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SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Kaelo responds to the changing healthcare landscape with new 2021 product developments and enhancements

21 September 2020 Kaelo

Kaelo, the provider of innovative, essential, healthcare solutions that enable the physical and psychological well-being of clients, announced its 2021 product developments and enhancements at a virtual launch event on the 15th of September.

The event also saw the health insurance provider share insights on the future of health insurance and lifestyle medicine in response to market and regulatory movements in the wake of Covid-19.

“COVID-19 has brought the increased need for affordable healthcare and lifestyle solutions to the fore. The pandemic has not only impacted industries and businesses but has also added pressure to the healthcare system, as seen with the council for medical schemes’ recommended 3.9% increase limit for medical schemes in line with the 3.9% CPI,” said John Jutzen, CEO at Kaelo. “This is against the backdrop of medical inflation, which has always been substantially higher than inflation itself, and has created further tension between healthcare costs and healthcare access.”

Kaelo aims to provide ways to deal with this tension and bridge the gap between healthcare costs and access to quality healthcare, which would have otherwise required a reduction in healthcare administration costs, a reduction in healthcare expenditure or compression of the benefit design. The healthcare solutions provider says its 2021 products and benefits can achieve better healthcare outcomes and increase healthcare access without compromising the benefit design.

Included in these benefits is Kaelo’s Lifestyle Digital product, which offers members unlimited counselling, financial advice, legal advice and employee support to promote mental wellness through virtual counselling platforms and address the psychosocial impact of the pandemic.

"We've witnessed moderate to very high-risk counselling cases entering our 24-hour service through our Kaelo Lifestyle product almost double from the same period last year, said Jutzen. "To ensure Kaelo members can reach trauma response and counsellors when they need them most, we have extended our counselling hours from 08h00 – 19h00 , making it possible for members to access the help they need through telephonic mechanisms or virtual platforms.” The telephonic counselling service remains a 24hr, 7 days a week, 365 days a year service. Unlimited Face to Face counselling remains as a major differentiator and sincere engagement mechanism on the full Kaelo Lifestyle programme – Ask Neslon.

To address the increasing stress and anxiety among the youth, Kaelo has also included a Lifestyle Youth programme. The programme is aimed at helping youth in schools and universities, between the ages of 13 and 24, deal with issues such as cyberbullying and substance abuse.

A new addition to the Kaelo private primary healthcare offering is Kaelo Access – a healthcare solution that will be through Dis-Chem’s wellness clinics. This is a nurse-based care solution with referrals to two virtual GP consultations per annum. Members can register for chronic disease medication, which would be procured through the state, but delivered through the Dis-Chem pharmacy network. Members will also have access to an Over the Counter medicine benefit.

The healthcare solutions provider has increased the overall annual limit of its Gap Cover Products, from R165 000 to R172 000 in 2021. Kaelo will now also pay 25%, or R10 000, of the total drug cost of any scheme approved innovative medicine. Members or intermediaries on behalf of members will be able to submit claims using Kaelo’s new user-friendly digital claims process.

“Going into 2021, Kaelo will be integrating Kaelo Lifestyle for all Gap policyholders, offering access to Kaelo Lifestyle Digital. This will be standard for all Gap policyholders,” concludes Jutzen.

About Kaelo and Kaelo Prime Cure:
Kaelo’s overarching business goal is to provide more South Africans with access to quality healthcare. To do this effectively, we are progressive in our design, simple in our approach, and sincere in the way we engage with our clients, changing the way healthcare is delivered to meet the needs of our members.

Kaelo provides innovative, essential, healthcare solutions enabling the physical and psychological well-being of all South Africans. Kaelo Prime Cure, which is wholly owned by Kaelo, is one of South Africa’s leaders in affordable, integrated managed care with over 25 years’ experience and over one million lives under management.

Kaelo Prime Cure’s core services include but are not limited to:
• Network management
• HIV disease management
• Chronic disease management
• Drug utilisation management

Kaelo offers the below-listed products/services
• Kaelo Lifestyle: Psychosocial medicine for employees in the form of an Employee Assistance Programme
• Kaelo Health: Primary healthcare services which provide affordable and quality treatment for a comprehensive range of health problems
• Kaelo Gap and Western Gap: Shortfall cover which provides protection and peace of mind to the medically insured population of South Africa

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