; as it covered 300% in hospital cover and then R4800 in day-to-day cover and the premium was fairly good
Based on this info I agreed and sighned up for the plan
The next day i was forwarded all documentation and certificate of membership. I read the brochure and fiund out that hospital cover was only 100% and not 200% as mentioned by the consultant.

I called to query and the consultant admitted to making the mistake.
However due to the calls from Discovery; no one offered to help me. They said it was fine to cancel if i did not want to upgrade my plan.
Totally unprofessional; unhelpful and Incompetent.
I believe I should get what was agreed telephonically.
Whats worse was i recommended a collegue of mine and he sighned up for the very same plan and the same consultant mentioned to him that hospital cover is 200%.

Discovery has put me through alot of frustration and inconvenience and for this i would not recommend Discovery services to anyone

Very disappointed dealing with Discovery

Discovery medical aid is one the worst, most irresponsible and unorganized medical aid which can not be trusted at all.
on the weekend I went to clicks to buy medicine, I found out my membership has been deleted.
Today when I called discovery, they informed me that they deleted my membership based on  Cell C  ( my company ) HR  request.
An employee with same surname has resigned from Cell C who even wasn't a main member of discovery and then discovery deleted my membership!

I need proper answer from discovery, first don't you work based on policy number or even ID number of your member. How is possible to delete membership account only based on surname and how irresponsible you are that even didn't bother yourself to check at least first name and surname. The person who resigned from my company even wasn't a discovery main member and  for sure she has different ID number.
How come when she resigned from Cell C, Discovery deleted my membership only based on similar surname? Don't you know people with same surname might work for the same company?

Discovery even didn't contact me by email or sms to notify me about deleting my account. Such a huge mistake is not accepted at all. Discovery has to contact their agent at Cell C head office to find out how such a huge mistake has happened.
Since first of March my membership has been deleted and I didn't have any coverage without even being notified. I have R27000 saving with discovery and I don't understand how discovery can be such an irresponsible medical aid company.
Discovery is the worst, the most irresponsible and unorganized medical aid company that I have ever seen in my life.

First I am very unhappy with the fact that I must pay a lot of money for my child’s teeth to be fixed in the chair and second of all why do I want to put my child through that trauma when Discovery KeyCare plan can at least work on a plan that can help with little children to get their teeth fixed. Why will Discovery KeyCare not put something together for at least the children that ages up to 7 years in order to prevent a child from going through that type of trauma of the dentist. I feel like I am paying a lot for medical aid and they do not even cover the things that is the most important especially the children that does not like the dentist. As a Medical Aid your first priority is to ensure that the members at least get covered for the things that is the most expensive not even to say that a dentist is not a very child friendly place. I really hope that Discovery can assist with this matter. Thank you

Never EVER rely on Discovery to help you preserve your dying dad's health.

Discovery has a very valid process in place where, if you claim for a procedure that requires authorization in the first 12 months of your policy, they put your claim through their "Standards" committee. The committee checks for pre-existing conditions. The idea is to help prevent the abuse of medical aids by individuals who sign up just to take advantage of the medical aid.

** Wednesday, 1 Feb:
My dad is rushed to the ER at Life Carstenhof Clinic with trouble breathing. After 4 hours of care, we leave the ER with a referral to an ENT and a prescription for some medication.

** Friday, 3 Feb:
We see the ENT. Long story short, I'm not happy with the level of care and diagnosis so I go for a second opinion to an ENT in Netcare Rosebank Clinic. He expresses concern that there is stridor and my dad has very obvious trouble breathing. He notes my dad's careful demeanour to not overdo himself and cause any further complications with his breathing.

He examines my dad, very thoroughly, and expresses concern that he may have 4 malignant growths in various parts of his larynx. He clinically diagnoses C32.9 and requests authorization from Discovery to hospitalize my dad on the basis that he needs assistance and monitoring with his breathing and he needs to get scans and a Fine Needle Aspiration done ASAP!

At this point Discovery starts the process of authorization (around 2pm Friday afternoon). The consultant he speaks to lets him know that, because he's indicates it's an emergency (due to my dad's diminished ability to breathe), we will have our auth within 8 hours.

Dr Eisenberg receives the PMA form (an investigatory form sent to confirm some details about whether or not my dad has been treated for this before - indicating a pre-existing condition). He pushes out his patient appointments because he places serious gravity on my dad's ability to continue without breathing assistance.

Upon asking "Okay, so I have a patient who needs to be admitted asap" the consultant advises they can provide a temporary 24 hours which is usually provided to give their Standards Committee time to conclude their investigation and provide complete authorization... Except that the Standards Committee is not available to complete any investigation outside of business hours - even for a life threatening emergency. "But, Sir, I promise, we'll give you the answer within the 8 working hours as promised".

