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For members to treat themselves until they can consult their doctor.
Benefits are per financial year, what you do not make use of expires and new benefits are allocated to you during the next financial year.
Namibian private medical aid funds pay according to the NAMAF benchmark tariffs for out of hospital (day-to-day) services rendered by health professionals to members. The benefits are designed to cover the member(s) throughout the year and paying exact amounts even when the claimed amount is above a tariff rate could result in a member depleting benefits early in the year.
No, the member should ensure that he/she registers the newborn with the Fund within 30 days after birth.
It’s a once-off benefit; as a result it is only from time to time.
Other accommodation other than Hospitalisation will be subject to Managed Health Care’s protocol.
The Fund pays for vitamins from the acute medication benefit if prescribed by a doctor for members above 50 and below 5-years of age. For other age categories, vitamins are payable from self-medication benefit. Members above 50 and below 5-years old may also claim vitamins under their self-medication benefit.
It’s an excluded benefit on the Fund. Suicide, attempted suicide or intentional self-inflicted injury forms part of the fund exclusions unless, the patient qualifies in terms of the suicide protocol.
The day-to-day doctor consultations and procedures benefits are structured to accommodate all outside hospital visits and tests. On the other hand, consultations by specialists and general practitioners whilst a member is hospitalised are paid from the Overall benefit.
The Fund does inform members once they have reached 80% of a specific benefit via remittance statements. In addition, members receive statements indicating claims paid to health professionals; members can register to have online access to benefits or they can request the benefit statement from client services any time of the year.