Trauma Medical Aid Option Is Nammed's Hospital Plan

The Trauma medical aid option in Nammed’s hospital plan and is ideal for members wishing only to cover hospital costs. This option offers comprehensive benefits for major medical expenses normally associated with hospitalisation.

The Trauma medical aid option has and overall annual benefit of N$3 000 000.00.

It is available from N$1 581 per month.

Ideal life stages suited to the Standard medical aid option:

The Trauma option is available to all ages.

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	N$ 886 500 per family
Immuno-suppressant drugs (subject to pre-authorisation)	100% of Namaf Tariff	N$ 117 500 per family Part of organ transplant benefit
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$ 52 700 per family
Cardiac stents limited to three (3) stents - per annum	100% of Cost	N$ 30 500 per stent
Cardiac pacemaker - per annum	100% of Cost	N$ 75 600 per family
Spinal instrumentation - per annum	100% of Cost	N$ 54 500 per family

Radiotherapy and/or Oncology

All services (including chemicals) - Subject to OAL

100% of Namaf Tariff

Limited to N$ 650 000 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$ 11 100 per family
Dental implants procedure in theatre (Hospitalisation and Anaesthetist)	NO BENEFIT	N

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$ 21 000 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)	NO BENEFIT	N

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$ 21 000 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	NO BENEFIT	N

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$ 14 700 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$ 35 800 per family
Substance abuse	NO BENEFIT	N
Infertility treatment	NO BENEFIT	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 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 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	NO BENEFIT	N
6 Childbirth education classes (maximum of N$ 210/class. Subject to 12 Ante natal consultations)	NO BENEFIT	N
4 Visits to General Practitioner in first year of new-born	NO BENEFIT	N
Immunisations from birth to 10 years.	NO BENEFIT	N
FiRst visit to Paediatrician for 6 week check-up	NO BENEFIT	N

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

Annual Day to Day		N
Consultations/Visits (out of hospital)	NO BENEFIT	N
Procedures/Services (out of hospital)	NO BENEFIT	N
Material & Disposable items	NO BENEFIT	N
Radiology & Pathology (out of hospital)	NO BENEFIT	N
HIV & AIDS treatment (out of hospital)	NO BENEFIT	N

Medication

Self Medication (including selected sunscreens and vitamins)	NO BENEFIT	N
Acute/Prescribed Medication 20% script levy at point of service	NO BENEFIT	N
Chronic medication - Subject to Fund approval (Application forms are available on request)	NO BENEFIT	N

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

NO BENEFIT

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)

NO BENEFIT

Specialised Dentistry

Specialised Dentistry (Overall limit)	NO BENEFIT	N
Orthodontic treatment (subject to registration and provision of a treatment plan) Subject to specialised dentistry overall limit	NO BENEFIT	N
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)	NO BENEFIT	N

Optical Benefits

Consultation by an Optometrist	NO BENEFIT	N
Spectacles (frames and lenses), contact lenses Prescription sunglasses (only on specialist recommendation)

Supplementary & Paramedical services

NO BENEFIT

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

Trauma Medical Aid Option Is Nammed's Hospital Plan

Trauma Medical Aid Option Is Nammed's Hospital Plan

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

Trauma Medical Aid Option Is Nammed's Hospital Plan

Trauma Medical Aid Option Is Nammed's Hospital Plan

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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