When I enquire "Okay, so after 24 hours when the cancer hasn't magically disappeared and cleared his airway, what do we do then - it'll be Saturday evening at that point". The honest to God response is "I can't answer that, Sir". Fffffffffuuuuuu

So, we'll take what we can get at this point. We admit my dad and he starts a round of antibiotics, adrenalin nebulizers, saline nebulizers, blood thinning apparatus (because cancer patients have a very high chance of lethal blood clotting) and half hourly observations.

Anyway, after the 24 hours, the doctor really wants to keep him but the medical aid simply won't grant authorization. So, he prescribes me some meds and I go on my way. I've never had such a nerve wracking weekend in my life. I checked up on my dad's breathing at least 50 times until Monday morning.

** Monday, 6 Feb:
Monday comes along and I start my nagging (because obviously, Discvovery isn't proactively showing any interest in keeping me up to date). Eventually a woman named Jillian calls me to confirm details (which confuses me because they sound like preliminary questions that should have been asked on Friday). But, we answer the questions and she lets me know she will be calling Dr Eisenberg and asking him for the endoscopy report - again, confusing. They knew there was an endoscopy done on Friday. I wonder why they didn't ask for it then and speed up the process. But such is life.

I find out later that she did get in touch with him and he reiterated EXACTLY what he told the consultant on Friday - the scope report is generally done in theatre. Since there is no authorization, there is no scope report. So, he reiterates that his clinical diagnosis is a C32.9 - laryngeal cancer.

He is then called about 40 minutes later and quizzed by, presumably, a member of the Standards Committee. One of the questions that bothered me was "But surely this couldn't have presented so quickly. Surely, you must think that this existed a while back". I've not got a problem with the investigation as a principle but you've asked the Dr for the PMA form and you're now second guessing it. He's already dedicated about 5 hours of his time completing Discovery related admin in lieu of this process and we're taking more of his time. But, Dr Eisenberg is a consummate professional - he undergoes the interrogation with a smile on his face.

No one calls me for the rest of the day. At 4pm, I call for an update. Apparently, at 15:40, the Standards Committee has now decided to send another PMA form to the casualty doctor that we initially saw on 1 Feb. All they're doing is sending it and they're going to wait and hope they fill it out.

So, obviously, this isn't acceptable to me. Not only will we now miss our 8 hour promise, but we're not putting any urgency on the fact that my dad needs urgent scans and diagnosis and treatment for the cancer that is killing him.

So I call through, and push the issue. It's simply not acceptable and someone needs to start taking ownership of this process and rushing it along. So, long story short, I speak to two people - one of them a supposed clinical manager. She says she'll call Carstenhof and find out the progress of the PMA.

She calls, and they confirm that the person that Discovery sent the email to is on leave and will only be in the next day (Tuesday, 6 February). I'm beyond annoyed and beg for there to be some other way to expedite this. Nope, no alternative but to wait for the person to come back from leave. So, out of interest I enquire "So, this person comes back and the extent of their action is to then send it on to the doctor who treated my dad in casualty. But there is no guarantee he is going to fill it in with any urgency. Let alone when he's going to be available again - he is a casualty doctor after all". The response is simply "we have to wait for the PMA". Me: "Despite the fact that my dad's airway is getting more and more constricted and he is in more and more pain?". Discovery "Yep". Sigh.

** Tuesday, 7 Feb:
I call the hospital myself to basically beg someone to help me and speed this up. I speak to the person to whom these emails are sent. She advises that the doctor isn't in today. Fffffffuuuuuuuu.

I've now basically begged her to please bother the doctor on his day off and relay to him that I'm dealing with a high risk, potentially life and death situation in which every passing hour means an increased risk of an emergency tracheostomy - additional trauma that can be avoided. The most she can do for me is call the doctor and relay the urgency and hopefully the doctor returns the PMA today. But she explicitly tells me that the doctor is under no obligation to send this back within any given time frame.

So I call Discovery and my question is simple: "How long do we wait for this PMA to come back? 1 day? 1 week? 1 month? Until my dad is dead?". I'm not joking, the answer is "We wait for as long as it takes for the doctor to return the PMA.". :-O. #IJustCant

Discovery, you're a disgusting mess when it comes to situations like this.

1. You have made promises that you actively didn't keep. You promised an 8 hour turnaround. A turnaround I mentally and emotionally prepared for. "I can do this for the weekend. I'll just keep checking on my dad. I'll keep making sure he's breathing. I will wait on him hand and foot so he doesn't over exert himself. I can do this". Except Monday came around and you basically slapped me in the face and reminded me to whose mercy I'm at.

2. Your procedure to deal with this is unacceptable. You have no emergency Standards Committee members to deal with these issues where such an emergency is very obvious (and made so by the specialist).

3. Your contingency for the unavailability of the doctor is non-existent. How long do we wait for this doctor? Do we wait until my dad is dead? How exactly do you handle the unavailabililty of this doctor? "Sir, we have to wait for the PMA to be returned". "Okay, can it be returned by another health professional that was there? Maybe the Night Matron or someone else?". "No, it must be completed by the doctor that attended to your dad". Fffffuuuuu

4. Your lack of ownership in this issue is astounding. I've not quite come across such a callous approach to a slowly dying patient with an imminent medical breathing emergency before. Truly, your ability to transcend the general idea of not giving a damn, is truly impressive.

