Discovery Network hospitals ?

[I.am.Sam]

Hello all

so we have panaroma in CPT as a network hospital close by

now last week we took son in for emergency and he wasnt admitted cause it wasnt severe

when i went to get meds they said medical aid wont pay cos its not a network doctor

Now how does it work if he had to get admitted

discovery would have paid for the hospital costs but not the doctor costs ?

and how do we work around this if thats teh case

 

[I.am.Sam]

and i had to settle the bill which wasnt much though for the 3hrs he was there which was around R800

 

[Hemi300c]

On 2nd January I went to a dentist centre because I have an abscess and was in pain since 26th Dec. They were the only open dentist and guess what - Discovery didn't pay because they not on their list even though they were cheaper than their listed dentist.

Discovery are k@k

 

[Friggs]

ER rooms are private practices and not actually part of the hospital. The medical aid will only cover an ER visit as part of the network hospital benefit if he is admitted. The fact that he wasn't admitted means the visit was the same as if you took him to Intercare or your local GP - just with the added "emergency" charge levelled on top.

 

[I.am.Sam]

ER rooms are private practices and not actually part of the hospital. The medical aid will only cover an ER visit as part of the network hospital benefit if he is admitted. The fact that he wasn't admitted means the visit was the same as if you took him to Intercare or your local GP - just with the added "emergency" charge levelled on top.

so if he does get admitted the doctors will be paid for as its a network hospital ?

do i need to worry and get gap cover and stuff

 

[I.am.Sam]

On 2nd January I went to a dentist centre because I have an abscess and was in pain since 26th Dec. They were the only open dentist and guess what - Discovery didn't pay because they not on their list even though they were cheaper than their listed dentist.

Discovery are k@k

all medical aids ..insruances alles are kak

we need it sadly

 

[Friggs]

all medical aids ..insruances alles are kak

we need it sadly

That I agree with. Totally a grudge purchase for...

 

[Friggs]

so if he does get admitted the doctors will be paid for as its a network hospital ?

do i need to worry and get gap cover and stuff

Correct. If he got admitted then they will pay the ER docs and meds as part of the in-hospital benefit 100% due to the hospital being a network hospital.

But even with the top medical aid plans where you can visit any hospital, if you get admitted, they pay everything from the in-hospital benefit but if you don't get admitted then you either have to pay the ER docs cash or it comes out of your savings portion - so they can still claim from the medical aid but it comes out of the day to day funds.