Tired of Discovery's bs Looking for medical aid alternatives?

[Johnny Bravo]

Ok this has been a long time coming been with Discovery since I got my first job upgraded my plan a few times now one at just under R5k/month (and my SO is included). The past 2 years or so after we upgraded, to claim anything has just been a hassle, so much paper work and bs. To the point where we've just been denied for the 5th time in the last two years... I could hire someone full time just to do my discovery paper work just to get the money out for a simple claims. I've had to basically take them to Council for Medical Schemes (CMS) to get them to make them pay what we are covered for. They do eventually pay out after CMS but just such a time waister.

I'm actively looking to and going to choose one to hop over to an alternative within the next couple of months. It's going to be for me my SO and little ones in the future. We have gap not through discovery and very happy with them.

Anyways anyone recommend other health care / medical aid schemes that has worked for them and happy with their service?

 

[el3venth]

I switched from Discovery to Profmed. And the it has been pretty good.

For example, to get my wife PMBs registered, it took a single phonecall from the pharmacist to say what the drugs were and what the code was on the prescription. No paperwork, it was registered as a PMB and they pay for it. Same with getting a second mammogram. Took me emailing a single letter from the doc to them approving it.

So I can say that they are easy with PMBs. Also, they had no problem with approving my moms' eye operation.

I am much happier with them.

 

[JDoubleU]

Also with Discovery, also paying about 5k with SO. Also get declined every time I claim but I haven't had any actual medical issues claim worthy.

With who is your Gap cover? I am looking for a decent one.

The reason I am hesitant to move is the benefits outside medical aid but I get them because of medical aid. I have my bank account and both cars with discovery insure. I get about R1200 back a month between all the rewards which almost covers both cars.

 

[Johnny Bravo]

I switched from Discovery to Profmed. And the it has been pretty good.

For example, to get my wife PMBs registered, it took a single phonecall from the pharmacist to say what the drugs were and what the code was on the prescription. No paperwork, it was registered as a PMB and they pay for it. Same with getting a second mammogram. Took me emailing a single letter from the doc to them approving it.

So I can say that they are easy with PMBs. Also, they had no problem with approving my moms' eye operation.

I am much happier with them.

Thank you adding them to the list

Also with Discovery, also paying about 5k with SO. Also get declined every time I claim but I haven't had any actual medical issues claim worthy.

With who is your Gap cover? I am looking for a decent one.

The reason I am hesitant to move is the benefits outside medical aid but I get them because of medical aid. I have my bank account and both cars with discovery insure. I get about R1200 back a month between all the rewards which almost covers both cars.

I hear you. Yeah we've just got vitality (for gym) and health everything else separate (thank God). I was thinking of switching more over to Discovery but held off for a bit (control reasons) then the bs with claims started happening after about 8 years hassle free. The gap is only for accountants (my SO is one) it's called camaf.

 

[Dom]

If I add my 11c on Profmed, their claims are horrible & their limits on benefits are horrible - their plans are however decently geared towards young (healthy) professionals + small families

 

[Dom]

Ok this has been a long time coming been with Discovery since I got my first job upgraded my plan a few times now one at just under R5k/month (and my SO is included). The past 2 years or so after we upgraded to claim anything has just been a hassle, so much paper work and bs. To the point where we've just been denied for the 5th time in the last two years... I could hire someone full time just to do my discovery paper work just to get the money out for a simple claims. I've had to basically take them to Council for Medical Schemes (CMS) to get them to make them pay what we are covered for. They do eventually pay out after CMS but just such a time waister.

I'm actively looking to and going to choose one to hop over to an alternative within the next couple of months. It's going to be for me my SO and little ones in the future. We have gap not through discovery and very happy with them.

Anyways anyone recommend other health care / medical aid schemes that has worked for them and happy with their service?

What Discovery plan were you on (I assume one with an MSA)?

 

[RoSsIkId]

Good day gents.

I have been on discovery for a while, my 1st job paid in full for medical and when i left i moved over to Bonitas. Was there for about 2 years and moved back to Discovery. Myself and SO is on discovery, she needs monthly meds and had a few incedents over the years that needed her to claim from discovery, like all things insurance related there where snags but nothing that couldnt be solved. I just got out the hospital, emergency operation. Bill was close to 100k, discovery paid without any issues. Got my house hold and car insurance with them and i got no problems. Just dont like the driving app thing.

 

[DeathByIp]

Bestmed. Was on it for years with my parents and parents stayed on it for years following even when they didn’t need too.

Nurse friend says Bonitas is also okay

 

[SneaQ]

I usually don't have a problem with Discovery, but we are paying a heck of a lot more than 5k p/m for our family of 4.

In a bad year we have claimed well over a 200k (emergency procedures, scans, tests etc.) these can add up very quickly

I have been with them 20 years+ now and haven't had a issue claiming.

 

[Frana.mtb]

I'm paying 4k for a single young healthy person on Bonitas , its fucking killing me.

