A Guide to Medical Aid Societies in Zimbabwe

Choosing a medical aid society is one of the most important financial decisions a family can make in Zimbabwe. With a wide range of providers and plans, understanding how the system works is the first step to securing the right healthcare cover for your needs. This guide provides an impartial overview to help you make an informed decision.

Part 1: Understanding the Basics of Medical Aid

At its core, medical aid works like insurance. You and/or your employer pay a monthly fee (a premium), and in return, the society covers a portion of your medical bills.

• Premiums: The fixed monthly amount you pay to keep your membership active.
• Benefits: The specific medical services covered by your plan, such as GP visits, specialist consultations, hospital stays, and medication.
• Shortfall: The portion of a medical bill that your medical aid does not cover, which you must pay yourself. This often happens if a doctor charges more than the rate set by the medical aid society.
• Co-payment: A fixed amount you may be required to pay for certain procedures or hospital admissions before the medical aid covers the rest.

Part 2: Types of Plans - What to Look For

Medical aid plans in Zimbabwe generally fall into a few key categories. Understanding these will help you narrow down your options.

Plan Level: Comprehensive vs. Basic (or Core)

• Comprehensive Plans: These are the most expensive plans and offer the widest range of benefits, including higher limits for hospital stays, specialist care, dental, and optical services. They are best for those with chronic conditions or who want maximum peace of mind.
• Basic/Core Plans: These are more affordable and focus on covering essential services, primarily major hospital events and emergencies. They often have lower limits and may not cover day-to-day expenses like GP visits.

Currency: USD vs. ZWL Plans

• USD Plans: Premiums are paid in US Dollars, and benefits are paid out at USD rates. These plans are generally preferred as they offer more stability and are accepted by a wider range of private healthcare providers without the risk of significant shortfalls.
• ZWL Plans: Premiums are paid in the local currency. While often cheaper, they can be subject to the effects of inflation, which may lead to larger shortfalls if medical providers are charging in USD.

Part 3: How to Choose the Right Provider

With several medical aid societies to choose from, it's important to do your research. This is not just about price; it's about reliability and the quality of cover.

Key Questions to Ask a Potential Provider:

1. What is your network of doctors and hospitals? Ensure the hospitals and doctors you prefer to use are part of their direct payment network.
2. What are the waiting periods? Most societies have waiting periods (e.g., 3-6 months) for new members before certain benefits can be claimed. This is especially true for pre-existing conditions.
3. How are claims processed? Do they pay the doctor directly, or do you have to pay upfront and claim a refund later?
4. What are the specific limits on major procedures? Ask for the monetary limits on things like surgery, hospital stays, and cancer treatment.