Standard Medical Aid Option And Healthcare Benefits

The Standard medical aid option from Nammed offers extensive healthcare benefits associated with hospitalisation, major medical expenses (MME) 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.

The Standard option has an unlimited overall annual benefit.

It is available from N$ 3 170 per month.

Ideal life stages suited to the Standard medical aid option:

Mid-Lifers ages 36-55
Grey Foxes ages 56-60

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

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$ 123 380 per family
Renal Dialyses (On application and approval)	100% of Namaf Tariff	N$ 247 800 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$ 59 010 per family
Cardiac stents - per annum	100% of Cost	N$ 34 130 per family
Cardiac pacemaker - per annum	100% of Cost	N$ 84 630 per family
Spinal instrumentation - per annum	100% of Cost	N$ 60 900 per family

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$ 11 550 per family
Dental implants procedure in theatre (Hospitalisation and Anaesthetist)	100% of Namaf Tariff - Hospitalisation 200% of Namaf Tariff - Anaesthetist	N$ 7 670 per family

Radiotherapy and/or Oncology

All services (including chemicals) - Subject to OAL

100% of Namaf Tariff

N$840 000

Specialised Radiology In and Out of hospital

MRI, CT & Bone Density Scans (On Specialist request) Subject to pre-authorisation	100% of Namaf Tariff	95% of Cost N$ 38 220 per family 5% co-payment
US Scans and Mammogram	100% of Namaf Tariff	As per available Specialised Radiology benefit
Radiology & Pathology while hospitalised	100% of Namaf Tariff	Y
Pregnancy sonars (Limited to 3 sonars per pregnancy)	100% of Namaf Tariff	Y

Diabetic Benefit

Insulin Pumps (One per beneficiary every four years)	100% of Cost	90% of Cot limited to N$ 50 000 per beneficiary
Other Diabetes devices and related consumables including Glucose Monitoring Systems/Readers	100% of Cost	N$ 55 000 per beneficiary per annum

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$ 22 050 per family
Artificial leg or part thereof	100% of Cost	N$ 58 700 per family
Artificial arm or part thereof	100% of Cost	N$ 58 700 per family
Artificial Eye	100% of Cost	N$ 20 060 per family
Hearing aids subject to a maximum of two (2) per beneficiary every four (4) years	100% of Cost	N$ 22 050 per device

Ambulance Services

Non-emergency transport (doctor motivation required) (Subject to available limit)	100% of Cost	N$ 12 600 per family
Emergency transport	Benefit according to LifeLink Emergency Rescue Capitation agreement	Y

Other Services (Subject to OAL)

Physiotherapy in hospital (3month rehabilitation after surgery included) on referral only	100% of Namaf Tariff	Y
Blood Transfusion	100% of Cost	Y
Radial Keratotomy/Examiner Laser procedures	100% of Cost	N$ 25 100 per family
Hyperbaric Oxygen therapy (subject to approval) (Limited to N$ 48 930 per family)	100% of Cost	Y
Psychiatric in Hospital treatment (inclusive of medication)	100% of Namaf Tariff	N$ 45 360 per family
Private nursing, Hospice service and Frail care services (including medication)	100% of Cost	N$ 44 210 per family
Substance abuse	100% of Namaf Tariff	One rehabilitation per family
Infertility treatment	100% of Namaf Tariff	N$ 42 740 per family

Maternity Benefit (Subject to OAL)

Medical practitioner visits in hospital	100% of Namaf Tariff	Y
Medical practitioner: Surgical procedures in theatre	100% of Namaf Tariff	Y
Labour and ward fees: Length of stay limited to: * Normal birth - 3 days * Caesarean - 4 days Refer to page 19 for more information on the N$2 500 incentive for normal birth	100% of Namaf Tariff	Y
Midwife services (Limited to N$ 15 440 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$ 220/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
First 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$ 16 600 M+1 = N$ 20 300 M+2 = N$ 23 100 M+3 = N$ 25 000 M+4 = N$ 26 900 M+5 = N$ 28 800
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

N$ 1 330 per family for each quarter one and four

N$ 1 640 per family for each quarter two and three

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

100% of Pricing Structure

M+0 = N$ 10 100
M+1 = N$ 13 900
M+2 = N$ 17 500
M+3 = N$ 20 100
M+4 = N$ 21 000
M+5 = N$ 22 700

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

100% of Pricing Structure

N$ 37 280 per family
20 % Script levy - member over
65 - 10% script levy

Specialised Medication

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

100% of Pricing Structure

N$ 247 800 per family

HIV Medication

Anti-retroviral Medication therapy

100% of Pricing Structure

As per available chronic medication - No script levy

Basic Dentistry

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$ 5 360
M+1 = N$ 7 770
M+2 = N$ 8 820
M+3 = N$ 9 660
M+4 = N$ 10 400
M+5 = N$ 11 130

Specialised Dentistry

Specialised Dentistry (Overall limit)		M+0 = N$ 45 260 M+1 = N$ 50 190 M+2 = N$ 53 450 M+3 = N$ 55 230 M+4 = N$ 56 910 M+5 = N$ 58 700
Orthodontic treatment (subject to registration and provision of a treatment plan) Subject to specialised dentistry overall limit	100% of Cost	N$ 30 140 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$ 30 140 M+1 = N$ 35 070 M+2 = N$ 38 430 M+3 = N$ 40 110 M+4 = N$ 42 630 M+5 = N$ 45 260

Optical Benefits

Consultation by an Optometrist	100% of Namaf Tariff	M+0 = N$ 5 360 M+1 = N$ 7 080 M+2 = N$ 8 800 M+3 = N$ 10 520 M+4 = N$ 12 240 M+5 = N$ 13 960 Frame included in benefit and limited to N$ 1 940
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$ 15 960
M+1 = N$ 20 370
M+2 = N$ 24 890
M+3 = N$ 30 030
M+4 = N$ 34 440
M+5 = N$ 36 960

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$17 000).

from
N$733
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$1744
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$1787
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$3041
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$3497
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$4425
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

Standard Medical Aid Option And Healthcare Benefits

Standard Medical Aid Option And Healthcare Benefits

Hospitalisation & Sub-Acute Facilities

Medical Specialists & General Practitioners

Organ Transplants Subject to OAL (All inclusive)

Internal Prostheses (subject to OAL) Including cement and antibiotics

Dental Surgery(Subject to pre-authorisation)

Radiotherapy and/or Oncology

Specialised Radiology In and Out of hospital

Diabetic Benefit

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

Ambulance Services

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 Dentistry

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

Standard Medical Aid Option And Healthcare Benefits

Standard Medical Aid Option And Healthcare Benefits

Hospitalisation & Sub-Acute Facilities

Medical Specialists & General Practitioners

Organ Transplants Subject to OAL (All inclusive)

Internal Prostheses (subject to OAL) Including cement and antibiotics

Dental Surgery(Subject to pre-authorisation)

Radiotherapy and/or Oncology

Specialised Radiology In and Out of hospital

Diabetic Benefit

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

Ambulance Services

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 Dentistry

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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