24 January 2013

Zimbabwe: Concern Over Cimas Claims Package

CIMAS Medical Society members have expressed outrage over the medical aid society's claims cost rationalisation. With effect from this month, the society will cover a maximum hospital stay of two days for a normal maternity delivery. Hospitalisation for all other cases has been reduced to three days after which members will have to pay cash for any other costs incurred.

The society announced that reports would have to be submitted from the hospital should there be need for an extended stay. The hospitalisation benefit now has a sub-limit equivalent to 50 percent of the Annual Global Limit of the package. The new private hospitalisation sub-limit applies to ward fees only.

Cimas head of public relations, Mrs Lindiwe Mhunduru, said casualty units would now be accessed for emergency cases only with a maximum of three visits in a membership year.

Members accessing these units outside these guidelines, she said, would be asked to pay cash. Pathology and radiology benefits would also have a sub-limit with effect from this month. Last year, Centre for Health Strategies director Dr David Parirenyatwa said national health insurance scheme was the way to go for Zimbabwe if the entire population was to have medical cover.

Only 10 percent of the population is on medical aid and these are the ones who are more financially stable.

There was a need for the remainder to be catered for and these new regulations were likely to discourage people from joining medical aid societies.

Health insurance schemes have been talked about for the past 10 to 15 years but nothing has come of it.

"There are five ways of health financing. The fiscus, private insurance, out of pocket, NHIS and NGOs. NHIS is the most inclusive and Zimbabwe has advanced plans to launch such a project," said Mr Kadzere.

The current plan is to have NHIS administered by the National Social Security Authority. A fully vibrant NHIS would ensure that public hospitals and clinics would have state-of-the-art equipment as all services rendered would be adequately paid for.

Other countries that have universal health cover have seen significant benefits for their populace. Some medical aid societies are reportedly facing collapse due to late remittances of contributions, low subscriptions and rising costs of medical services.

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