This sought-after entry level plan is designed to benefit those looking for a comprehensive yet affordable package. Providing access to both private and public healthcare institutions, it also makes provision for specialist visits. This scheme lets you be in full control of your health while looking out for your pocket.
- Hospitalisation in a Private Hospital is paid in full for a four bedded ward. Pre-authorisation is required for a twin bedded ward.
- Hospitalisation in a Government, Mission or Municipal hospital including Parirenyatwa is paid in full.
- In-hospital drugs are paid in full whilst in a Private, Government, Municipal or Mission hospital (To-take-Out Drugs are paid up to seven (7) days stock only).
- Ambulance Services are fully covered for life threatening situations only.
- General practitioners.
- Specialist Treatment Services by Private/Government specialists.
- Pathology and Radiology Services at Private/Government facilities (a nonrefundable co-payment may apply for certain tests.)
- Blood Transfusion Services (BTS) is covered. A non-refundable 20% co-payment applies.
- Drugs supplied on prescription outside Zimbabwe are paid at 75% of cost up to the Annual Family Limit.
- There is no drug deduction fee applicable to this package. Members can access generic prescription drugs on the Society’s Drug Facility arrangement with some pharmacies.
- Drugs are paid at the Approved Medical Aid Award rate (which is agreed to by pharmacies and medical aid societies for generic drugs).
- Maternity is generally paid at 70% of AHFoZ rates, covering maternity care and delivery. Hospitalisation is paid in full.
- Antenatal and postnatal visits are restricted to nine (9) and five (5) respectively with two (2) antenatal ultra-sound scans covered.
Global Travel Cover (GTC)
- Cimas in association with HEALTHGUARD International (Pty) Ltd R.S.A. offers the (GTC) to any person travelling outside their country of usual residence. It is available on application to both Cimas and non-Cimas members.
For treatment not available in Zimbabwe:
- The Society will pay 70% of global limit provided prior authorisation is obtained from Cimas before the treatment is rendered.
- Where prior authorisation is not obtained, the claim will be paid at 50% of costs up to foreign treatment limit.
- Foreign claims (in English) must be submitted for payment within a period of six (6) monthsnfrom date of treatment.
Study Mate Health Cover
- Study Mate is an international student plan that offers comprehensive medical aid cover for students studying outside their country of normal residence. (See the Study Mate Brochure for detailed information.)
Prostherics and Applicances
Awards are paid up to an Annual Limit
- Internal prostheses paid at 90% of cost
- External prostheses paid at 80% of cost
- Nebulisers paid at 50% of cost
- Ostomy bags paid at 80% of cost
- Miscellaneous appliances paid at 50% of cost
- This caters for Occupational and Speech Therapy, Clinical Psychology, Social Work and Physiotherapy. Awards are paid up to an annual limit.
- Caters for consultation by a specialist psychiatrist for in-hospital treatment only. Award is paid at Cimas rates up to an annual limit.
Awards are paid at up to an annual limit:
- Air Evacuation
- Hospital transfers
- Family Planning
The following benefit waiting periods shall apply to those who will be joining the Society for the first time or where there has been a lapse in membership.
- A mandatory three (3) months waiting period will apply to all new members.
- Subject to the foregoing, where a member downgrades to lower packages
these waiting periods will not apply.
Six months for:
- Specialist treatment
- MRI, CT scans and Nuclear medicine
- Admission or treatment at a hospital
- Upgrading to a higher package
Nine months for:
One (1) year for:
- Specialist Foreign Treatment
Two (2) years for:
- All internal prosthetic devices
- Chronic Disease Add-On
- All conditions with a two (2) year waiting period listed above or needing the remedies set out above have no cover. Cover is subject to Prior-Authorisation by the Society. Prior-Authorisation must be sought at all times before a service is enjoyed.
Five (5) Years for:
- Ex-Gratia Chronic Drug Award
*Members must apply to the Society for ex-gratia chronic medication.
- For all instances requiring prior-authorisation, members must approach the Society’s Marketing and Client Services Department. The Marketing and Client Services Department will readily explain the procedure and factors considered in granting or withholding such authorization. Members needing information should approach this department.
- Members may also approach the Marketing and Client Services Department if they have any other queries or concerns about these benefits, waiting periods or any terms herein.