How To Claim

Below is a step by step process on how to make a claim.

EMERGENCY ALERT: Go directly to hospital. No pre-authorization needed. Call us within 48 hours at 086 77 000 716

For Urgent & Emergency Care

1

Get Treatment

Go directly to emergency room.

  • Your health comes first
  • Show member card if possible
  • Focus on getting help
2

Notify Us

Call within 48 hours.

  • Report the emergency
  • Provide hospital details
  • Get case number
3

We Handle Claims & Settle Direct

We coordinate directly with the hospital.

  • Direct settlement arranged
  • Documentation handled
  • You focus on recovery

Planned Treatment

For Scheduled Procedures & Hospital Admissions

1

Get Pre-Authorization

Contact us before your procedure.

  • Call at least 48 hours before
  • Have your member number ready
  • Provide procedure details
2

Receive Confirmation

Authorization number provided

  • Coverage limits explained
  • Any co-payments noted
3

Get Treatment

Present your details at the facility.

  • Show member card
  • Provide auth number
  • Sign admission forms
4

We Settle Direct

We pay the provider directly.

  • No upfront payment needed
  • Pay only your portion
  • Get your statement

Plan-Specific Claim Information

Require Assistance towards your Medical Needs?

Client Services Team

  • Client Services Team: +263 86 77 020 406 / 86 77 000 716 / 0772 126 119 / 0772 126 120 / 0778 244 129
  • WhatsApp: +263 772 126 120 (messaging only)
  • Email: callcentre@healthzim.com

Documents You May Need

For Hospital Admission

  • Member card or member number
  • Valid ID document
  • Doctor's admission letter
  • Pre-authorization number

For Specialist Visits

  • GP referral letter
  • Member card
  • Previous test results
  • Medical history if relevant

For Reimbursements

  • Original receipts
  • Completed claim form
  • Doctor's report
  • Proof of payment

Important Reminders

Important Reminders

Timing Matters

For planned procedures, always get pre-authorization at least 48 hours before. For emergencies, notify us within 48 hours after admission. Late notifications may affect your claim.

Check Your Benefits

Before any treatment, confirm your available benefits and any waiting periods that may apply. Know your coverage limits and any co-payments required.

Keep Records

Always keep copies of all medical documents, receipts, and correspondence. Take note of reference numbers and authorization codes for future reference.

We're Here to Help

Should you have any queries, contact our team. We provide the best advice and support throughout your healthcare journey.