US EditionSouth Africa: Regulator Probe, Public Uproar Spare 16,507 Discovery Health Members From R125m Billing Error
Discovery Health will cover the cost for 16,507 members affected by claims-processing errors involving Above Threshold Benefit limits, representing just over 10% of certain plan members.
- On Sunday, 11 January 2026, Discovery Health announced it will cover incorrect payments and release 16,507 members on selected plans from repayment demands.
- A system update in early 2025 caused certain medicine claims to accumulate incorrectly under the Above Threshold Benefit , leading members to reach ATB limits faster and triggering unintended payments.
- Company figures show the affected group represents 10.5% of those plans and under 0.6% of total membership, with overpayments valued at about R125-million and benefits paid at about R3.6bn last year.
- Deductions already taken from Medical Savings Accounts, Personal Health Fund or HealthPay will be reinstated and affected members who repaid will receive full refunds, while 2026 benefits remain unaffected.
- Amid social media backlash and consumer pressure, MediCheck engaged intensively with Discovery Health, prompting emergency meetings and legal notices while advocacy groups credited activism for the reversal.
11 Articles
11 Articles
South Africa: Regulator Probe, Public Uproar Spare 16,507 Discovery Health Members From R125m Billing Error
Discovery Health's systems hiccup turned routine claims into nasty 'you owe us' notices for 16,507 members, with some demands climbing toward R80,000. After MediCheck lit the fuse and the Council for Medical Schemes began asking questions, Discovery has backtracked, promising refunds and no 2026 benefit pain, but questions remain about governance, controls and accountability.
Regulator probe and public uproar spare 16,507 Discovery Health members from a R125m billing error
Discovery Health’s systems hiccup turned routine claims into nasty ‘you owe us’ notices for 16,507 members, with some demands climbing toward R80,000. After MediCheck lit the fuse and the Council for Medical Schemes began asking questions, Discovery has backtracked, promising refunds and no 2026 benefit pain, but questions remain about governance, controls and accountability.
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Discovery to absorb cost of claims error after member backlash
The announcement by Discovery means that affected members will be relieved of any repayment obligations. Last week The South African reported on a claims glitch that impacted members on five high-end Discovery Health plans. The medical aid had asked some of its members to repay money after an internal processing error led to claims being paid at higher levels than their plans allow. Above Threshold Benefits At the centre of the problem was the A…
Discovery Health apologises, refunds 16 500 members after system error
Discovery Health has announced it will cover the costs of a claims system error that led to the overpayment of certain Above Threshold Benefit (ATB) claims in 2025, relieving affected members of any repayment obligations. The error impacted 16 507 members across selected Executive, Comprehensive and Priority plans, accounting for about 10.5% of members on those plans and less than 0.6% of Discovery’s total membership. Discovery CEO Ron Whelan ap…
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