In the ever-evolving landscape of healthcare, the importance of making informed decisions regarding your medical aid benefits cannot be overstated. For high claiming members, understanding how to navigate your benefits effectively is crucial not only for your health but also for the sustainability of your medical aid plan. Here are some thoughtful tips to help you preserve your funds while still receiving the care you need.

1. Make use of virtual consultations

Virtual consultations can save you up to 60% of a normal consultation.  It is a great way to reduce day-to-day healthcare costs.

2. Use Blue Zone network!

Networks allow members to benefit from favourable tariffs that have been negotiated to reduce out-of-pocket costs and increase value. Using networks also means you can reduce or eliminate co-payments.

3. Save on medicines.

• Ask your health care provider if you can switch to generic medicines. Though they cost less than brand-name medications, they contain the same active ingredient. A generic medicine is an exact replica of a name-brand drug. They are identical to the original in terms of dose, intended use, effects, side effects, administration route, dangers, safety, and strength. But cost, on average, between 30 and 80% less than the originals. The Medicines Control Association of Zimbabwe (MCAZ) carries the responsibility of making sure that generic drugs are safe and effective. While you will save money by using generics, your healthcare will not be compromised.
• Ask your provider if there is a less expensive medicine that treats the same condition.
• Follow the directions on all of your medications. Additional health issues could result from not taking your medication or from taking insufficient amounts.

4. Shop around

Healthcare costs in Zimbabwe are generally unregulated, this means providers are free to charge any tariff. However, by using the Blue Zone Network you can limit out-of-pocket expenses and co-payment and stretch your annual benefits.

Every medical scheme has a rate of payment called the Scheme Rate. It is the amount the scheme will pay for specific treatments and procedures.

Medical practitioners and hospitals often charge more than medical aid rates, this means that at times there is a shortfall. A co-payment refers to the outstanding portion of the account, for which you will be responsible.

5. Register with Cimas Care

Non-communicable or lifestyle diseases, such as diabetes, high blood pressure and cancer are on the rise. 80% of these conditions are caused by lifestyle risk factors, which is why Managed Care programmes, aimed at assisting members understand and manage chronic conditions include cancer, diabetes, HIV/AIDS, hypertension are important.

6. Be doctor-wise

Follow your doctor’s recommendations and be open and honest with them about your health, any symptoms, and any worries. Only if you accurately describe your symptoms to your doctor can they make the proper diagnosis.  You pay a lot for the consultation as well, so be sure that it is worthwhile and that you won’t need to visit the doctor again soon. Avoid using “Dr. Google,” as we cannot be certain of the reliability of the material. Ask your treating physician instead which websites offer trustworthy information about your disease.

7. Go the iGo way!

Prevention is better than cure. Take care of yourself! You can take steps to remain healthy and avoid costs associated with ill health and chronic diseases such as diabetes. One of the best investments you can make is in your own health, which is what you are doing here. IGo is your partner to wellness.

You know the drill: eat well, move about, keep a healthy weight, reduce stress, get enough rest, stop smoking, and drink alcohol sparingly, if at all.

8. Use your wellness benefits.

Get routine annual health screenings. These consultations and tests can catch health problems early, when they may be more easily treated.

9. Plan for Urgent Care

• When an illness or injury occurs, you must decide how serious it is and how soon to get medical care. This will help you choose whether to call your healthcare provider, make an appointment or seek emergency care at an Emergency Room.
• You can decide where to get care by thinking about how quickly you need care.
• If a person or unborn baby could die or have permanent harm, it is an emergency. Examples include chest pain, trouble breathing, or severe pain or bleeding.
• If you need care that cannot wait until the next day to see your provider, you need urgent care. Examples of urgent care include septic sore throat, bladder infection, or a dog bite.
• Visiting your general practitioner or an urgent care facility instead of the emergency room will save you time and money. Be prepared by being aware of the closest urgent care facility. Learn to spot emergencies in both adults and children.

10. Ask About Outpatient Facilities

If you need a procedure or surgery, ask your provider if you can have it done at an outpatient clinic (Day Case Centre). Often, getting care at a clinic is cheaper than having the same procedure in a hospital.

11. Choose a Health Plan That is Right for You

When choosing a plan, think about the health needs of you and your family. If you pick a plan with higher premiums, more of your health costs will be covered. This may be a good idea if you have a health problem, such as diabetes, and need regular care. Also compare prescription drug coverage.

12. Keep Track of Your Claims

Regularly monitoring your claims can help you identify patterns in your healthcare utilization. If you notice an unusual number of claims or discrepancies, address them promptly. This practice not only helps you stay informed but also empowers you to make adjustments where necessary. 

13. Reach out!

Don’t hesitate to reach out to your medical aid provider for assistance. They can offer personalized advice based on your claims history and health needs. Engaging with your provider can help you stay informed about any updates or changes to your benefits.

14. Plan your elective procedures wisely

If you are considering elective procedures, take the time to research your options thoroughly. Consult with multiple healthcare professionals, review different facilities, and compare costs.