How Our Clinical Services Help Your Customers Get More from Their Cover

When customers choose a health insurer, they're looking for more than access to treatment. They want confidence that they're receiving the right care, support navigating the healthcare system, and guidance when life's health challenges arise.

That's why our clinical services are designed to deliver value far beyond claims reimbursement, helping customers access the support, expertise and resources they need throughout their healthcare journey.

Expert Clinical Support When It Matters Most

Our integrated clinical services bring together specialist expertise, personalised programmes and digital health solutions to help customers make informed decisions about their care.

Customers can access a range of support services, including:

Chronic Condition Management

Living with a long-term health condition can be challenging. Our Clinical Team provides personalised guidance and support for members managing chronic conditions, such as diabetes and cardiovascular disease, helping them better understand their condition and make informed decisions about their health. This service may be available even where a special exclusion has been applied to the chronic condition on the policy.

Case Management

When facing a complex diagnosis or treatment journey, having expert support can make all the difference. Our dedicated nurse case managers act as advocates for members, coordinating care between healthcare providers, supporting treatment planning and helping members navigate their healthcare journey from diagnosis through to recovery.

Global Telehealth: Your 24/7 Doctor

Access medical support whenever and wherever you need it. Global Telehealth provides unlimited consultations via phone or video, giving members 24/7 access to non-emergency medical care at no additional cost. Depending on location and medical requirements, doctors may also be able to issue prescriptions when appropriate.

Decision Support: Second Medical Opinion

A significant diagnosis can raise important questions. Through our Second Medical Opinion service, members can access independent specialist expertise to better understand their diagnosis, review treatment options and gain confidence in the decisions they make about their care. This confidential service provides objective, evidence-based advice from leading specialists.

The Importance for Customers of Medical Necessity Reviews

These services are underpinned by our Medical Necessity Review process, which helps ensure treatment is clinically appropriate and supported by evidence-based medicine, helping customers receive the right care at the right time.

Supporting Mental Wellbeing Every Day

Health support extends beyond physical conditions. Customers with the Health & Wellbeing module can access a range of mental wellbeing and lifestyle support services designed to help them navigate life's challenges before they become bigger concerns.

Through the Life Management Assistance Programme (LMAP), customers have access to 24/7 support, including counselling, coaching, cognitive behavioural therapy (CBT) and practical life assistance. Additional services such as Wellness Coaching and our Mental Health Support Programme can help customers build healthier habits, manage stress, improve sleep and access support for anxiety and depression.

Whether someone is adjusting to an international relocation, balancing family commitments or simply looking to improve their overall wellbeing, expert support is readily available.

Family-Building and Hormonal Health Support with Carrot

For customers enrolled on Platinum, Carrot provides personalised support across family-building and hormonal health journeys.

From fertility planning and preservation to assisted reproduction, pregnancy, postpartum support and early parenting, Carrot gives customers access to expert guidance, educational resources and tailored care plans. The programme is designed to support individuals and families through important life stages, helping them make informed decisions with greater confidence.

More Than a Health Plan. A Partner in Better Health

These services provide an opportunity to demonstrate the value of cover beyond the benefit schedule alone.

By highlighting the clinical, wellbeing and family-building support available, brokers can help customers better understand how their cover supports them not only when they need treatment, but throughout every stage of their health journey.

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