+263 4 793 389
Private hospitals, government, municipal and mission facilities
Contributions Schedule
|
Age Band |
Principal Member/Member |
Spouse |
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|
18 - 25 |
86 |
86 |
||||
|
26 – 39 |
95 |
95 |
||||
|
40 – 50 |
103 |
103 |
||||
|
51 – 60 |
113 |
113 |
||||
|
61 an over |
124 |
124 |
||||
|
+60 first time joiner |
165 |
165 |
||||
|
Child |
76 |
|||||
|
Routine Benefit Account *Entitlement determined by MSA contribution level MSA Low MSA Medium MSA High MSA Super High |
Allocation per principal member $208 $250 $300 $360 |
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|
MEDICAL SAVINGS ACCOUNT CONTIBUTIONS |
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|
Level |
Member with no dependant |
Member with 1 dependant |
Member with 2 dependants |
Member with 3 dependant |
Member with 4 or more dependants |
|
|
Low |
8 |
17 |
25 |
34 |
42 |
|
|
Medium |
13 |
25 |
38 |
50 |
64 |
|
|
High |
17 |
34 |
50 |
67 |
84 |
|
|
Super High |
22 |
42 |
64 |
84 |
106 |
|
Benefits Schedule
|
Plan Name |
IVORY PLAN |
|
Insured Benefit Annual limit |
$60 000 |
|
Facility Admission |
Private, government, mission & municipal |
|
Ward Admission |
Private wards |
|
GP Consultations |
Limited to MSA & RBA |
|
Chronic Medication Members must register on the Chronic Care Network |
US$600 Generic policy applies.
|
|
Acute Medicine Excluding over the counter medication |
Limited to MSA & RBA |
|
Dental (annual limit) Member liable for dental co-payment |
Paid per AHFoZ tariff. US$3,300 |
|
Orthodontic Max age limit is 18 years |
US$2 600 |
|
Optical (2 yearly limit) |
US$800 |
|
Pathology |
Paid per AHFoZ Overall limits apply |
|
Radiology (Pre-notification required for MRI scans, CT scans & Bone densitometry Scans) |
Paid per AHFoZ Overall limits apply |
|
Prosthesis i. Internal ii. External |
US$7,000 US$600 |
|
Rehabilitation Notification required. |
US$1 440 per annum |
|
Special Appliances i) Hearing Aid (lifetime award) ii) Glucometer, Nebuliser, etc. iii) Ostomy bags. (Motivation letter from doctor required) |
US$960
US$250 per 4 years.
Paid in full, global limit |
|
Funeral Grant |
US$700 |
|
Medical Emergency Travel Insurance |
US$1.5 million |
Biller Code: 35376 
Biller Code: 22411 
Biller Code: 100126
