Masca Medical Aid Society

Scheme Details

SUPERMASCA SCHEME

Top of the range scheme for Zimbabwe Executives (modest contribution).
Comprehensive cover under generous annual limit.
Payments to all providers of services in terms of US Dollar tariffs. Free choice of private practitioners and specialists for MRI scans, pathology and other diagnostic procedures. Awards for specialists at ZIM/US Dollar tariffs, and shortfalls are likely.
MASCA pays 90% for acute and chronic drugs and the patient pays 10% to the pharmacy under the two separate annual drug benefit limits. MASCA pays 75% for cancer drugs and other medical categories deemed by the society to be essential and high cost items on pre-authorisation limited by the absolute annual benefit. Any shortfalls can be claimed at 50% from PAYE.
Referrals outside Zimbabwe by specialist medical practitioners are considered on merit provided prior approval from MASCA is obtained. MASCA pays up front direct to the foreign practitioners/providers of services.
Members paying initially will be refunded in US Dollars on return to Zimbabwe.
Emergency evacuations by road or air to the nearest referral centre in Harare is accepted to the specific limit only.
Grant In Aid benefits like dental, optical, nebulizers and other appliances accepted up to the specific limits published.
Holiday travel worldwide through a contracted travel agent is available for emergency conditions. Costs incurred for minor injuries & ailments are refunded by MASCA on presentation of receipted accounts.

Other Schemes

COMBO PACKAGE

Executive scheme Unlimited benefits up to $2 million dollars per year and free choice of hospitals and specialist practitioners anywhere in Sub Saharan Africa; includes surgery, maternity, psychiatric disorder limits, anaesthetics, scans, pathology, radiology and other diagnostic procedures. Covers full oncology treatments for all types of cancers. No shortfalls, payments made in full through Health International direct to practitioners

PRINCIPAL CHRONIC

For senior executives with chronic conditions like diabetes, kidney dialysis, heart disease, cholesterol etc. Comprehensive cover under generous annual limit for chronic and acute drugs. MASCA pays 90% and patient pays 10% to the pharmacist for acute and chronic drugs up to the two separate annual drug benefit limits. MASCA pays 75% for cancer drugs and other medical categories deemed by the society to be essential and high cost items on pre-authorisation limited by the absolute annual award. Any shortfalls can be claimed at 50% from PAYE.

PRINCIPAL FAMILY

For those young married couples who want to plan for a family. Comprehensive cover for maternity benefits ante / post natal / deliveries. Payments to all providers of services in terms of the US Dollar tariff; shortfalls are possible on specialists and anaesthetists claims. Free choice of private hospital in a two bedded ward for all surgery. Public hospitals paid in full. Hospitalisation over 10 days must have prior authorisation from MASCA on appeal from the specialist. Free choice of specialists for MRI scans and other practitioners for pathology, radiology and other diagnostic procedures, prior approval from MASCA required.

PRINCIPAL BASIC

For middle management personnel; best value for modest contributions. Comprehensive benefit cover under generous annual limits in US Dollars Payments to all providers of services in terms of tariff; shortfalls are experienced on specialist and anaesthetics claims as charges are in excess of tariff. Free choice of private hospital in a two bedded ward for all surgery. Public hospitals paid in full. Appeal by specialist for hospitalisation over 10 days must have prior authority from MASCA

STANDARD

For skilled personnel this scheme bridges the gap between the upmarket and lower schemes. Covers 10 days per illness in private hospitals (Three bedded ward) for all surgery. After 10 days member pays 50% of the bill and MASCA accepts the other 50% of the bill provided a specialist has appealed for longer admittance because of the patient’s serious condition. The absolute annual benefit cannot be exceeded. Covers hospitalization in public hospitals and municipal clinics in full up to the annual award.

SELECT

For semi skilled personnel at an affordable contribution rate. Covers basic day to day primary health care with one’s selected private doctor and drugs so prescribed. MASCA pays 90% for acute and chronic drugs and the member pays 10% to the pharmacist up to the two separate annual drug benefit limits. MASCA pays 75% for cancer drugs and other categories deemed by the society to be essential and high cost items on pre-authorisation limited by the absolute annual benefit. Provision for private hospital admissions up to six days in a general ward and after six days at 50% of the hospital bill.

HOSPITAL & CLINIC

For semi skilled workers at minimal affordable contribution rates. Covers basic day to day primary health care with one’s selected private doctor and drugs so prescribed. MASCA pays 90% for acute and chronic drugs and the member pays 10% to the pharmacist up to the two separate annual drug benefit limits. MASCA pays 75% for cancer drugs and other categories deemed by the society to be essential and high cost items on pre-authorisation limited by the absolute annual benefit.

STUDENT PLANS

Tailor made for students both local and foreign at affordable contribution rates. Peace of mind whilst studying academically or on agricultural courses. Covers basic day to day primary health care with one’s selected private doctor and drugs so prescribed. MASCA pays 90% for acute and chronic drugs and the member pays 10% to the pharmacist up to the two separate annual drug benefit limit. MASCA pays 75% for cancer drugs and other categories deemed by the society to be essential and high cost items on pre-authorisation limited by the absolute annual benefit.