Medical Aid Proposal

Medical Aid Proposal
A Brief Introduction Of FLIMAS

Established more than 40 years ago Operated as a closed Society (in house fund) till 2002
Became an open Society administered by Fidelity Life Medical Services Company

Licensed with the Ministry of Health Affiliated to AHFoZ (formerly NAMAS)
Our Track Record

Have persistently offered competitive rates which are accompanied by superior benefits . Have been Innovative e.g. look up tool, Life card and shortfall fund in 2007 Nationwide acceptance of FLIMAS card - Throughout the turbulent times the FLIMAS card was well accepted without any co-payments or Shortfalls Have maintained good relationships with service providers A survey put us as number 1 in 2008 & 2009 Have persistently paid hospital deposits to cover cash requirements (reviewed regularly) for the convenience of our members
What separates us from others

We are available 24 hours a day, 365 days of the year Low claims rebate (cash back) Funeral cover No blanket increases in subscriptions Risk management reports Our products are relevant and ensure convenience, accountability and flexibility Claims paid within 7 working days
What separates us from others

We believe in providing choices Able to offer highly personalized service Backed by a strong and financially sound shareholder Smart partnerships: with numerous service providers the key principle being providing members with choice Wide acceptance of the FLIMAS card nationwide
DELUXE: Executive private wards in private hospital facilities up to GROUP ONE (1), (Avenues Clinic, Mater Dei, St. Annes, Murambi Gardens, , Montague Clinic), Private practitioners, Emergency rooms, Specialists GRAND: Private Hospital facilities in twin-bedded and general wards up to GROUP ONE (1), (Avenues Clinic, Mater Dei, Murambi Gardens, Montague Clinic), Private practitioners, Emergency rooms, Specialists . (Management and other specialized staff), ACCESS: Private hospitals - up to GROUP TWO (2), (West End Hospital, Belvedere Maternity, Baines Maternity, Gallen House). Private practitioners, Emergency rooms, Specialists. EXPRESS: Value oriented Scheme , Private hospital up to GROUP THREE (3), (Suburban Hospital, PSMI Clinics ,Harare East Memorial, Willowvale Medical Centre, Claybank Hospital etc), General Practitioners, Government and or public hospital facilities No emergency rooms FOUNDATION :Economy Package. Mainly for public hospitals, Mission hospitals, and Municipal clinics
The Packages
Hospital Groups
Group 1 Avenues Clinic Mater Dei Hospital Avenues ER Corporate 24 ER Michael Gelfand Rock Foundation Murambi Gardens St Annes Hospital Group 2 West End Hospital Baines Maternity Belvedere Maternity Suburban ER Gallen House Southmed Chitungwiza Hillside Bulawayo Group 3 Suburban Hospital Clay Bank Borradaile Willowvale Med Centre Harare East Memorial Arcadia Medical Centre Marlborough Medical Centre PSMI Clinics
Schemes Available
FLIMAS Health Partner available to those who will be attending the Societys recommended service providers and those who charge AHFoZ rates. These service providers charge negotiated fees hence the reduced fees. Claims are settled at the AHFoZ tariff.
Schemes Available
FLIMAS Elite available for those who do not want to be restricted to our partners or to incur shortfalls if they elect to be attended to by service providers who are on the Flimas Health Partner network The service provider fees are not controlled
Rates for the Elite Scheme are available on request
Benefits Covered
Comprehensive cover providing for all requirements for restoring good health. Evacuation by road or air, emergency rooms, consultations, hospitalisation, surgical procedures, maternity , dental, optical, scans, radiology, therapy, foreign treatment and prescription drugs. Chronic diseases are all covered for.
Benefits Covered continued

Cover for: Hospitalization fees paid for in full Prescription drugs covered 100% up to the predetermined limits Optical benefit paid in full up to $250 . Maximum benefit is up to the predetermined limits and once every two years for all appliances Consultation covered 100% There is now a new and exciting option where members can take the dual package that combines Medical Aid and Funeral benefit at a reasonable cost . Evacuation covered in full up to the agreed limits per package Foreign Treatment paid for 80% up to the agreed benefit limits. Separate Travel cover if required shall be arranged in advance if a member does not want to pay cash up front for treatment while on business travel or leisure All packages except Foundation have foreign treatment cover
FLIMAS POOLED MEDICAL COVER

How it works Members Contribute to a pool of resources and it belongs to the Society Contributions are determined by the Society Benefits are determined by the Society. Payments to providers are determined by the Association of Health Funders (AHFOZ). In the case of the Health partner scheme or according to the providers tariffs on the Elite scheme Contributions are paid monthly in advance Claims related bonus there is a low claims bonus OF UP TO 30% payable to the account every 12 months.
FLIMAS Pool - Special Features

