Tendai Kamhungira 
THE government says it is working on modalities to ensure health insurance policyholders are not charged shortfalls, at a time medical aid societies collected ZWL$21 billion from contributors in 2021.
At the 13th annual all stakeholders’ conference on health held by the Association of Healthcare Funders of Zimbabwe (AHFoZ) in Victoria Falls recently, Vice President Constantino Chiwenga, who is also the Health minister, said shortfalls were deterrents and retrogressive to the objectives of medical insurance.
Association of Healthcare Funders of Zimbabwe chief executive Shylet Sanyanga
“As the government, we are concerned by the exchange rate disparities, which are resulting in huge shortfalls for patients at the point of care. Medical aid cards should serve their purpose.
“These challenges should be resolved so that all cards for bona fide members serve their purpose,” Chiwenga said, adding that the government was also targeting to improve healthcare services offered by public sector facilities
He further said that the government was working on creating a robust public-private partnership framework in the maintenance of high-value health equipment to enhance an effective corporate culture, among other initiatives aimed at improving the sector.
“The plans to introduce a universal health cover are still underway. We are aware that there is no ‘one-size -its-all’ model for universal health coverage as each country should apply a model that is relevant for its people… we believe that our universal health coverage should co-exist with the medical aid system which has been tried and tested over the years,” he said.
Meanwhile, AHFoZ chief executive officer Shylet Manyonga also said shortfalls remained a challenge because medical aid subscriptions were pegged below recommended rates.
“… in such instances, the medical aid will be collecting subscriptions that are not enough to cover the claims costs.
“AHFoZ member societies have continued to be guided by the AHFoZ scientific tariff for claims settlement, which tariff is benchmarked in US dollars and is regularly adjusted to reduce the shortfall gap.
“The tariff is converted using the official exchange rate and this sometimes results in some service providers charging shortfalls to cover the exchange rate gap,” Manyonga said.
She added: “Whilst shortfalls are common world over, as they are also used to avoid abuse of the medical aid card, they should not be barriers to access.
“Since illness strikes when people are not prepared, it is ideal that shortfalls are either eliminated completely or are at the barest minimum”.
AHFoZ currently has 42 member schemes, collectively covering approximately 1,7 million lives.
Manyonga said in 2021, AHFoZ members had collectively paid ZWL$15,3 billion to various healthcare service providers.
“The biggest slice of 20,5 percent went to in-patient/private hospital fees followed by medicines at 19,4 percent then at 10,9 percent of total claims expenditure,” she said.
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