Essential Medical Aid Option From Nammed Healthcare

The Essential medical aid option is an ideal healthcare solution for the healthier person or family between the ages of 36 and 55. It balances cost and cover, offering more benefits than the Active option, but is not as comprehensive as the Standard option.

There is an overall annual benefit of N$2 200 000.00.

The option is available from N$2 757 per month.

Ideal life stages suited to the Essential medical aid option:

Nest Builders ages 26-35
Mid-Lifers ages 36-55

Hospitalisation & Sub-Acute Facilities

Ward Fees - Hospital (Private ward accommodation will be covered at General Ward rates unless approved by the Fund	100% of Namaf Tariff	Y
Ward Fees - Sub-Acute	100% of Namaf Tariff	Y
Theatre fees, recovery rooms, Intensive Care & High Care	100% of Namaf Tariff	Y
Medicine & Materials used in hospital (Subject to agreed reimbursement model) TTO medicine limited to a seven (7) day supply	100% of Cost	Y

Medical Specialists & General Practitioners

Hospital visits (subject to OAL)	150% of Namaf Tariff	Y
Surgical procedures in theatre (subject to OAL	150% of Namaf Tariff	Y
Equipment / apparatus / machine hire fees (subject to OAL)	100% of Namaf Tariff	Y

Organ Transplants Subject to OAL (All inclusive)

The supply & transportation of the organ plus hospital accommodation (Services rendered to donor are excluded from benefit)	100% of Namaf Tariff	Y
Immuno-suppressant drugs (subject to pre-authorisation)	100% of Namaf Tariff	N$ 117 500 per family
Renal Dialyses (On application and approval)	100% of Namaf Tariff	N$ 236 000 per family

Internal Prostheses (subject to OAL) Including cement and antibiotics

Any INTERNAL prosthesis not specified (includes materials used and actual cost of prosthesis) - per annum	100% of Cost	N$ 47 600 per family
Cardiac stents limited to three (3) stents - per annum	100% of Cost	N$ 28 300 per stent
Cardiac pacemaker - per annum	100% of Cost	N$ 70 500 per family
Spinal instrumentation - per annum	100% of Cost	N$ 50 700 per family

Radiotherapy and/or Oncology

All services (including chemicals) - Subject to OAL

100% of Namaf Tariff

550 000

Dental Surgery(Subject to pre-authorisation)

Trauma Surgery (Subject to OAL)	150% of Namaf Tariff	Y
Maxillofacial and oral surgery: Hospital visits (Subject to OAL)	150% of Namaf Tariff	Y
Maxillofacial and oral surgery: Elective procedures in theatre	150% of Namaf Tariff	N$ 9 500 per family
Dental implants procedure in theatre (Hospitalisation and Anaesthetist)	100% of Namaf Tariff - Hospitalisation 150% of Namaf Tariff - Anaesthetist	N$ 5 500 per family

Specialised Radiology In and Out of hospital

MRI, CT & Bone Density Scans (On Specialist request) Subject to pre-authorisation	100% of Cost	90% of Cost N$ 23 100 per family 10% co-payment
US Scans and Mammogram	100% of Cost	As per available Specialised Radiology benefit
Radiology & Pathology while hospitalised	100% of Cost	Y
Pregnancy sonars (Limited to 3 sonars per pregnancy)	100% of Cost	Y

Medical Appliance and External Prosthesis (Subject to pre-authorisation)

Any EXTERNAL prosthesis not specified below (subject to submission of two quotes)	100% of Cost	N$ 14 000 per family
Artificial leg or part thereof	100% of Cost	N$ 55 900 per family
Artificial arm or part thereof	100% of Cost	N$ 55 900 per family
Artificial Eye	100% of Cost	N$ 19 100 per family
Hearing aids subject to a maximum of two (2) per beneficiary every four (4) years	100% of Cost	N$ 14 000 per device

Other Services (Subject to OAL)

Physiotherapy in hospital (3 months rehabilitation after surgery included)	100% of Namaf Tariff	Y
Blood Transfusion	100% of Cost	Y
Radial Keratotomy/Examiner Laser procedures	100% of Cost	N$ 11 200 per family
Hyperbaric Oxygen therapy (subject to approval) (Limited to N$ 46 600 per family)	100% of Cost	Y
Psychiatric in Hospital treatment (inclusive of medication)	100% of Namaf Tariff	N$ 37 900 per family
Private nursing, Hospice service and Frail care services (including medication)	100% of Cost	N$ 27 200 per family
Substance abuse	100% of Namaf Tariff	N
Infertility treatment	100% of Namaf Tariff	N
Non-emergency transport (doctor motivation required) (Subject to available limit)	100% of Cost	N$ 8 000 per family
Emergency transport	Benefit according to LifeLink Emergency Rescue Capitation agreement	Y

