Discovery Health - Vitality & Team Vitality plus everything else you need to know

[Pure Savage]

no, if you're on a Core plan that won't cut it. It has to be part of a procedure ie: We know you have cancer, we're booking you in for it but we want to get an extent of the disease.

 

Or if you're in a car crash and admitted for that, and go for a scan.

 

If you're admitted JUST for a scan, no dice.

 

Momentum are the only ones who have cover for purely investigative scans on their basic hospital plans without MSA. ALL other med aids will not cover investigative MRI / CT / XRAY scans unless you have day-to-day cover, and even then there will be a co-payment.

Or Camaf that covers all scans in or out of hospital and blood tests

[Captain Fastbastard Mayhem]

Or Camaf that covers all scans in or out of hospital and blood tests

Yeah, but that's cos they can control their risk pool by only admitting accountants. Who, as we all know, are pretty darn boring and never take risks. 

 

Except maybe this one

 

Edited May 16, 2016 by Myles Mayhew

[Wannabe]

Same with me in Dec. All u had to do was be booked in overnight and it would have come out of your hospital benefit.

 

 

do you have a plan with MSA? If not, then that's why. Investigative scans aren't covered unless they form part of an admission for a procedure. 

 

 

Sounds like a nice little clause and easy cop out by them......what if your GP sends you to a specialist and they admit you ?

 

 

This was in Dec after my Mtb fall.

Was admitted on Thursday, had X-rays, etc taken. Paid for by Discovery, no problem.

Neck was injured, but x-rays showed everything in order, waited for Orthopedic surgeon to come see me, by Sat afternoon he still did not arrive. Emergency room Dr contacted him to find out when he is coming to see me, only to be told "he forgot about me" and that he could not see me over the weekend. Was discharged by ER docter and told to report back on Monday and to go straight to Ortho.

Did just that, more ex-rays was taken, same result., nothing broken or cracked (although my left index finger was clearly broken, still struggling with it, and x-rays was taken of my hand)

 

Was then told to go to Neuro surgeon, which I did. (consultation paid out of my pocket -R1250.00) This was on the Monday.

Neuro guy did a cursory exam and told me that MRI is needed for my neck, he booked me into the hospital again, and authorisation was obtained for procedure. Laid in Hospital for two days before MRI was done. 

 

Discovery now refutes the claim, saying it was "preventative treatment, not as direct result of fall" This, according to them, is due to the fact that it could not have been as serious if the Dr discharged me on the Sat and I went back again on the Monday. There was also some confusion regarding the procedure codes used by Neuro and the Ortho from ER that discharged me again the Wednesday after the MRI was done.

 

Disco says they've exhausted all the avenues now, I must PAY BACK THE MONEY.....

 

Edit = I only have the Hospital Plan.

Edited May 16, 2016 by Wannabe

[Thor Buttox]

Then you should just have had to pay the co-payment, and the rest would have come from the risk portion of your med aid. That would have been the same regardless of whether you were admitted or not, as it was a purely investigative scan.

Sigh, where were you when I was crocked!? For future ref, what is a co-payment? (Had a crash on Sat, and but for landing on my face, I may very well have had to go again to ER)

[Thor Buttox]

Yeah, but that's cos they can control their risk pool by only admitting accountants. Who, as we all know, are pretty darn boring and never take risks.

 

Except maybe this one

 

https://www.youtube.com/watch?v=DBfsgcswlYQ

Hey!! Edited May 16, 2016 by Thor Buttox

[Captain Fastbastard Mayhem]

This was in Dec after my Mtb fall.

Was admitted on Thursday, had X-rays, etc taken. Paid for by Discovery, no problem.

Neck was injured, but x-rays showed everything in order, waited for Orthopedic surgeon to come see me, by Sat afternoon he still did not arrive. Emergency room Dr contacted him to find out when he is coming to see me, only to be told "he forgot about me" and that he could not see me over the weekend. Was discharged by ER docter and told to report back on Monday and to go straight to Ortho.

Did just that, more ex-rays was taken, same result., nothing broken or cracked (although my left index finger was clearly broken, still struggling with it, and x-rays was taken of my hand)

 

Was then told to go to Neuro surgeon, which I did. (consultation paid out of my pocket -R1250.00) This was on the Monday.

