Basic Healthcare Option From Nammed Medical Aid Scheme

Basic Option from Nammed Medical Aid Fund

You deserve quality healthcare.  The Basic option provides reasonably priced primary healthcare services to the lower-income group, who previously could not afford and did not have access to funded-healthcare options. 

The Nammed Healthcare Provider Network

Basic Option provides access to private healthcare for medical treatment provided by our Designated Service providers.  

Any visits to healthcare providers not on our Designated Service Provider list are for the member’s personal account. It is advised that members make appointments before visiting their healthcare providers.

Sign up for the Basic medical aid option today.

In-Hospital benefits

Ward Fees - Hospital
(Private ward accommodation will be covered at General Ward rates unless approved by the Fund
100% of State TariffReimbursement as per DSP contract
Ward Fees - Sub-Acute100% of State TariffReimbursement as per DSP contract
Theatre fees, recovery rooms, Intensive Care & High Care100% of State TariffReimbursement as per DSP contract
Medicine & Materials used in hospital (Subject to agreed reimbursement model)
TTO medicine limited to a seven (7) day supply
100% of State TariffReimbursement as per DSP contract

Doctor visits in hospital

Doctor visits As per DSP contract Reimbursement as per DSP contract 
Surgical procedures in theatre 100% of State Tariff Reimbursement as per DSP contract 

Maternity Benefits

Maternity in hospital100% of State TariffState Facility only

Psychiatric Treatment & Substance Abuse

Psychiatric treatment 100% State Tariff State facility only
Substance abuse 100% State Tariff
 Limited to N$ 4 000 per family per annum (As per contract)

Ambulance Benefit

Non-emergency transport (doctor motivation required) (Subject to available limit)              100% of Cost                                                                                N$ 4 300 per family

Emergency transport                                                                                                                                            Benefit according to Rescue Me Policy                            Y

Unlimited Day-to-Day Doctor consultations

Consultations/Visits (out of hospital)As per DSP agreementUnlimited visits at DSP N$15 co-payment
Procedures/Services (out of hospital)100% of Namaf TariffLimited to available Private Hospital Limit
Radiology & Pathology (out of hospital)100% of Namaf Tariff

Reimbursement as per network contract

(as per agreed formula list)

Medication Benefit

Self-Medication (including selected sunscreens and vitamins)100% of Pricing StructureN$ 400 per family per quarter
Acute/Prescribed Medication

100% of Pricing Structure

N$ 2 200 Per Principal Member Limited to N$ 3 200 per family per annum.

Script limit N$ 300 (No Co-Payment)

Chronic medication - Subject to Fund approval
(Application forms are available on request)
100% of Pricing StructureN$ 3 200 per family per annum.

Script limit N$ 300 (No Co-Payment)

HIV Medication

Anti-retroviral Medication therapy100% of Pricing Structure

N$ 11 300 per family per annum. No co-payment.

Optical Benefit

Consultation by an Optometrist

100% of Cost at DSP

N$ 1 200 per family per annum including frames. N$15 co-payment

6 Month waiting period for private members

Spectacles (frames and lenses), contact lenses
Prescription sunglasses (only on specialist recommendation)

Dental Benefit

Additional basic conservative dentistry

(e.g. comprehensive consultation, root canal, oral hygiene counselling

refinement of restorations, treatment of hypersensitive dentine,

partial & full dentures)

100% of Namaf Tariff

N$ 1 800 per principal member & limited to N$ 3 400 per family per annum.

unlimited at state facility

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