Earlier Focus on Prevention and Screening

The new benefits in CGHO v5 place greater emphasis on early detection and prevention, helping your customers identify and manage health issues before they escalate.

Enhanced Screening Benefits

Under the Health & Wellbeing optional module, eligible members now benefit from increased cancer screening frequencies for the following:

• Annual cervical screening (previously every 3 years)
• Annual mammograms (previously biennially)
• 5-yearly colonoscopy (previously every 7 years)

Diabetes Prevention Programme (US Only)

For customers residing in the US, our diabetes prevention programme, Omada, has been expanded to all eligible individuals after its pilot. This programme should assist engaged members with both reducing their blood glucose levels and achieving a healthy weight, reducing their likelihood of developing preventable Type 2 Diabetes.

Significant Enhancements to Cancer Care

Our commitment to supporting your customers through their full cancer journey – from diagnosis to recovery – has been strengthened across all product tiers and is designed to support both customers and their families.

Included on All Plans

• Cancer treatment
• A dedicated Cancer Case Manager and Care Coordinator
• Counselling support for customers and family members through our provider of choice
• Access to an oncological dietician
• Reconstructive and robotic surgery*

Additional Benefits

Gold & Platinum: Home chemotherapy** cover

Platinum only:

• Fertility cryopreservation, with a lifetime benefit limit of $5,000/€3,700/£3,325 for up to seven years from first claim

These enhancements should provide comprehensive cancer care, and offer your customers and their families clinical, emotional, and practical support in one solution.

*Robotic surgery paid in full where it has been clinically proven to have improved patient outcomes. If not, paid to reasonable and customary value of conventional surgery.

**Based on medical necessity review.

Broader Support for Pre-Existing Conditions

After positive feedback on the 60+ Care benefit (now called 60+ Pre-Existing Condition Care), we've ensured that CGHO v5 significantly expanded outpatient support for the maintenance of pre-existing conditions in our senior population, and now your customers aged 40+ on Platinum can use this benefit too.

60+ Pre-Existing Condition Care

• Gold: limit increased to $1,500/€1,100/£1,000
• Platinum: limit increased to $3,000/€2,200/£2,000

NEW: 40–59 Pre-Existing Condition Care (Platinum only)

• Platinum: limit of $2,000/€1,600/£1,300

Extended Conditions List (for Pre-Existing Condition Care benefits)

In addition to the existing six conditions, we've extended the list to include (for all plan tiers):

• Migraine
• High cholesterol
• Asthma
• Allergies
• Atherosclerosis / arteriosclerosis
• Coronary artery disease

This update should provide greater flexibility and options for customers aged 40+ who do not wish to accept a loading or exclusion.

Additional preventative benefits

Hearing aid cover has been significantly strengthened:

• Gold: limit increased to $5,000/€3,700/£3,325
• Platinum: now Paid in Full

This change further differentiates Gold and Platinum tiers from Silver and enhances day to day outpatient value.

Additional preventative benefits include:

• Advanced Medical Imaging (Gold): limit doubled to $30,000/€22,200/£19,200
• Footcare treatment (Platinum): allowance increased to $2,000/€1,600/£1,300 (up to 20 sessions)

These updates should reinforce CGHO's focus on proactive health management, rather than reactive treatment.