Discovery Health Medical Aid
Reviews and Complaints

I’m assisting my dad on behalf of his claim, and so far we have received a very bad service from Discovery.
My dad had went in for an operation for his heart, and had previously been battling with this symptoms for about the last 3 years.
His medical aid is with discovery, so all information is for full verification.
He is self-employed and currently supports his wife and other various expenses.
We had lodged a claim with discovery, and with no communication, discovery eventually paid (5% + 5%) of the claim.
We find this completely in bad taste and not in good faith as the insurer of choice.
Discovery had never communicated details of the payment, we simply found a deposit in our account.
They failed to honour the 100% claim as information was provided.
They have hidden the assessment as too how they worked out the value.
They have never been in contact with Mr Ramnarian.
They have never issued a settlement letter.
Zero for Customer service, First for advertising about the fantastic service.
Due to Mr Condition, he is unable to provide for Mrs Ramnarian, able to pay his medical aid, pay the Insurance premiums ( Life) and as a result of this he is currently thinking of selling off his business.
His three (3) sons are currently assisting to Provide for Mr Ramnarian assistance and managing the business.
Mr Ramnarian had chosen Discovery due to the brand, and the hasslefree claim process – Guess what?
Now he is suffering, together with a financial burden and huge insurance premiums. Very Unfair.
Please can we get some valuable assistance.

Claim number 34116 Policy number [protected]

I have sent over 10 emails now and made phone calls. They would call and as soon as I take cut it expecting me to call back. They are very incompetent towards clients. I have experienced issues about my app and fees recently due to an idiot cancelling my vitality by mistake. The next day they email me saying that I cancelled my subscription and another email saying it is a mistake. From there everything went hairy! Nothing works and I've been contacting them for months and they replied the next month.. i got pissed off when they charged me R615 for my gym membership when I am on the vitality fee R158 pm.
They are thieves.

what the h... IS GOING ON AT DISCOVERY? You act like we have to be at your beck and call to receive payment of claims once we have already serviced your members. Especially the Oncology department. Since you brought Bankmed into your administration department there is total chaos and I have to perform and threaten legal action and only then do you sit you up and very reluctantly pay me as a service provider! Most of the time you take more than a month to pay me for my professional services and in future I will think twice about treating your members and make them pay up front and THEY can then wait for over a month to be paid by your inept and disgusting claims department! This is an on going disrespect to me when I submit my claims to you, I have to perform and threaten legal action all the time before I am paid WHAT IS GOING ON! Get Adrian Gore to answer this please!

I have growths / lumps under my arms and discovery refuses to pay. I am in pain daily yet discovery says the surgery is cosmetic. They make cold heartless decisions. Should this happen to your ceo or panel of doctors family you would have approved this surgery. A person cannot live in pain daily how is this cosmetic. This medical aid has a risk management team that is employed to look for every reason not to pay our claims. Cold and heartless. I am a member since 2011 and my first claim on my medical aid is declined. I am sure to expose discovery for the crooks they are. Will be taking you to the media! People must be made aware this.

My complaint is with regards to discovery vitality active rewards where you can get a apple watch for achieving your goals. I can't get a smart watch because i don't have a apple watch. I have a flag ship android phone (S7 edge) and i can't receive a reward. I should be able to receive some sort of reward in the same category for reaching my goals. You will see emails which i copied and pasted below which are back and forth with discovery and there assistance is pathetic!

Me
Category selected: fitness devices
Query:
Hi i would like to know why for for the vitality active rewards you offer a apple watch but not the samsung watch? I would like to receive rewards and get a watch but i cant as you don't offer the samsung gear watch. A lot of people have android phones and you don't cater for that which does not seem fair. I would just like to know the reason for this. Kind regards tyrone

Discovery
Thank you for your recent contact with discovery vitality.
Our new vitality active rewards with apple watch benefit is part of a global collaboration with apple and is hence only available on apple watch at this stage.

Vitality continues to cater for various device preferences – our members can use their preferred fitness device to track their activity and earn rewards by downloading the discovery app onto their ios or android smartphone.

Also, with vitality healthycare and healthygear, vitality members can get up to 25% cash back on various fitness devices at our partner stores.

We’re committed to our entire vitality community and are constantly looking for ways to enhance our benefits so please keep an eye out for new developments.
If you have any more queries, please visit our online vitality support page: www.Discovery.Co. Za > vitality > vitality support for a range of troubleshooting options.

Me
Hi
So if its a global collaboration with apple. What does this mean on your web site.
(Apple is not a participant in or sponsor of vitality active rewards)
If they not a sponsor how are dicovery only able to give apple watches as rewards and not a samsung or another
Android smart watch?