Claims have also not been silky smooth but not big issues

 

[Machules]

I have had no issues with Bestmed thus far. Been with them for about 5 years now and haven't had any issues when claiming and the prices are not that bad either

 

[Dom]

I'm paying 4k for a single young healthy person on Bonitas , its fucking killing me.

Claims have also not been silky smooth but not big issues

Look at Discovery Classic Smart - PM me if you need more info (when quite into depth about their options).

 

[natpoeper]

With who is your Gap cover? I am looking for a decent one.

I have gap cover with Discovery, they paid for out-of-pocket expenses (CT scans) after my car accident without even having to claim, they got the info from my medical aid and a couple of weeks later the money was in my bank account.

 

[thecurto]

Avoid the Discovery Essential Smart Plan if you can.

Thought I would try and save some money this year but this plan doesn't cover any planned expenses linked to wisdom teeth extraction which I have learnt the hard way. Now I either need to spend 30K out of pocket to get all four removed or hope they can last until the end of the year so I can upgrade my plan again. Sigh

I got quoted 10K for extracting all four teeth, 6K for the anaesthetist and 14K for the hospital visit. The worst part is that they're too far gone to be extracted in the chair

 

[ovisser1]

Avoid the Discovery Essential Smart Plan if you can.

Thought I would try and save some money this year but this plan doesn't cover any planned expenses linked to wisdom teeth extraction which I have learnt the hard way. Now I either need to spend 30K out of pocket to get all four removed or hope they can last until the end of the year so I can upgrade my plan again. Sigh

I got quoted 10K for extracting all four teeth, 6K for the anaesthetist and 14K for the hospital visit. The worst part is that they're too far gone to be extracted in the chair

Thats rough.
I had two pulled last year april - literally as soon as the pain started I went and had them removed.

R1200+- all in via the chair.
Took a sleeping pill ahead of time to knock me out, which did not work FYI, and did it in the chair.

Took the pill as I got there (as recommended by the dentist).
I managed to go through the chair, pay at reception and walk down two flights of stairs. Opening the front door is the last thing I remember.

Woke up in my own bed the next day. Friend who had to pick me up at the dentist said as I walked out the door I simply sat down on the sidewalk and he had to pick me up from there

They did show me a video of myself in basically a drunk state eating a pie at home though.
Was not as funny as it sounds.

 

[Nast555]

Well... be careful. I was on Spectramed/Health Squared and it went bust when I was in hospital... R200k out of my pocket after they had fiddled around to try pay something. I was with them since I turned 21. It was ok but the shock of the payment nearly put me straight back on my death bed.

My daughter and myself are on Discovery Classic Priority now. I had to fumble to try get one without a very long waiting period. I pay a shitload, but my meds are about 2k a month. I haven't had too many issues.

BUT MY FUCKING GAP COVER is/was pathetic. It is with Ambledown, and since my med aid went bust they paid me fuck all. I am trying to claim again for a nerve block that I did recently but they are PATHETIC!

 

[Helios23]

I'm on Momentum Extender and spending R8.2k just for me a month. Honestly not impressed with coverage and value offerings for this much money.

 

[Johnny Bravo]

What Discovery plan were you on (I assume one with an MSA)?

Classic Smart Plan (started on Key Care, Coastal Saver looks like it gives you less for way more)

Bestmed. Was on it for years with my parents and parents stayed on it for years following even when they didn’t need too.

Nurse friend says Bonitas is also okay

I have had no issues with Bestmed thus far. Been with them for about 5 years now and haven't had any issues when claiming and the prices are not that bad either

Will add both to the list dankie

Look at Discovery Classic Smart - PM me if you need more info (when quite into depth about their options).

It's the plan we're on covered basically everything (physios kyros, SO's wisdoms, dental check ups + portion payed for annual cleaning, emergency op I had to go for) but with us having to fight every-step of the way to get our money back.

 

[Johnny Bravo]

Thats rough.
I had two pulled last year april - literally as soon as the pain started I went and had them removed.

R1200+- all in via the chair.
Took a sleeping pill ahead of time to knock me out, which did not work FYI, and did it in the chair.

Took the pill as I got there (as recommended by the dentist).
I managed to go through the chair, pay at reception and walk down two flights of stairs. Opening the front door is the last thing I remember.

Woke up in my own bed the next day. Friend who had to pick me up at the dentist said as I walked out the door I simply sat down on the sidewalk and he had to pick me up from there

They did show me a video of myself in basically a drunk state eating a pie at home though.
Was not as funny as it sounds.

LOL did your friend get a funny video out of it?

 

[Johnny Bravo]

Avoid the Discovery Essential Smart Plan if you can.

Thought I would try and save some money this year but this plan doesn't cover any planned expenses linked to wisdom teeth extraction which I have learnt the hard way. Now I either need to spend 30K out of pocket to get all four removed or hope they can last until the end of the year so I can upgrade my plan again. Sigh

I got quoted 10K for extracting all four teeth, 6K for the anaesthetist and 14K for the hospital visit. The worst part is that they're too far gone to be extracted in the chair

Eish this sucks man.

