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Conditions We Cover

Expert second opinions for serious and complex conditions.

WorldCare Multidisciplinary MSOs are available for 100+ conditions that have high medical and emotional complexity, like cancer, Alzheimer’s, and heart disease.

We specialize in these conditions because of their complexity and fast-moving diagnostic and care innovations.

Coverage may vary by health plan. Members should contact their benefits administrator or insurance provider for details.

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All Cancers and serious tumors

All neoplastic conditions, which include malignant tumors (cancers) and serious benign tumors 1

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Spine

  • Major spinal trauma²
  • Infection: osteomyelitis/discitis
  • Neoplasms: benign or malignant tumors
Breast health

Breast health

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Cardiovascular

  • Cardiac infarction
  • Aneurysm of great vessels
  • Vasculitis, myocarditis
  • Cardiac tumors
  • Cardiac failure
  • Cardiac myopathy
  • Cardiac valve disease
  • Pericarditis, Cardiac tamponade
  • Cardiac arrhythmias
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Congenital disabling disorders

  • Related Cancers including:
  • Thyroid
  • Pancreas
  • Pituitary gland
  • Hashimoto’s thyroiditis
  • Disabling diabetic complications
Endocrinology

Endocrinology

  • Related Cancers including:
  • Thyroid
  • Pancreas
  • Pituitary gland
  • Hashimoto’s thyroiditis
  • Disabling diabetic complications
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Gastroenterology

  • Related Cancers including:
  • Esophagus
  • Stomach, small and large intestines, rectum
  • Liver, spleen, pancreas, gall bladder
  • Peritoneum
  • Infection
  • Pancreatitis
  • Peritoneal infections
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Genitourinary

  • Related Cancers including:
  • Kidney
  • Ureter and urinary bladder
  • Testicles, prostate
  • Renal failure
  • Complicated renal transplant
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Gynecology

  • Related Cancers including:
  • Ovary
  • Uterus/fallopian tube
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Hematology

  • Complications of Sickle cell disease and Thalassemia
  • Leukemia
  • Multiple myeloma
  • Lymphoma
  • Waldenstrom Macroglobulinemia
  • Severe anemia
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HIV infection/AIDS

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Musculoskeletal

  • Cancer
  • Infections
  • Bone and joint infections
  • Myositis
  • Trauma
  • Complicated fracture: pelvis, hip, rib
  • Amputation
  • Rheumatoid arthritis
  • Marfan syndrome
  • Muscular dystrophy
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Neurology

  • Neurodegenerative disorders
  • Alzheimer’s disease
  • Multiple sclerosis
  • Parkinson’s disease
  • Amyotrophic lateral sclerosis (ALS)
  • Motor Neuron disease (MND)
  • Vascular disorders
  • Intracranial aneurysm
  • Vascular malformation:
  • Brain and spinal cord
  • Brain and spinal cord embolism
  • Disabling cerebral vascular accident
  • Related Cancers including:
  • Brain
  • Spinal cord
  •  Trauma
  • Traumatic brain and spinal cord injury
  • Coma
  • Infection
  • Brain and spinal cord abscess
  • Encephalomyelitis
  • Idiopathic intracranial hypertension
  • Paralysis caused by any of the above
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Ophthalmology

  • Sudden onset blindness
  • Retinal detachment
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Otolaryngology

  • Related Cancers including:
  • Paranasal sinuses/salivary glands
  • Pharynx/larynx
  • Vocal cords
  • Tongue and buccal cavity
  • Sudden onset deafness
  • Traumatic facial injury
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Respiratory tract

  • Related Cancers including:
  • Lung, trachea
  • Thymus
  • Respiratory failure
  • Pulmonary embolism
  • Chronic obstructive airways disease/emphysema
  • Traumatic injury to the lung/pneumothorax
  • Cystic fibrosis
  • Heart/lung transplant
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Skin/Dermatology

  • Melanoma
  • Complications from major burns
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Mental Health

Available only with select plans. Check with your carrier for eligibility. 

  • Bipolar disorder
  • Generalized anxiety disorder (GAD)
  • Major depression
  • Post-traumatic stress disorder

1 All neoplastic conditions: A) Coverage includes benign tumors that are clinically significant, complex, and pose a risk to health due to their size, location, or potential to cause complications. B) Benign tumors/cysts that are asymptomatic, non-progressive, and do not require medical intervention are excluded from the coverage. This would typically include benign tumors that are small, stable, and unlikely to cause complications.

2 Major Spinal Trauma: A) MSO can be provided only after member has received critical care and has seen a local specialist.  B) Condition must have caused or could lead to partial or total loss of motor and/or sensory function below the level of injury. C) Includes: Burst fractures, fracture dislocation, odontoid fractures, hyperflexion/ hyperextension injuries, penetrating injuries.

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New and Notable

Mental wellbeing enhancement adds psychologist input to WorldCare's multidisciplinary team reviews. It is included in our Premier Cancer and Mental Illness specialty case reviews and can be made available to elements of our core MSO.

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