Medical Aid Frequently Asked Questions

Membership is open to individuals, SME’s, small and large corporates. Each member type has specific conditions of service.

CellMed has two types of corporates, i.e., small corporate which has 20 – 49 principal members and a large corporate which has 50+ principal members.

One can start using the card after serving the applicable waiting periods on their Plan.

The Age limit is 65 years.

Newly born babies should be registered within 24hrs of birth or latest within 30 days. The registration will be effective from the first day of the month of birth and a full subscription for that month is payable so that the newly born has their own benefits. However, in circumstances:

1. where the biological mother is the principal member, the child will be subjected to the same waiting periods as the mother.
2. where the principal member who in this case is the father, has no waiting periods and registers a newly born baby and the biological mother is still on waiting periods, the child will be subjected to the same waiting periods as the mother.
3. where the principal member who in this case is the father, has no waiting periods and registers a newly born baby and the biological mother is not on medical aid, the child will be subjected to full waiting periods.
4. where a newly born baby is registered by a guardian and the biological mother is not on medical aid, in this case the child is treated as a new beneficiary and attracts full waiting periods.
5. In all scenarios above, if a baby is registered later than the stipulated period, the full waiting periods shall apply.

A dependent above 18 years will enjoy the child/student rates until 23 years of age if they are attending full time education and proof in the form of the latest fees receipt or confirmation from the school, college or university should be submitted to the Fund for this condition to be applied. If there is no proof, the adult rate will apply.

Yes, you will need to complete an amendment form to transfer your corporate membership to an individual membership and individual subscriptions become applicable.

No, a member can have as many dependants as they wish on individual medical aid cover. For corporates company policy applies.

CellMed has contracted several service providers countrywide such as hospitals, doctors, pharmacies, and laboratories. The CellMed preferred service provider list is available on request.

Yes, chronic medication is covered without any extra subscription. Members are however required to declare all chronic conditions on registration. Waiting periods apply according to the membership category as stipulated in the Fund’s Conditions of Service.

Members should take their membership card as well as their proof of identification with them when visiting a doctor.

Members can pay cash upfront to the service provider and make a claim to CellMed for a refund. CellMed will pay up to the tariff limit to the members bank account. Alternatively, members can get a quotation from the service provider and CellMed will prefund prior to service being provided.

Refunds are processed within 14 working days.

All claims should be submitted to CellMed Health Medical Fund within three (3) months from date of treatment. For cash claims reimbursement an original cash receipt should be attached to the claim form and for drug claims a prescription should be attached to the claim form for reimbursement.

Refunds are paid directly into the members’ bank account. Members are therefore required to register their banking details with the Fund.

No, CellMed does not cover over the counter drugs.

CellMed Health Medical Fund (CellMed) subscriptions are to be paid in advance before the first day of every month. Failure to do so will result in suspension of the account. If payment has not been made after 30 days of suspension, the account will be terminated, and all claims accrued during the period will be liable to the member.

You can pay your medical aid account through our online payment platform, RTGS, bank cash deposit and ECOCASH. CellMed does not accept ZIPIT and cash payments at all our offices.

CellMed Health offices are in Harare, Bulawayo, Mutare, Hwange, Ngezi and Zvishavane.

No, members need to serve the stipulated waiting periods before starting to access service.

Shortfalls arise when what the service provider is charging, is more than what CellMed is paying.

For individual members wishing to downgrade, the minimum applicable plan is Superior and thus cannot downgrade to any plan lower than Superior. If transferring from a corporate to individual account and one was registered on either Essential or Vital Plan, one can continue the current plan on individual subscriptions or upgrade to any of the higher applicable plans. For those registered on a customised plan one will upgrade to the next plan on the standard plans’ bouquet.

When a member exhausts their annual limit, they must wait for a new year when new benefits are awarded. The member must however continue to pay their full monthly subscriptions.

No, benefits will be pro-rated wherein the CellMed benefit year runs from January to December.

Unutilised limits will be forfeited when the year ends. Members will then be awarded new limits in the new year.