Discovery Health
Authorised for treatment? Don't expect coverage

I gave notice for the termination of my policy with Discovery Health in March 2013, and was informed that coverage would extend till the end of April 2013 - payment was made in advance as per usual.

I recently discovered that I have a blood disease, and my specialist recommended that I undergo a specific test urgently. Knowing it to be expensive, and that my coverage with Discovery was ending in April, my doctor's nurse requested authorization for the test (as I did not want to incur the expense unless I knew it was covered). Authorization was received from Discovery, and I immediately went for the authorized test, which happened to fall on 30 April 2013 - the last day of my membership with Discovery.

Low and behold, Discovery is now repudiating the claim on the basis that my medical savings account is depleted by virtue of it being pro-rata'd. The entire reason for requesting authorization was to ensure that I would be covered. Discovery was aware of the termination of my membership, why did they authorize the procedure if they had no intention of paying?

Now I am liable for a massive bill which was explicitly authorised for payment.

Company: Discovery Health
Country: South Africa
City: Johannesburg

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