Neuro guy did a cursory exam and told me that MRI is needed for my neck, he booked me into the hospital again, and authorisation was obtained for procedure. Laid in Hospital for two days before MRI was done. 

 

Discovery now refutes the claim, saying it was "preventative treatment, not as direct result of fall" This, according to them, is due to the fact that it could not have been as serious if the Dr discharged me on the Sat and I went back again on the Monday. There was also some confusion regarding the procedure codes used by Neuro and the Ortho from ER that discharged me again the Wednesday after the MRI was done.

 

Disco says they've exhausted all the avenues now, I must PAY BACK THE MONEY.....

 

Edit = I only have the Hospital Plan.

That's indeed a tricky one (had a lapse re your crash) and one that I'd fight. Essentially up to the doctors to motivate it. Not your fault you were discharged, but I have a feeling that the Ortho won't do anything as completing a letter detailing why he wasn't able to see you would potentially be an admission of negligence... 

 

Tough one. One I'd take up with the doctors for sure. 

[Captain Fastbastard Mayhem]

Sigh, where were you when I was crocked!? For future ref, what is a co-payment? (Had a crash on Sat, and but for landing on my face, I may very well have had to go again to ER)

co-payment is the part-payment of a scan that normally costs thousands ie: MRI & CT scan

 

Essentially you have to pay a portion of it. I *think* the current rate is R 3,250. Could be wrong as I don't have it to hand at the moment. Normally paid from MSA, if you have some left.

 

Different to a deductible as that isn't payable from MSA and the hospital requires that up front as they know med aid won't cover that.

Edited May 16, 2016 by Myles Mayhew

[Thor Buttox]

co-payment is the part-payment of a scan that normally costs thousands ie: MRI & CT scan.

 

Essentially you have to pay a portion of it. I *think* the current rate is R 3,250. Could be wrong as I don't have it to hand at the moment.

ah, OK, cool, thanks, Myles. yes, I had 2 Cats and had to pay about R5, 700 after a savings residual, so then all is good.

[BarHugger]

This was in Dec after my Mtb fall.

Was admitted on Thursday, had X-rays, etc taken. Paid for by Discovery, no problem.

Neck was injured, but x-rays showed everything in order, waited for Orthopedic surgeon to come see me, by Sat afternoon he still did not arrive. Emergency room Dr contacted him to find out when he is coming to see me, only to be told "he forgot about me" and that he could not see me over the weekend. Was discharged by ER docter and told to report back on Monday and to go straight to Ortho.

Did just that, more ex-rays was taken, same result., nothing broken or cracked (although my left index finger was clearly broken, still struggling with it, and x-rays was taken of my hand)

 

Was then told to go to Neuro surgeon, which I did. (consultation paid out of my pocket -R1250.00) This was on the Monday.

Neuro guy did a cursory exam and told me that MRI is needed for my neck, he booked me into the hospital again, and authorisation was obtained for procedure. Laid in Hospital for two days before MRI was done. 

 

Discovery now refutes the claim, saying it was "preventative treatment, not as direct result of fall" This, according to them, is due to the fact that it could not have been as serious if the Dr discharged me on the Sat and I went back again on the Monday. There was also some confusion regarding the procedure codes used by Neuro and the Ortho from ER that discharged me again the Wednesday after the MRI was done.

 

Disco says they've exhausted all the avenues now, I must PAY BACK THE MONEY.....

 

Edit = I only have the Hospital Plan.

Skelm bliksems.........

[shaper]

Back on Topic!!.... uploaded to garmin connect my weekends activities this morning as have been uploaded to vitality

[jcza]

Back on Topic!!.... uploaded to garmin connect my weekends activities this morning as have been uploaded to vitality

 

Whats your target this week? Mine still 600. 

Edited May 16, 2016 by jcza

[shaper]

Whats your target this week? Mine still 600. 

Also stayed at 600

[Captain Fastbastard Mayhem]

600

[Pure Savage]

Back on Topic!!.... uploaded to garmin connect my weekends activities this morning as have been uploaded to vitality

Mine just registered steps :/

[splat]

Whats your target this week? Mine still 600. 

Also stayed at 600

[lerouc]

Ive de-linked and re-linked mine now, will see if that helps.