Discovery Health
Self payment gap and claim payments

I am a single member of the classic comprehensive health plan. Please explain to me how the second highest plan in a medical scheme can charge you a self payment gap of R6500.00 for a single member in the same breath charge you a premium of R3086.00 per month. Everything gets paid out of your medical savings account that comprises out of a portion of your premium, thus constituting out of your own money. Now tel me how do you justify increasing the self payment gap with any schedule 1 or 2 medication costs if it is paid out of your MSA, thus decreasing your MSA (YOUR OWN MONEY) and simultaneously increasing your self payment gap. Are you not paying double for that item just because you have a medical aid? Please give me a reason to keep using your services and not just get a hospital plan from another service provider and create my own savings account for the difference in premium? Because it is unacceptable to pay a premium of R3086.00 per month and then to be stuck with a dental bill of R7358.47 where by only R415.04 gets paid back for the removal of an amalgam filling that lead to chronic headaches.

Company: Discovery Health
Country: South Africa
City: Claims

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