Private Health Insurance (Medical Aid) and Huge Shortfalls in Zimbabwe: Policymakers playing ducks and drakes

By: Enock Musungwini, MPH, MBA Introduction A shortfall is the difference between what a health service provider charges for a patient’s treatment and what the medical insurance company will pay for that service. Shortfalls are sometimes presented as a co-payment, which is the gap between what the Private Health Insurance (PHI) company or medical aid pays to the health service provider for service rendered to the patient and what the health service provider will have charged the patient, known as a tariff. According to Suriyawongpaisal et al. (2016), huge shortfalls…

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Zimbabweans value funeral cover more than Medical Aid…Only 11 Percent Zimbabweans Have Medical Aid

The loss in value in the local currency to the greenback, has forced several Zimbabwean medical aid policyholders to terminate medical aid policies while some are resorting to removing some beneficiaries from cover as a survival strategy. By Michael Gwarisa These developments come at the back of revelations that a few Zimbabweans are currently under medical aid cover and yet, more people have up-to-date funeral policy coverage. A study that was conducted by Finmark Trust and published by the Zimbabwe National Statistics Agency (ZIMSTAT) revealed that just 30 percent of…

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First Mutual RTGS Medical Aid holders stranded

ZIMBABWEAN Dollar Medical Aid holders under First Mutual Health insurance scheme will no longer be able to access healthcare services at any of the health facilities under the Medical Investments limited including the Avenues Clinic, a move that is likely to throw members into quandary. By Michael Gwarisa Sources privy to these developments told this publication that First Mutual Health (FMH) has not been forthcoming in terms of meeting their side of the bargain and have been paying for claims after a longer period in contradiction with a request from…

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COVID-19 Leads To Spike In Respiratory And Spectacles Medical Aid Claims In Zim

THE Association of Healthcare Funders of Zimbabwe (AHFoZ), which is the umbrella body for all medical aid companies in Zimbabwe says there has been an upsurge in respiratory and Eye related medical aid claims during the COVID-19 period. By Michael Gwarisa Speaking during a virtual meeting recently, AHFoZ Chief Executive Officer, Ms Shylet Sanyanga said, “In terms of the impact of COVID-19, we noticed that since the beginning of the pandemic and since the first case was diagnosed here in Zimbabwe, there has been an increase of respiratory related claims…

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Zim Medical Aid Companies Should Embrace Telehealth Post COVID-19- AHFoZ

THERE was a general decline in contributions to medical aid companies as well as delays in processing claims during the COVID-19 induced lockdown period amidst indications that most players struggled to process claims as they still rely on obsolete manual systems. By Michael Gwarisa Speaking during a virtual dialogue, Association of Health Care Funders (AHFoZ) Chief Executive Officer Ms Shylet Sanyanga said Medical Aid players have to think outside the box and prepare for future emergencies and also ensure they continue offering services even in the presence of global a…

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#OPNION: Government Moves To Regulate Medical Aid Societies: This Doesn’t Sound Like A Very Brilliant Idea

GOVERNMENT recently announced that cabinet had deliberated and considered the submissions made on the Regulation of Medical Aid Space Societies as proposed in the Insurance and Pensions Commission Bill, which were presented by Vice President as Minister of Health and Child Care, Dr Constantino Chiwenga. By Michael Gwarisa According to information minister, Senator Monica Mutsvangwa, they had realised that since medical aid societies were not for profit enterprises and represent members’ efforts to pool funds to assist in covering health bills and expenses, it was best international practice for such…

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77% of medical-aid babies are now born via c-section in SA

ALMOST 77% of babies covered by South African medical schemes are delivered by caesarean section – among the highest rates in the world, a new study by the Council for Medical Schemes (CMS) has found. According to the World Health Organisation, c-sections should only represent 10% to 15% of births. In South African state hospitals, the c-section was only around 26% in 2016. Read: The C-section rate among Discovery members is now up to three times higher than at American celebrity hospitals – here’s why The CMS now wants urgent…

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Medical Aid Coverage Drops Below 10 Percent

MEDICAL Aid coverage among Zimbabweans as of last year must have dropped from the previous figure of 10 percent owing to the continued economic decline  greatly reducing citizens’ capacity to spend and invest towards their healthcare. By Kudakwashe Pembere The Association of Healthcare Funders of Zimbabwe (AHFoZ) issued new pricing guidelines in November last year to cushion members against huge co-payments and shortfalls. The adjusted rates have prompted  members to either downgrade packages or drop health insurance completely. Responding to HealthTimes,  Association of Healthcare Funders of Zimbabwe chief executive officer…

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Prohibition Of Service Provision By Medical Aid Societies Challenged

CIMAS Group Chief Executive Officer Mr Vuli Ndlovu on Thursday vented his reservations on the Medical Aid Regulatory Bill prohibiting medical aid societies into service provision. By Kudakwashe Pembere With medical service providers lobbying for this move, the Health and Child Care Minister Dr Obadiah Moyo has pushed for this bill to be approved by Cabinet. Speaking at an information campaign launch at CIMAS head office, Mr Ndlovu said he is against the prohibition part. “The next issue I want to say on the bill is the story coming out…

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CIMAS Launches Campaign To Demystify Medical Aid Misconceptions

CIMAS Medical Aid Society on Thursday launched an information campaign to address the stereotypes about medical aid societies. By Kudakwashe Pembere Dubbed ‘Secure With Us’, the campaign also seeks to increase awareness to their services along with steps taken to add value to them. CIMAS Group Chief Executive Vuli Ndlovu said the primary concern was to promote health of its members and ensure access to affordable quality healthcare. As part of our strategy to preserve and add value to the services that we offer we have restructured our medical aid…

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