Medical conditions that are eligible for Medix Personal Medical Case Management Service
1. Medical Conditions without Diagnosis
For medical conditions without diagnosis, the medical inquiry and consultation process must include a consultation with at least one specialist in a field related to the medical problem.
2. Medical Conditions in which the Diagnosis matches one of the following medical categories
Customers are eligible for personal medical case management services if they have one or more of the following conditions, provided they have already consulted at least one specialist in a field related to the medical problem.
2. Liver diseases;
3. Kidney diseases;
4. Chronic gastroenterological diseases experienced during a period of at least 30 days;
5. Cardiovascular diseases;
6. Neurological diseases and invasive procedures into the central or peripheral nervous system;
7. On-going Orthopedic diseases experienced;
8. Elective invasive procedues following disease with the intent of treating a disease/medical condition and excluding diagnostic reasons;
9. Hematological diseases;
10. Rheumatological diseases;
11. Metabolic diseases;
12. Endocrine diseases;
13. Ear, nose and throat (ENT) diseases and related invasive procedures;
14. Immunological diseases;
15. Pulmonary diseases;
16. Infectious diseases experienced during a period of at least 7 days;
17. Ocular diseases;
18. Orphan diseases;
19. Combined pathologies: several diseases requiring multidisciplinary treatment and, consequently, coordination between at least two specialists from different fields of expertise;
20. Any medical problem that requires hospitalisation or a medical problem that requires hospitalisation due to complications following a procedure or treatment, lasting more than 3 consecutive days; and
21. In addition to the above-mentioned categories, a pediatric patient whose case matches one of the following descriptions is also eligible for the Service:
- Elective surgery, i.e., a non-urgent procedure prescheduled following the recommendation of a specialist from a pediatric clinic (including outpatient clinics);
- Chronic disease;
- Hereditary disease;
- Congenital anomaly; and
- Developmental impairments following a period of at least 6 months of consultation and treatment at a pediatric development centre and consultation with at least two specialists in fields related to the medical problem.
3. Excluded Medical Conditions
Customers diagnosed with one of the following medical conditions are not eligible for the Service:
1. Emergency care and or any medical conditions of urgent invasive and/or urgent surgical procedures;
3. Short Stature as sole medical condition; Medix will cover congenital syndroms that are represented by various medical conditions, which may include short stature but not as stand alone.
4. Endocrine conditions that affect only fertility;
5. Snoring surgery and sleep apnea
6. Cosmetic/Aesthetic surgery;
7. Excluded medical conditions in the pediatric medical field:
Pediatric gastroenterological diseases of the following types:
- failure to thrive;
- eating disorders (e.g. anorexia, bulimia);
- attention deficit/hyperactivity disorder (ADHD); and
- any medical condition pertaining to premature babies during initial hospitalisation after birth or during the first 6 months of life.
8. Excluded disorders:
- Anorexia/Bulimia and other related eating disorders; and
- Sleeping disorders.
9. Fertility-related conditions or procedures, with the exception of cases of 3 or more consecutive miscarriages;
11. Child, youth, and adult psychiatric and/or mental diseases;
12. Conditions related directly or indirectly to issues of looks and aesthetics, including obesity, with the exception of reconstructive breast surgery following a mastectomy;
13. Medical conditions in the fields of dentistry;
14. Fibromyalgia disease;
15. Chronic fatigue syndrome;
16. Complete and irreversible blindness;
17. Acute Cerebrovascular accident (CVA);
18. Severe burns if patient is hospitalised;
20. Sexual diseases; STD
23. Any condition that necessitates urgent medical attention; and
24. Any condition resulting from substance, drug or alcohol addiction.