\n\t\tWhen Discovery discovered its processing mistake, it emailed members to inform them of their debt, which is estimated to be R20 000 on average.\n\t<\/p>\n
In a dramatic about-turn, Discovery Health announced it will cover the costs of claims overpayments, remedying its year-long pharmacy medication claims funding error, resulting in the scheme paying more than 16 000 members more than what they were entitled to.<\/p>\n
2026 got off to a financially challenging start for millions of Discovery Medical Aid members, who were initially told to fork out thousands of rands for an error in processing medicine claims for the entire 2025 year.<\/p>\n
Headache<\/p>\n
The\u00a0error related to the Above Threshold Benefit (ATB) on the Executive, Classic Comprehensive, Classic Smart Comprehensive, Classic Priority, and Essential Priority plans; which affected how<\/a>\u00a0certain prescription and over-the-counter medicines were processed in 2025.<\/p>\n Discovery reprocessed the affected claims, with some requiring a co-payment at the time of claiming, which Discovery incorrectly covered.\u00a0<\/p>\n The claims were initially processed between January and December 2025.<\/p>\n ALSO READ: Can Discovery Health really ask you to pay back the money? What you need to know about medical aid\u2019s claims error<\/a><\/strong><\/p>\n Pressure<\/p>\n After pressure from members and protests at its offices in Sandton, Discovery has had a change of heart and will now cough up the money to cover the cost of a claims system error that resulted in the overpayment of what it called \u201ccertain ATB claims\u201d during 2025.<\/p>\n \u201cAffected Discovery Health Medical Scheme members will not be required to repay any amounts related to the error, and no other members of the Scheme will be disadvantaged because of this decision,\u201d said Dr Ron Whelan, CEO of Discovery Health, on Sunday, to the schemes 16\u00a0507 members who were affected by the error.<\/p>\n \u201cThe error affected a limited group of members whose ATB claims were inadvertently overpaid during 2025. With Discovery Health absorbing the full cost, neither the Scheme nor any members are negatively impacted in any way.\u202f<\/p>\n How many affected?<\/p>\n Whelan said, notwithstanding the validity of the recovery, \u201chaving carefully listened to members\u2019 concerns\u201d and considered their individual experiences and circumstances, the scheme has decided to cover the cost on members\u2019 behalf.<\/p>\n \u201cThe error affected 16,507 members across certain Executive, Comprehensive and Priority plans where ATB applies.\u201d<\/p>\n