A couple of days ago I was part of an interesting discussion on medical aid cover in Zimbabwe. The main focus was on whether or not it is worth it. There were some notable submissions made and I figured let me write about it. I have never been on any medical aid cover since becoming a young adult. Thus on a personal level, I could argue that it is not worth it. However, that would be a warped and limited perception and that is why I will explore various angles. Here are some of the core points that emerged during the discussion:

The Issue Of Ever-Present Shortfalls

It turns out most people were complaining about how there are always shortfalls. Some even complained that shortfalls can even be encountered right from consultation fees. It seems commonplace to almost always be asked to pay more when in need. Some argued that scenarios like that are to be expected if you are subscribed to basic packages. The logic here is you cannot expect much from a package where you are paying small subscriptions. This is particularly so for local currency subscriptions (sadly which most Zimbabweans afford). Logical as that might be but there are still many who complain of shortfalls even whilst on premium packages. Plus this also brings up another concern – not everyone can afford to subscribe for premium packages. No matter how you choose to look at it, it seems shortfalls are a common experience.

Healthcare Providers Denying Medical Aid Covers

This is yet another challenge that many Zimbabweans are usually faced with. Imagine being fully paid upon a particular medical aid cover. Then a time comes when you need medical assistance. You go to a healthcare provider e.g. a clinic or hospital (private or public), then you are told they do not accept your medical aid cover. This usually ends up in people paying cash – which might not be readily available. Probably the help they need will be available only at that particular healthcare provider. A healthcare provider denying medical aid covers is quite telling. It is usually indicative of how they are not confident of the efficacy of the service provider in question.

Maybe It Is The Operating Environment – Is It?

Here comes a justification of sorts on why medical cover service providers are ailing. This is based on how they operate i.e. they in principle have to invest your subscriptions to multiply them. Yet the economic situation in Zimbabwe makes that extremely difficult. Another consideration is that these service providers typically rely on there being a huge pool of premium subscribers. That way the subscription base is widely spread out to spread out the risk as well.

However, premium subscribers tend to be few given how most people cannot afford it. You put these two variables together and you have an explanation of why the service providers are limping. At least that is what some of the people think regarding the poor service. Regardless, in business service provision it is always imperative upon the service provider to figure out how to rise above the storm.

To add here, it is true that the operating environment could be and is an impediment. However, service providers are likely capitalizing on that to fleece their customers. Some people even feel that service providers are being fraudulent. Though it is not immediately easy to prove it is not farfetched at all.

Are There Reputable Service Providers To Consider In Zimbabwe

I wish it were that simple but it is not. You find different people saying opposing experiences about the same service provider. For example, one was singing praises for a particular service provider, based on their experience with it. Then, for the same service provider, another highlighted how they had been paying monthly subscriptions close to US$200. Yet there came a time when they had to top up a shortfall of US$2500 for an operation. This is virtually applicable to every service provider – there are always evidence-based castigators and proponents. This makes it hard to know which is the most reputable. Maybe you can comment with what you think. Which do you consider to be the most reputable medical cover service providers in Zimbabwe?

Should You Sign Up For Medical Aid Cover Or Not?

This pertinent question is not that easy to answer. On the one hand, some feel it is akin to half a loaf of bread being better than nothing. Meaning that if you have medical aid cover, in times of need you will not start from zero. Yet on the other hand, whilst having it the circumstances you might face might be as good as starting from zero. For the most part, it seems most medical aid covers hold up when it is just for minor illnesses.

When it comes to major ones, especially involving operations, shortfalls are inevitable. Sadly, the shortfalls then tend to be the lion’s share of the required amount. At the end of the day, it is unsurprising when you hear people seeing no need for having medical aid covered. Some feel it is way better to save up for medical emergencies on your own rather than entrusting your money with mercurial service providers.

This is an intricate subject with so many variables to consider. What are your thoughts? Do you think medical aid cover is worth it in Zimbabwe? Where do you think the root cause of all the problems is? If you were to suggest a solution or best approach, what would it be? Let us continue the discussion in the comments below.