Cover is comprehensive up to the predetermined limits There is cross subsidization amongst pool members Monthly reports on claims and risk management are provided Subscriptions are standard, however, they are reviewed every 6 months subject to the risk each organization is bringing into the pool Global subscriptions review driven by increases in cost of health services
THE FUNERAL ADD-ON

ROSES(FOR DELUXE & GRAND CORPORATE CDC WITH FUNERAL COVER) Supply of dome casket Coffin Supply of lace and flower Groceries - 40kg mealie meal; - 4litres cooking oil; - 10kg sugar; 2kg salt; 500g tea leaves; 2 dozens bread; 30kg beef; 6*2litres Mazowe; 20pints milk Removal of deceased (from local hospital/residence up to 30km) Use of mortuary, washing and dressing of the deceased Documentation i.e. burial order and internment. Transportation of the deceased to a burial place in Zimbabwe Tent & chairs for mourners
1 ) LAVENDER(FOR FOUNDATION
PACKAGE)
THE FUNERAL ADD ON (Optional)

2 ) CARNATIONS(FOR EXPRESS &
ACCESS PACKAGES)
Supply of grain Casket Supply of lace and flower Groceries - 40kg mealie meal; 4litres cooking oil; 10kg sugar; 2kg salt Removal of deceased (from local hospital/residence up to 30km) Use of mortuary Washing and dressing of the deceased Documentation i.e. burial order and internment. Transportation of the deceased to a burial place in Zimbabwe
Supply of 2/3 tier casket Supply of lace and flower Groceries - 40kg mealie meal; 4litres cooking oil; - 10kg sugar; 2kg salt; 500g tea leaves; 2 dozens bread; 15kg beef Removal of deceased (from local hospital/residence up to 30km) Use of mortuary Washing and dressing of the deceased Documentation i.e. burial order and internment. Transportation of the deceased to a burial place in Zimbabwe
MONTHLY CONTRIBUTION RATES ( USD) HEALTH PARTNER

Packages Member Spouse US$ US$ FOUNDATION F.3 Corporate F.5 Corporate with Funeral cover EXPRESS E.3 Corporate F.5 Corporate with Funeral cover ACCESS A.3 Corporate F.5 Corporate with Funeral cover GRAND G.3 Corporate F.5 Corporate with Funeral cover DELUXE D.3 Corporate F.5 Corporate with Funeral cover 13 14 25 27 42 44 66 69 84 87 13 14 25 27 42 44 66 69 84 87 Child 0-18yrs US$ 8 9 16 17 24 25 42 43 50 51 Student 18-25 yrs US$ 12 12 23 25 37 40 60 64 66 70 Other Dependant US$ 17 19 32 34 52 55 82 72 106 110
Waiting Periods
Waiting periods apply to ALL as follows;
3 Months For: Admi ssion or treatment at a Hospi tal Visits to General Practitioners Up-grading to a higher package 6 Months For: Spectacles (including contact lense s) CT and MRI Scan, nuclear medicines Specialist treatment 9 Months For: Maternity benefits 12 Months For: Foreign Specialist Treatment Homes providing special care 24 Months For: Chronic medication (member will have to apply for the benefit) Haemodialysi s (Pre-authorization will have to be sought) Chemotherapy ( pre-authorization will have to be sought)
There is no waiting period applied for companies coming from other medical aid societies.
Shortfalls (The Society will pay the indicated levels)

Procedure Deluxe Grand Access Express Surgery & Anesthetist 100% 80% 75% 70% Maternity-Normal Delivery 100% 80% 75% 65% Maternity-C-Section 90% 80% 75% 65% Specialist treatment 90% 80% 75% 65% Dental 90% 80% 75% 65% Scans 90% 90% 90% 90% Optical 90% 80% 75% 75%

Medical Aid Proposal

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Medical Aid Proposal

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Medical Aid Proposal

A Brief Introduction Of FLIMAS

Became an open Society administered by Fidelity Life Medical Services Company

Our Track Record

What separates us from others

What separates us from others

Benefits Covered continued

FLIMAS POOLED MEDICAL COVER

FLIMAS Pool - Special Features

THE FUNERAL ADD-ON

THE FUNERAL ADD ON (Optional)

MONTHLY CONTRIBUTION RATES ( USD) HEALTH PARTNER

Shortfalls (The Society will pay the indicated levels)

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