Date: 16 August 2024

WELCOME TO POLMED’S DISEASE RISK MANAGEMENT (DRM) PROGRAMME

POLMED is committed to giving you the best possible solutions to manage your health. You are a valued member of our scheme, and we are always looking for ways to ensure that you benefit through excellent support that makes a difference to your health and wellbeing.

POLMED has identified you for registration onto the Disease Risk Management (DRM) Programme, based on claims relating to the chronic conditions that are managed within the Programme.

What are the benefits of this Programme?

  • You will receive health information and guidance that will assist you in improving your health and quality of life.
  • You will be empowered to take responsibility for your health and wellness.
  • You will receive information on how to access medical, dietary and nutritional information using the POLMED HealthCloud.
  • We will assist you in obtaining authorisation for appropriate healthcare services.
  • We will provide information on how your doctor can use your Care Plan to monitor and manage your health.
  • We will explain why co-ordination of care is important in managing your health.
  • We will explain the importance of preventative care and the use of the wellness benefit.
  • We will assist with any queries related to your chronic condition.

How will you be registered onto the Programme?

Our Care Managers will contact you to go through a short questionnaire and provide you with the support as listed in the benefits above.

What is a Care Plan?

POLMED will pay for the diagnosis, treatment and care of a number of chronic conditions. To support you with the management of your condition(s), POLMED has put a Care Plan in place that provides you with specific benefits relating to your condition(s). A Care Plan is therefore a list of the services that POLMED will cover. It details the services/care you have access to in order to manage your condition(s), such as doctor consultations, radiology and pathology tests.

Important points about your Care Plan:

  • Your Care Plan services are revised annually, and these benefits can be accessed from the beginning of each year.
  • These Care Plan services are for a full calendar year (12 months). If your doctor requires modification of the treatment plan, a motivation can be emailed to polmedapmb@medscheme.co.za. Additional treatment/services will be considered based on the information provided and whether it is clinically appropriate. The outcome of the decision will be communicated to you and you will receive an updated Care Plan.
  • The authorised Care Plan services will be paid from your overall in-hospital benefit and not from your overall out-of-hospital (day-to-day) benefit.

Should you require assistance or have any questions after registration onto the programme, you may contact us on 0860 765 633 (follow the voice prompts to the Disease Risk Management programme) between 08:30 and 17:00, Monday to Friday or send an email to: polmeddiseaseman@medscheme.co.za.

Kind regards,

POLMED Disease Risk Management Programme