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Biggest medical insurance scraps shortfalls

June 30, 2023
in Local News
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Biggest medical insurance scraps shortfalls

West End Hospital Matron Nhamo Kurarinyu (right) assists a patient, Dr Hillary Mugiyo, yesterday following the reopening of the hospital in Harare recently. — Picture: Nicholas Bakili

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The country’s biggest medical insurance by membership, Premier Medical Aid Society (PSMAS), will beginning July 1 scrap the shortfall payment requirement for its members attending all its facilities after Government bailed the society out with a financial injection.

The move comes as Government intervened to rescue the society, whose membership is predominantly civil servants and others working for the State, after it almost closed for business due to failure to meet its obligations.

The injection by Government has been directed towards the purchase of medical drugs and operational expenses for clinics, pharmacies and hospitals.

The rescue is in line with the Second Republic’s drive towards universal health coverage as well as the quest to continuously improve Government employees’ conditions of service as espoused by President Mnangagwa.

The scrapping of the shortfall requirement will initially target members presenting at PSMAS close to 100 medical facilities across the country.

It will also be applicable until a member exhausts their respective medical plan threshold.

“PSMI will with effect from 1 July 2023 remove co-payments for a majority of services sought by its clients, most of whom are civil servants on PSMAS,” said Premier Service Medical Investments (PSMI) Executive Director Health Services Dr Margaret Maulana.

“This move is part of the organisation’s strategy to ensure that issues of barriers to access are addressed following the Government’s interventions.

“However, members seeking services from non PSMI facilities may be asked to pay shortfalls and co-payments. Following resumption of services on the 2nd of May 2023, PSMI is currently operating with 78 percent of our units operational, this translates to 94 out of 121 of our units operational across the country.

“In the month of June we again received financial support from the Government which covered mostly stocks, staff welfare obligations of 50 percent salary, and managed to cover and pay our other litigious creditors.

“For this we greatly appeal to our PSMAS members, mostly civil servants, the general public, to bear with us as we strive to bring PSMI back on its feet.”

Dr Maulana said the pharmacies which had since reopened their doors to members were as a result of Government intervention and they had been able to procure affordable medications from Natpharm.

She said to date, their fill rate at pharmacies was sitting at 57 percent following receiving of the stocks and were also working on getting to the industry standard of 80 percent fill rates to improve availability of both acute and chronic drugs.

Patients at different medical facilities visited yeseterday confirmed the full resumption of services at PSMAS facilities.

“I was involved in an accident, so I was admitted here at West End. At first I thought I could not be helped but I have been here more than 20 days and indeed PSMAS is working,” said Dr Hillary Mugiyo, a civil servant who was involved in a car accident.

“I am waiting for my operation, I am in pain, but I feel good because these guys are very helpful, the service here is perfect.”

Mrs Peggy Tazvibinga said the service had greatly improved, but complained about the shortfalls which the society announced will be removed on Saturday.

Mr Mateo Magore said he had accessed the service using his PSMAS medical aid card.

Mr Tinashe Mushanyu said: “This is my first time to come here after they re-opened. I am happy with their services, I have paid something. I do not know if it is a shortfall or co-payment so I think it is the last thing which needs to be addressed.” – The Herald

Tags: Premier Service Medical Investments (PSMI) Executive Director Health Services Dr Margaret Maulana
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