Maternity Benefit (Subject to OAL)

Medical practitioner visits in hospital	150% of Namaf Tariff	Y
Medical practitioner: Surgical procedures in theatre	150% of Namaf Tariff	Y
Labour and ward fees: Length of stay limited to: * Normal birth - 3 days * Caesarean - 4 days Refer to page 15 of brochure for more information on the N$2 500 incentive for normal birth	100% of Namaf Tariff	Y
Midwife services (Limited to N$ 14 700 per case)	100% of Namaf Tariff	Y
12 Ante-natal consultations per family per annum	100% of Namaf Tariff	Y
6 Childbirth education classes (maximum of N$ 210/class. Subject to 12 Ante natal consultations )	100% of Cost	Y
4 Visits to General Practitioner in first year of new-born	100% of Namaf Tariff	Y
Immunisations from birth to 10 years	100% of Pricing Structure (0% script levy)	Y
Fist visit to Paediatrician for 6 week check-up	100% of Namaf Tariff	Y

General Practitioners' Services & Specialist services excluding surgery (includes private nursing consultations)

Annual Day to Day		M+0 = N$ 9 600 M+1 = N$ 11 900 M+2 = N$ 14 100 M+3 = N$ 14 500 M+4 = N$ 14 700 M+5 = N$ 15 000
Consultations/Visits (out of hospital)	100% of Namaf Tariff	Y
Procedures/Services (out of hospital)	100% of Namaf Tariff	Y
Material & Disposable items	100% of Namaf Tariff	Y
Radiology & Pathology (out of hospital)	100% of Namaf Tariff	Y
HIV & AIDS treatment (out of hospital)	100% of Namaf Tariff	Y

Medication

Self Medication (including selected sunscreens and vitamins)

100% of Pricing Structure

Q1: N$ 1 130 per family
Q2: N$ 1 330 per family

Q3: N$ 1 330 per family

Q4: N$ 1 130 per family

Acute/Prescribed Medication
20% script levy at point of service

100% of Pricing Structure

M+0 = N$ 6 000
M+1 = N$ 6 500
M+2 = N$ 6 800
M+3 = N$ 7 200
M+4 = N$ 7 500
M+5 = N$ 7 600

Chronic medication - Subject to Fund approval
(Application forms are available on request)

100% of Pricing Structure

N$ 13 600 per family
20% Script levy

Specialised Medication

Biological drugs applicable to monoclonal antibodies and interleukins Tyrosine
Kinase inhibitors, Azacitidine, Proteasome inhibitors

100% of Pricing Structure

N$ 236 000 per family

HIV Medication

Anti-retroviral Medication therapy

100% of Pricing Structure

As per available chronic medication - No script levy

Basic Dental

Additional Basic Conservative Dental Benefit (e.g. comprehensive consultation,
root canal, oral hygiene counselling, refinement of restorations, treatment of hypersensitive dentine, partial & full dentures)

100% of Namaf Tariff

M+0 = N$ 4 900
M+1 = N$ 5 900
M+2 = N$ 6 300
M+3 = N$ 6 700
M+4 = N$ 7 100
M+5 = N$ 7 400

Specialised Dentistry

Specialised Dentistry (Overall limit)		M+0 = N$ 23 000 M+1 = N$ 25 100 M+2 = N$ 25 700 M+3 = N$ 26 300 M+4 = N$ 26 800 M+5 = N$ 27 400
Orthodontic treatment (subject to registration and provision of a treatment plan) Subject to specialised dentistry overall limit	100% of Cost	N$ 16 000 per family
Other specialised Dentistry & Dental implants(e.g. crowns, bridges, extra oral radiographs, surgical tooth extractions, metallic, ceramic or resin inlays, root canal Dental Consultation, procedure & implant component)	100% of Namaf Tariff	M+0 = N$ 12 800 M+1 = N$ 14 400 M+2 = N$ 15 900 M+3 = N$ 17 500 M+4 = N$ 18 300 M+5 = N$ 18 300

Optical Benefits

Consultation by an Optometrist	100% of Namaf Tariff	M+0 = N$ 3 900 M+1 = N$ 5 340 M+2 = N$ 6 780 M+3 = N$ 8 220 M+4 = N$ 9 660 M+5 = N$ 11 10 Frame included in benefit and limited to N$ 1 640
Spectacles (frames and lenses), contact lenses Prescription sunglasses (only on specialist recommendation)

Supplementary & Paramedical services

Clinical Psychology/Psychological Counsellor, Physiotherapy,
Audiology/Speech Therapy, Dietician, Occupational Therapy, Biokinetics, Chiropractor, Homeopathy Naturopathy/Phytotherapy (consultation only),
Hearing Aid Acoustician, Podiatry/Chiropody, Social Worker, Orthotist/Prosthetist

