Wooltru Healthcare Fund has embarked on a new programme called HomeCare+, which ensures early identification and management of beneficiaries with multiple conditions.
The managed care company identifies high-risk beneficiaries based on their claims history and health assessment data. Thereafter beneficiaries are categorised into low, medium and high risk and based on this, the high-risk beneficiaries are registered on the HomeCare+ Programme. A specialist care coach is assigned, who will assist with understanding their risk as well as provide information to adequately manage the risk.
In addition, they will identify and apply benefit and clinical protocols to effectively manage these members. These services may be paid from the Major Medical Expenses benefit.
Nursing and frail care benefits are subject to clinical motivation and a quotation from your doctor. These services will be limited to the benefits available.
Should you require assistance post discharge from hospital, nursing care may be considered on receipt of a full clinical motivation and a quote and may be considered "in lieu of hospitalisation". Approval would be as per the recommendation of the Wooltru Healthcare Fund's medical advisor.