Generation Health

  • High Annual Benefits
  • Private Hospitals
  • Specialists Hospitals
  • Use anywhere in Zimbabwe
  • Funeral Grant
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The Generation Health Medical Fund

Generation Health (GH) is an open medical fund launched by Sovereign Health. The GH Medical Fund benefit design is modeled along the “new generation” health concept which offers healthcare cover that is radically different from the traditional approach, and is relevant to the prevailing economic circumstances of individual members.

Initially, GH packages gave clients the opportunity to sign up for the Medical Savings Account (MSA). While this component was beneficial, their research and experience over time showed that the majority of their clients were actually not benefitting from the MSA the way it was intended. It has disproportionately benefited a small percentage of their clients and was starting to lead to detriment for some. In an effort to ensure the majority of GH clients benefit, GH have removed the MSA component of their packages (effective 1 January 2018) and introduced an out-of-hospital benefit for the packages. Members will continue to have access to MSA balances for payment of claims as has been the practice.

In addition to removing the MSA, the following are other changes to complement this:

  • Spouses pay different contributions if they belong in different age bands.
  • Normal delivery (Maternity) will now pay 100% for all in-hospital costs.
  • Chronic Medication is limited to the global limit. Members are encouraged to purchase generic medication as first preference.
  • Cancer treatment (Oncology) has a sub-limit across the different plans.
  • Members must be under 70 years of age at the time of joining.
  • Members above 60 years of age who are joining medical aid for the first time pay the +60 contribution.

All the above changes mean it is clearer for each client to understand exactly what they are getting for their premiums as well as the benefits for each package. Click plan title in chart below for a detailed costs breakdown.

GENERATION HEALTH CONTRIBUTIONS

18 – 25 26 – 39 40 – 50 51 – 60 61+ +60 first timers Children below 18
EBONY £37 £47 £53 £64 £78 £93 £28
IVORY £49 £57 £68 £75 £83 £105 £40
MAHOGANY £93 £100 £110 £119 £129 £165 £82.50

Rules for Plan Changes:

When members join Generation Health, their “anniversary date” is recorded as 01 January. The “anniversary date” determines the annual entitlement for services where annual limits apply. Members who join during the course of the year will have prorated benefits for the remainder of the year.  Members should note that changing Plan options can only be done at the beginning of the calendar year.

Insured Benefit Annual Limit

Ebony Plan   $20,800

Ivory Plan   $35,000

Mahogany Plan   $60,000

All the three plans above cover regions: In country, Africa & India.


Waiting Periods:

Members joining Generation Health Medical Fund may be subject to waiting periods as detailed below. Waiver of waiting periods is at the discretion of the Fund Administrator. Waiting periods cannot be paid off.

All members joining the Fund will be subject to a six (6) month waiting period for optical benefits, this also applies where waiting periods have been waived.

Three months waiting period for all benefits. After the general 3-month waiting period, the following condition specific waiting periods apply:-

Six months for:
• Chronic medication, Laboratory tests & x-rays
• Funeral Grant
• Travel Insurance
• Specialist treatment and Special Appliances e.g. nebulisers, glucometers, hearing aids, and ostomy bags
• Spectacles and contact lenses, Dental services
• Planned or elective surgery
• Non-emergency hospitalisation, Pallative Care
• CAT scans, MRI scans, Bone Densitometry Scans and Nuclear Medicine

Nine months for:
Maternity benefits

Twelve months for:
Anti-Retroviral Therapy Programme
Internal prosthesis and surgery involving the use of internal prosthesis

Twenty Four Months for:
Treatment of Cancer
Haemodialysis

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