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Compulsory advertising above this line. Please just ignore it.
By reading past this point you indicate that you agree to the Terms and Conditions of this web site
In November 2003 I discovered that Discovery Health had unilaterally appointed "Health Care Solutions" in
July 2003 as my "intermediary" and given them not only my policy number, but access to my
claims, personal information and bank account number. Good of them to ask me first. Now it turns out
that they have appointed an associate company as the "broker" for my insurance policy. Again, it
was really good of them to ask me about this.
Initially when I contacted both Discovery Health and Health Care Solutions they were unable to explain why this had been done, or who was responsible. It took months for them to own up and apologise. To their credit they have promised to put systems in place so that this doesn't happen to other customers in future. They have assured me that the company that the details were provided to is both reputable and was screened by them before doing so. They also offered me the option of choosing another company from a list.
It pays to pay attention. Whenever you make or receive a phone call, write down the person's details. It makes them more accountable. It helped me get explanations and clarifications.
One of the biggest problems with medical aids is that the system is so darn complicated. So you keep finding out "nasties" when its too late. Basic things like the difference between Medical Aid Rates, Private Rates, and what the doctors actually charge. Dr B charges R250 for a 45 minute consultation. The official Private Rate is R234.80 and the official Medical Aid Rate is R125.10. So don't expect the Medical Aid to cover all your medical expenses. It just isn't going to happen. The "Aid" part just isn't what you think it is: it's partial assistance rather than genuine help.
And of course don't think you can go to a Casualty Unit and get help without having to pay. Your medical aid may cover most of the costs, but the initial expense of being seen to by a doctor has to be paid up front, and then claimed back afterwards. They may have pledged to uphold the Hippocratic Oath, but the doctors don't lend you money. So make sure you always have some reserve cash you can draw on for those unexpected visits to casualty.
And don't expect to be treated as soon as you arrive, either. My wife was kept waiting for 45 minutes even though she had a dog bite right through the palm of her hand, which was excruciatingly painful. The best kind of pain killer we could get was ice. This was a private hospital - I shudder to think what the public ones are like.
Make no mistake, Discovery Health is a good medical aid. I used to think they were brilliant, but now I'm not so sure. One of the selling points of Discovery Health used to be fact that for a small additional monthly amount I could have access to a "Health and Racquet Club" gym. And I got "Vitality Points" for going to the gym. Well the H&RC group went insolvent, and was replaced by Virgin Active. Fortunately I didn't lose any money in the insolvency.
But one of the conditions of joining Virgin Active as a "Vitality Member" was that you have
to go to the gym 24 times in a given 12 month period. Fine, no problem. I joined up but for
various reasons I stopped going regularly. So I should expect to have my membership
summarily cancelled, shouldn't I? No warning, nothing.
It turns out they have a computer program that does a check every month. But the evil person who devised the program used some nasty loopholes: The timer period starts with the calendar month you applied to join. Irrespective of the delay between applying to join and actually joining, the clock starts ticking. So effectively its 11 months if you happened to apply at the end of one month and get your card in the middle of the following month.
At no stage during this time are you reminded of the 24 visit rule, or encouraged to go back to gym if your visit count is low. No, they are watching you like a hawk! And bingo, if you miss the cut-off you have to pay R700 to join up again. The sad thing was that the month before I was summarily dismissed from membership, I had started going back to the gym to do some healthy exercise to deal with stress. Then this happened, and it resulted in a lot more stress dealing with officious bureaucrats who were not going to budge an inch.
In one fell swoop they managed to erase all the goodwill that I had towards my medical aid. And it has taken a long time to rebuild it. I wonder what petty little rule they are going to throw at me next? And did I mention that I pay more to my medical aid than I pay in rent? About 20% of my salary.
No, we aren't talking about JavaScript, but rather about prescription medication. I deal with a doctor who has changed the prescription for medication on numerous occasions. In one case we had a script for 6 weeks where we had to take 1 tablet a day. After 4 weeks he changed it to 2 tablets a day, and wrote out the new script. But the pharmacy couldn't issue the new quantities because the computer system still had the old script on file. No, and you can't just cancel a script and replace it with another one.
I went to collect the new script on a Friday evening, so we couldn't do anything until Monday morning. Of course. On the Monday the "pharmacy clearing house" told me that it would take 48 hours to fix the problem. By the time they did that the original script had almost expired anyway. Isn't officious bureaucracy wonderful?
The solution was to just buy the damn stuff without claiming it from the Medical Aid in the first place, which is kind of pointless because the reason why I pay for medical aid is to make my medical expenses manageable in the first place.
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