5. You're ignoring the fact that, as we progress without authorization, the chances are increasing that my dad has a lethal blood clot or that he needs an emergency tracheostomy. Apparently, you're perfectly happy running the risk of either of these things happening.

I need to ask: Are you simply waiting for my dad to die so that you needn't cover anything related to his health care? Is it better practice and cheaper to simply ignore his need for urgent treatment? As I said, I completely support the Standards Committee process as a concept. But I cannot support how it's being executed and the way in which I haven't been able to ensure my dad's quality treatment.

I have been a customer of Discovery Medical aid since 2004.03 01.
I changed my debit order details to Standardbank in 2016-17, and closed my Capitec account
End of January 2017 i was informed via SMS that my medical aid has been suspended.After enquiries i found that DISCOVERY had tried to get payment from the non existant Capitec account.Funds were available in the Standardbank account.
It took me a whole week to sort out the blunder that was made by DISCOVERY.I have proof that the paperwork was sent in 2017.07.
In this country having a medical aid is a matter of life and death.

I was also forced to make 2 payments, one in advance.I am disgusted by the treatment i have recieved.
I expect to be informed if my medical aid is to be suspended .
I have recieved no appology and had to make a lot of phone calls to get it sorted out
Cobus Whitehead

On resignation from my previous employer I had to pay discovery a stipulated amount due to terminating membership before a complete year. I received an sms notification of a larger amount owed as compared to the center agents amount over the phone. I had to query that just to be told that they could not source the sms! I abided and made full payment every month and even payed in advance. I sent email notifications to [protected]@discovery.co.za to absolutely no response of receiving payment. On last payment I clearly indicated last payment being made and requested for notification and to no surprise no one responded. Assuming that this is their normal practice of acknowledgment; I received an sms notification again stating that an amount is owed! Which leaves room for question, who the hell is not doing their job? Finance? Debt department? Management? Or maybe it's just Discovery!

hi guys

my girlfriend has been sitting with her wisdoms irritating her to pieces .
she has contacted you guys for the authorisation number and its been over 3 months now that no authorisation number had been given through so that the process may be started of extracting her wisdom teeth.
she is beyond swollen and constantly in pain, she has been living off pain killers waiting for this authorisation number to be transmitted ?
any reason why it may be taking so long?

On jan 4 2017, i applied to change my bank from nedbank to fnb.

On this date fnb on my behalf submitted a notification to discovery advising them of my new banking details and that discovery needs to change my debit order from nedbank to fnb!

Discovery informed fnb - they will not and rejected the request!

I am changing my bank, so from my side, i did everything to try and make this transition a smooth one - which is not happening!

I also submitted last week on discovery's website for someone to contact me, as i have the change form request for discovery to change my details - but nobody has bothered to come back to me? & it appears that they do not care

Discovery had better sort themselves out, as if there is any issues relating to the debit order or payment, do not blame me!

During 2016 I enquired about transferring my medical aid plan from a coastal saver option to a classic core option. I was told by a call centre operator that this would be an upgrade and I would have to wait till the end of the year (open period) to change. At the end of last year (31/12/2016) I successfully change my plan to a core option.

However, In the first week of 2017 I decided the saver plan suited my needs best and wanted to transfer back. On the Discovery website it clearly states that an upgrade can only occur during the open period but a downgrade may be preformed at anytime during the year. With this information I attempted to revert my change on the 03/01/2017. I was told again by a call centre operator that this is an upgrade and I have to wait till the end of the year. I emailed a request on the 04/01/2017 to cancel the change and again was told this is impossible as it is an upgrade.

I find this very frustrating as logically an upgrade from coastal saver to classic core would inherently be a downgrade if reversed (from classic core to coastal saver). How can every plan change be regarded as an upgrade? Not only is this a contradiction but if one refers to "Compare Plan Matrix" there are many options that also fall into this 'grey area'. This would then mean that these plans are neither seen as an upgrade nor downgrade i.e. equivalent, yet there is no condition outlined for this case. I feel that I cannot get through to a more senior staff member to discuss this issue as the contact channels always result in a standard, limited response.

My spouse used to be the main member but as she is now on pension and I am still working I changed in Dec 2016 to the main member. In my application I chose the debit order date as the 10th of every month as I receive my salary only on the 7th. On the 1st of Jan 2017 the debit order went of against my bank account. I phoned Discovery and the consultant informed me that the debit order that went off on the 1st Jan is payment for December and that they will on the 10th, deduct the instalment for January. It means that I must pay just over R9000 in one month for medical aid. Nobody at Discovery took the time to explain this to me! When I asked them to send my new cards to my place of work, I was told to phone them again on the 6th Jan as my application was send to them on the 6th of December. This is REALLY SILLY, why can they not do the changes on their system when a client request so?