Me
Hi
I am still waiting on a response on the smart watch subject, i have not received any information on my last email.
And i think the reason is discovery have no reason for why they only have a apple watch reward and not a android watch.
How can you cater for only some clients, when you should cater for everyone who is able to apply for the reward.
Just because i don't have and iphone i cant get a smart watch. Like your websites implies (Apple is not a participant in or sponsor of vitality active rewards)
Which from my understanding means you should be catering for all you clients!

I hope to receive a response to my queries asap.

Kind regards

Discovery
Thank you for your email regarding vitality fitness device and active rewards
Please note that you can also use the following fitness devices that vitality has partnered with to get rewards
You can link the following devices and apps directly to vitality:
• garmin
• polar
• fitbit
• fitbug
• withings
• misfit
• apple watch
• jawbone
• s health /
• samsung – the gear watch tracks heart rate. The s-health app tracks steps on newer samsung models, and select other android compatible phones.
• ihealth.
And also these are the smartphones that you can use that are partnered with discovery app
• the discovery mobile app is currently only available on apple ios devices and android smartphones – this decision was made because most of our members use these devices.
• we are constantly monitoring the growth of other operating systems like windows and blackberry and currently considering a mobile solution if these options become viable. If they do become available in the future, we will let all our members know through our vitality newsletters, on our website and our social media pages
If you have any more queries, please visit our online vitality support page: www.Discovery.Co. Za > vitality > vitality support for a range of troubleshooting options.
Regards
Vitality servicing team

Me
Hi
So i am just trying to understand your first email you replied to me the excuse for only having the apple watch for
A reward was because its part of a global collaboration with apple, then when i send a email saying that you site says that apple is not
A participant in or sponsor of vitality active rewards) now your excuse is your decision was made because most of your
Members use this device which sounds like rubbish to me.
And the samsung gear monitors your heart rate your steps you can also see how much water you drink and so much more.
Look at the attached pictures there is no excuse for discovery not to give the watch as a reward.
Yes you have all these other devices but you don't pay it in full if your client achieves there goals so whats the point.
If you can show me statistics that more of your clients have iphones that would be great because i would like to know
Where you got that from!
And if i can't get a apple watch with the rewards what reward do i get in terms of gear wear?
Like i said before, how do discovery cater for their other clients? If you can't get a gear paid in full for achieving your goals?
And i would like to know what the samsung gear can't do in therms of reaching the goals discovery need to supply there clients with the watch.
The watch can track everything samsung was one of the first to bring a smart watch out so i don't see the apple watch doing anything the samsung
Gear can't.
I would like your next replay to have some decent facts on why you cant supply your client with rewards like a samsung gear and as you can see
I am not going to just let it slide until i have some solid reasons from discovery.
I would actually like to add these emails to a discovery blog and see what other people think about this.

Dicovery
Thank you for your email regarding your apple watch query
The only way you can be eligible for an apple watch is as follows:
Who is eligible for the apple watch benefit?
To qualify for this benefit:
A. Iphone 5 or later is required to use apple watch.
B. You must activate vitality active rewards. If you haven’t yet activated it, do so today by downloading the latest version of the discovery app and clicking on vitality active rewards under ‘vitality’.
C. You must have a discovery gold card or higher. If you don’t have a qualifying discovery card, you can apply for one or request an upgrade on www.Discovery.Co. Za. You can also call us on [protected]. If you do have a qualifying discovery card, it must be in *good standing.
D. You need to have a discovery card limit of at least r15 000 and an available balance of at least r5 000. You can request a limit increase online or on [protected].
E. You need to be either the main member or secondary adult dependent on your vitality policy.
F. There must not be an existing vitality active rewards with apple watch benefit on the policy.
*your discovery card account is in good standing if it is open, active and not in arrears for more than one month. Your account is not in good standing if you need to undergo debt counselling
You will pay a r350 non-refundable activation fee for the vitality active rewards with apple watch benefit.

If you meet all your weekly vitality active rewards goals for 24 months, discovery vitality will fund your apple watch in full. If you don’t meet your goals, your discovery card will be debited by a monthly amount (Penalty) that is calculated as a percentage of the retail price (Pricing subject to change).
If you have any more queries, please visit our online vitality support page: www.Discovery.Co. Za > vitality > vitality support for a range of troubleshooting options.
Regards

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.

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

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] !

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!

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?

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]

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?

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.

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]

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

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.

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:

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!

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 .

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]