Clalit Mushlam Launches New Coverage To deal with Cancer in the Platinum Plan, Without Any Additional Premium
- NIS 40,000-100,000 to finance surgery and therapy in Israel and overseas.
- NIS 10,000 reimbursement of expenses to diagnosis and treat the disease.
- Patient guidance and direction services by a multidisciplinary team of physicians.
The Clalit Mushlam Platinum plan is expanding with innovative coverage aimed at assisting in dealing with cancer. After marking and launching the Platinum plan, which introduced new fields to health fund's complementary healthcare insurance, such as dental care for the whole family and a financial pregnancy basket which is exercisable by choice, Clalit Mushlam has once again launched exclusive innovative coverage which provides a solution for the ever growing need to deal with cancer. The upgraded plan enters into force on May 1, 2013 and includes new coverage as well as an upgrade and expansion of the current coverage. The jewel in the crown of the expanded plan: a service package which supports cancer patients.
Support package for oncology patients and their family:
- Reimbursement for private surgery in Israel and overseas: Clalit Mushlam Platinum members will be eligible for for additional reimbursement of up to NIS 100,000 for surgery and/or therapy overseas and up to NIS 40,000 for surgery in Israel in addition to the current Zahav and Platinum plan coverage. This coverage will allow choosing the institution where the therapy associated with the disease is administered and the attending physician.
- Coverage of expenses for diagnosis and treatment of the disease of up to NIS 10,000: Members will be eligible for reimbursement of NIS 10,000 for services excluded from the health basket, such as medical consulting, psychotherapy, alternative medicine, private nutritional consulting, patient care, travel expenses, supportive home aides, etc. All of this is in addition to the current benefits in both the Zahav and the Platinum plans.
- Patient guidance and direction by a supportive personal multidisciplinary team of physicians: The team will include an oncology nurse, social worker, and physicians in various fields who will provide multidisciplinary consulting for the patient. They will direct and guide the patient in issues associated with treating the disease, patient rights versus the various interfaces, etc. The service will be provided through the Mor Institute, which is fully deployed nationwide, in return for a NIS 500 deductible.
According to Peretz Guza, head of health insurance at Clalit: "We are constantly taking steps to expand the Platinum plan and offer coverage that provides a real solution for the needs of our customers. In-depth surveys that we’ve conducted show that the issue of managing and coping with cancer is a field where patients and their families need guidance and assistance. We meet customers daily who experience difficult in financing the many expenses involved in managing cancer. The new coverage allows receiving reimbursements for surgery, therapy and consulting, thereby lifting the financial burden from the shoulders of the members and their families. In addition, every patient may receive the personal guidance of a specialized multidisciplinary medical team which provides direction, training and consulting regarding the diagnosis process, the recommended rests, guidance during hospitalization and recovery, and assistance in making decisions at critical points of managing the disease.”
The coverage may be exercised for up to two years after receiving the diagnosis. The reimbursement for surgery is 75% of the actual expense up to specified amounts of NIS 40,000 for surgery in Israel and NIS 100,000 for surgery or therapy overseas and NIS 10,000 to cover miscellaneous expenses.
The following new services will also be introduced into the plan:
- Pregnancy basket (expansion of the current coverage): The reimbursement ceiling to Clalit Mushlam Platinum members for expenses and services associated with pregnancy and birth will be increased to NIS 5,000, at 75% of the actual expense (instead of NIS 3,000) to be exercised by choice.
- New! Didactic and psycho-didactic diagnosis: Between ages 6 to 18, at a deductible of NIS 550 for didactic diagnosis and NIS 950 for psycho-didactic diagnosis (at institutes in the arrangement plan).
- New! ADHD tests: moxo, brc, and tova tests at a deductible of only NIS 50 per test at institutes which have agreements with us.
- New! Vaccinations for overseas travelers at clinics in the arrangement plan, at a cost of NIS 20 per vaccination. The consulting is provided free of charge.
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