CLASSIC PRIVATE HOSPITAL PACKAGE
BENEFITS
SUMMARY
Provides access to Private Healthcare
Together we make a difference
Public Healthcare institutions
Cimas CLASSIC PRIVATE HOSPITAL
Benefit limits for Classic Private Hospital are paid per beneficiary per membership
year and begin from the date the beneficiary joins the Society, subject to waiting
periods stated below. Awards are made at Association Healthcare Funders of
Zimbabwe (AHFoZ) rates. All benefits and benefits limits are paid up to an annual
global limit.
Where usage is considered excessive the Society reserves the right to restrict
usage or recommend less expensive treatment options.
MEDICAL BENEFITS
The following benefits are paid at AHFoZ rates.
• Hospitalization in a Private Hospital is paid in full up to the AHFoZ award for
a four bedded ward (pre-authorisation 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.) at a
cost determined by Cimas.
• Ambulance Services is 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 non-
refundable co-payment may apply for certain tests.)
• Blood Transfusion Services (BTS) (a non- refundable 20% co-payment applies.)
DRUG BENEFITS
There is an Annual Family Limit to cover prescription drugs. 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 the Classic Private Hospital Package.
Members can access generic prescription drugs on the Society’s Drug Facility
arrangement with some pharmacies. Drugs are paid at Approved Medical Aid
Award rate (which is agreed to by pharmacies and medical aid societies for
generic drugs).
MATERNITY BENEFITS
• Maternity is generally paid at 70% of AHFoZ rates.
• It caters for maternity care, delivery .Antenatal and postnatal visits are
restricted to nine (9) and five (5) respectively.
• Two (2) antenatal ultra-sound scans
• Hospitalisation is paid in full.
FOREIGN TREATMENT
This caters for treatment not available in Zimbabwe. The Society will pay 70%
of cost up foreign treatment limit provided prior –authorization 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 must be submitted for payment within a period of six (6) months
from date of treatment. All hospitals and health service providers invoices to be
in english.
Global Travel Cover (GTC)
Cimas in association with HEALTHGUARD International (Pty) Ltd R.S.A. offers
the Global Travel Cover (GTC) to any person travelling outside their country
of usual residence. It is available on application to both Cimas and non-Cimas
members.( See GTC Brochure for detailed information)
Study Mate Health Cover
Study Mate is an international student plan that offers a comprehensive medical
aid cover for students studying outside their country of normal residence. (See
the StudyMate Brochure for detailed information.)
PROSTHETICS AND APPLIANCES
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
REHABILITATIVE SERVICES
This caters for Occupational and Speech Therapy, Clinical Psychology, Social Work
and Physiotherapy. Awards are paid at AHFoZ rates up to an annual limit.
PSYCHIATRY BENEFIT
Caters for consultation by a specialist psychiatrist for in-hospital treatment only.
Award is paid at Cimas rates up to an annual limit.
SUPPLEMENTARY SERVICES
Awards are paid at AHFoZ rates up to an annual limit:
• Air Evacuation
• Hospital transfers
• Family Planning
WAITING PERIODS
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. The
Society reserves the right to waive waiting periods for the members transferring
from AHFoZ affiliated medical aid Societies.
• 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:-
• Maternity benefits
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.
PRIOR-AUTHORISATION
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.
You may also visit us on our website at [Link]
Disclaimer
This Classic Private Hospital Package Benefits Summary must be read together
with the Cimas Constitution and the Cimas Membership Rules. It is an abbreviation
of the Benefits and Rules, and does not supersede the Cimas Constitution and the
Cimas Membership Rules. Interpretation will be based on the Cimas Constitutions
and the Cimas Membership Rules.
Particular note should be taken of those conditions and remedies for which there
is no automatic cover. Prospective members should understand the Society’s
considerations as to when cover is not available. In all these instances prior
authorization must be sought before service is accessed.
+CD Chronic Diseases ADD-ON
Did you know? Cimas offers all its members an optional ‘add-on’ to
cover chronic diseases. Our Chronic Diseases Add-On will cover the cost
of treatment of HIV and AIDS, including the acquistion of ARVs. To find out
more about this facility, contact your Cimas branch by phone, fax or email.
Cimas Head Office
Cnr Jason Moyo Ave./Harare St, P.O. BOX 1243, Harare
Tel: +263 (4) 777300-15, Fax: +263 (4) 753567
Email: marketing@[Link]
Cimas Bulawayo
Cnr Josiah Tongogara St./8th Ave, P.O. Box 5, Bulawayo, Zimbabwe
Tel: +263 (9) 64876, 72318, Fax: +263 (9) 883 069
Email: bulawayo@[Link]
Cimas Gweru
23 Sixth Street, P.O. Box 1402
Tel: +263 (54) 226 178
Email: gweru@[Link]
Cimas Mutare
Cimas House, 98 Second Street, P.O. Box 712 or 2560
Tel: +263 (20) 67703, 67639, Fax: +263 (20) 67795
Email: mutare@[Link]
Mount Pleasent Office
Shop Number 4 CABS, Building Bond Street Shopping Centre
Tel: +263 (4) 339862/9
Cimas Healthcare Centre
Healthcare Service Division
• Primary Healthcare Clinics
Head Office
Rowland Square Clinic, No 13 Rowland Square, Milton Park, Harare,
Tel: +263 (4) 797166, 0712 629976/7,
Email: managemnt@[Link]
Medical Sevice Division
• Network of Laboratories
• Harare Haemodialysis Centre
Head Office
Medical Chambers, 60 Baines Avenue, Harare
Tel: +263 (4) 703931, 72771131/2
Email: labs@[Link]
Cimas Emergency Air Rescue Service
13 Rowland Square,Milton Park, Harare
Tel: +263 (4) 700085/6, 700070, (Toll free)
Toll Free: 0800 322 4627
[Link]