100% of Namaf Tariff

M+0 = N$ 11 500
M+1 = N$ 13 900
M+2 = N$ 15 200
M+3 = N$ 15 900
M+4 = N$ 16 400
M+5 = N$ 17 000

Medical Aid Options

Help me find an Option

Compare our Options

Nammed

Basic

The Basic option provides reasonably-priced, primary healthcare services to the lower-income group. (Maximum monthly salary may not exceed N$7 000).

from
N$673
Overall Annual
Benefit of
Unlimited (State Facility)

Nammed

Trauma

The Trauma option offers comprehensive benefits for major medical expenses normally associated with hospitalisation. Ideal for members wishing to cover hospital costs only.

from
N$2298
Overall Annual
Benefit of
N$3 000 000.00

Nammed

Active

The Active option offers benefits associated with hospitalisation and day-to-day medical expenses. This option will cater for young, single people and smaller, healthy families.

from
N$1677
Overall Annual
Benefit of
N$1 500 000.00

Nammed

Essential

The Essential option is generally suited for the healthier person or family between 36 and 55, who seeks greater benefits than the Active option without needing as much as the Standard option offers.

from
N$3467
Overall Annual
Benefit of
N$2 200 000.00

Nammed

Standard

The Standard option offers benefits associated with hospitalisation and day-to-day medical expenses. This option is well-suited for the middle-to-higher-income earners who wish to enjoy peace of mind.

from
N$3985
Overall Annual
Benefit of
Unlimited

Nammed

Comprehensive

The Comprehensive option offers benefits associated with hospitalisation and day-to-day medical expenses. Ideal for members wishing to cover their medical costs to the greatest extent possible or whose health risks may be perceived as high.

from
N$5246
Overall Annual
Benefit of
Unlimited

Life Stages

Age
18-25

Starters

Beginning Employment.
Low - Medium Income,
Low Health needs,
For unexpected medical needs.

Active Basic

Age
26-35

Nest Builders

Seek value rather than cheapest option.
Need cover for expected medical needs for the young family..

Essential

Age
36-55

Mid-Lifers

Middle to High income levels,
Medical Aid is a routine monthly expense,
stable health needs,

Essential Standard

Age
56-60

Grey Foxes

Moving towards retirement,
Health risks and prevalence of chronic diseases increasing,

Comprehensive Standard

Age
61+

Wise Owls

Members approaching or in retirement,
Increased prevelance of chronic diseases,
Greater importance of extent of cover for major medical events like knee & hip replacements.

Comprehensive

Essential Medical Aid Option From Nammed Healthcare

Essential Medical Aid Option From Nammed Healthcare

Hospitalisation & Sub-Acute Facilities

Medical Specialists & General Practitioners

Organ Transplants Subject to OAL (All inclusive)

Internal Prostheses (subject to OAL) Including cement and antibiotics

Radiotherapy and/or Oncology

Dental Surgery(Subject to pre-authorisation)

Specialised Radiology In and Out of hospital

Medical Appliance and External Prosthesis (Subject to pre-authorisation)

Other Services (Subject to OAL)

Maternity Benefit (Subject to OAL)

General Practitioners' Services & Specialist services excluding surgery (includes private nursing consultations)

Medication

Specialised Medication

HIV Medication

Basic Dental

Specialised Dentistry

Optical Benefits

Supplementary & Paramedical services

Side Pannel

Medical Aid Options

Basic

Trauma

Active

Essential

Standard

Comprehensive

Life Stages

Starters

Nest Builders

Mid-Lifers

Grey Foxes

Wise Owls

NewsLetter

Essential Medical Aid Option From Nammed Healthcare

Essential Medical Aid Option From Nammed Healthcare

Hospitalisation & Sub-Acute Facilities

Medical Specialists & General Practitioners

Organ Transplants Subject to OAL (All inclusive)

Internal Prostheses (subject to OAL) Including cement and antibiotics

Radiotherapy and/or Oncology

Dental Surgery(Subject to pre-authorisation)

Specialised Radiology In and Out of hospital

Medical Appliance and External Prosthesis (Subject to pre-authorisation)

Other Services (Subject to OAL)

Maternity Benefit (Subject to OAL)

General Practitioners' Services & Specialist services excluding surgery (includes private nursing consultations)

Medication

Specialised Medication

HIV Medication

Basic Dental

Specialised Dentistry

Optical Benefits

Supplementary & Paramedical services

Side Pannel

Medical Aid Options

Basic

Trauma

Active

Essential

Standard

Comprehensive

Life Stages

Starters

Nest Builders

Mid-Lifers

Grey Foxes

Wise Owls

NewsLetter

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