 

[Fatmaninhell111]

not financial advise, but i moved from discovery to bonitas this year and is so far very happy and saving almost 3 k a month

 

[Karldp]

We moved over from Discovery to Momentum Health and its the best thing we could have done. Super happy and saving big time

 

[Johnny Bravo]

With how much money we spend towards heath care in general I'm thinking of matching my medical aid contribution into a stable fund (10% pa) until I've got good buffer (say R200k or R400k) then just downgrade everything to a good hospital plan and keep gap. Then basically manage my own private medical aid fund? Continue to pay my fund with contributions everymonth forever like normal medical aid. Everything I pay will be at the cash (lower prices) out of medical aid rates and I have a compounding asset that covers everything.

If my calcs are correct it will take about 3 years to reach the first R200k with what I'm paying now (10% return pa and increasing contributions with inflation every year say 7%). I was just thinking there's a reason medical aids are profitable. And my wife and I are quite healthy fit we're likely just going to make the med aids richer till we get old then hope back over to normal medical aid.

 

[DeathByIp]

With how much money we spend towards heath care in general I'm thinking of matching my medical aid contribution into a stable fund (10% pa) until I've got good buffer (say R200k or R400k) then just downgrade everything to a good hospital plan and keep gap. Then basically manage my own private medical aid fund? Continue to pay my fund with contributions everymonth forever like normal medical aid. Everything I pay will be at the cash (lower prices) out of medical aid rates and I have a compounding asset that covers everything.

If my calcs are correct it will take about 3 years to reach the first R200k with what I'm paying now (10% return pa and increasing contributions with inflation every year say 7%). I was just thinking there's a reason medical aids are profitable. And my wife and I are quite healthy fit we're likely just going to make the med aids richer till we get old then hope back over to normal medical aid.

This is a good option if you do not have kids and as long as you have some medical cover should keep you off the late joiner list.

 

[Trompie67]

With how much money we spend towards heath care in general I'm thinking of matching my medical aid contribution into a stable fund (10% pa) until I've got good buffer (say R200k or R400k) then just downgrade everything to a good hospital plan and keep gap. Then basically manage my own private medical aid fund? Continue to pay my fund with contributions everymonth forever like normal medical aid. Everything I pay will be at the cash (lower prices) out of medical aid rates and I have a compounding asset that covers everything.

If my calcs are correct it will take about 3 years to reach the first R200k with what I'm paying now (10% return pa and increasing contributions with inflation every year say 7%). I was just thinking there's a reason medical aids are profitable. And my wife and I are quite healthy fit we're likely just going to make the med aids richer till we get old then hope back over to normal medical aid.

On a similar note. If I had used my medical aid contributions to purchase shares in Discovery since they listed in 1997 instead of paying contributions, I'd now have a multi mullion ZAR nest egg.

 

[De_Stroya]

On a similar note. If I had used my medical aid contributions to purchase shares in Discovery since they listed in 1997 instead of paying contributions, I'd now have a multi mullion ZAR nest egg.

And then two medical emergencies and you are broke.

 

[JIK]

Avoid the Discovery Essential Smart Plan if you can.

Thought I would try and save some money this year but this plan doesn't cover any planned expenses linked to wisdom teeth extraction which I have learnt the hard way. Now I either need to spend 30K out of pocket to get all four removed or hope they can last until the end of the year so I can upgrade my plan again. Sigh

I got quoted 10K for extracting all four teeth, 6K for the anaesthetist and 14K for the hospital visit. The worst part is that they're too far gone to be extracted in the chair

All four of my wisdoms were completely fucked up.
Then I bit into a steak one day and one of them weird useless teeth decided to fracture and it was like getting hit in the side of the head with a sledgehammer and getting kicked in the balls at the same time.
One emergency visit later I was hopped on pain meds and in a few days after that I went in to get them extracted. Was about R80k for my situation as my wisdoms decided to grow in every direction but straight resulting in my jaw needing to be cut into to extract some of them. Went home feeling shit and eating yogurt for two weeks with multiple visits for scans so they can make sure shit was healing alright.
And guess what... it didn't so I needed another op yaaaaay

fuck you wisdom teeth.

 

[yourang]

I switched to bonitas, I just wanted to show middle finger to my broker about a discovery insurance problem. So I decided to cancel all discovery products because of the issue I had.

 

[Johnny Bravo]

And then two medical emergencies and you are broke.

Yes but that's what the fund is for and medical emergencies like a car accident will be covered by the hospital plan and gap. Everything else will be planned in advance and used from the fund at out of medical aid cash rates. We also have an emergency fund that we can draw from (6 month worth of living expenses) in worst cases. That all being said I completely hear you it is more risky and if we happen to be in the smaller group of people that manage to use more than we pay the aid it will not be profitable.

On a similar note. If I had used my medical aid contributions to purchase shares in Discovery since they listed in 1997 instead of paying contributions, I'd now have a multi mullion ZAR nest egg.

Hahahaha dang since 97 have you had any big medical expenses (besides the usual yearly dr's visits)? That would have crippled your nest egg?

 

[Frana.mtb]

Anyone with a decent broker please let me know, still looking for alternatives to bonitas