Blue Diamond - All Benefits Options | Namibia Health Plan

About Blue Diamond

NHP Blue Diamond offers unlimited coverage for day-to-day primary healthcare services at designated service provider facilities. These service providers can be found on our list of contracted general practitioners and registered nurses here. Blue Diamond gives individuals in the lower income group access to subsidised private healthcare with added access to our maternity benefit.

Note: If you are currently a member of any of the other NHP benefit options and not used to primary healthcare, we strongly recommend that you do not “buy down” to the Blue Diamond benefit option as your choice of general practitioner, nurse and healthcare facility is restricted. Blue Diamond benefits are not pro-rated apart from optical and dental benefits where sub-limits are applicable.

Compare to other Benefit Options

  • In-hospital & out of hospital services
  • Chronic and acute medicine
  • Basic and specialised radiology – in and out-hospital
  • Dentistry
  • Psychiatric treatment
  • Maternity
  • Preventative Care
  • Optical
  • Pathology and auxiliary services
  • Diabetic Devices Benefit
  • Back and Neck rehabilitation programme
  • Ambulance services
Age Principal Member Adult / Special dep Child dep
0-25 801 665 324
26-30 830 700 324
31-35 898 722 324
36-40 932 758 324
41-45 977 807 324
46-50 1,019 840 324
51-55 1,063 885 324
56-60 1,074 948 324
61-65 1,165 1,002 324
66+ 1,248 1,106 324
Age Principal Member Adult / Special dep Child dep
0-25 710 594 284
26-30 741 611 284
31-35 789 634 284
36-40 823 680 284
41-45 854 703 284
46-50 885 712 284
51-55 914 746 284
56-60 932 805 284
61-65 1,002 854 284
66+ 1,082 912 284

Downloads

Employer Group Application Form Membership Application Form Benefit Guide 2025 User Guide 2025

    NAMAF tarriff or % thereof Principal Member Per Additional Beneficiary Per Family Conditions
Overall Annual Limit (OAL) Unlimited
1. Doctors and specialists SPA
1.1 Consultations and visits: In-hospital 100% Max 5 virtual GP consultations Max 5 virtual GP consultations
1.2 Procedures: In-hospital 100%
2. Hospital services SPA
2.1 You can be admitted into the state hospital facility (private wing) but it has to first be approved by NHP - subject to pre-authorisation 100%
2.2 Selected private hospitals: Limited access benefit for treatment 100%
2.2.1 Ward fees 60%
2.3 Routine and scheduled surgical and hospitalisation events 100%
3. Ambulance services: Only for medical or trauma emergencies SPA
3.1 Air evacuation 100%
3.2 In an emergency you are covered for ambulance services but only in Namibia 100%
3.3 You are covered for transport between 2 hospitals 100% 5,397 5,397
3.4 Other transportation No benefit
4. Maternity SPA
4.1 When you are pregnant, you can go visit certain doctors 12 times per pregnancy - Subject to pre-authorisation. 100% 12 Visits
4.2 2D Sonar scans 100% 2 Scans
5. Back and Neck Rehabilitation Programme 100% Subject to DBC protocol OAL
6. Preventative care OAL
6.1 Vaccinations: COVID-19 100%

NAMAF tarriff or % thereof Principal Member Per Additional Beneficiary Per Family Conditions
Out-of-hospital: Sub-limit Unlimited
1. Doctors and specialists DSP
1.1 Consultations and visits: Obtained from certain doctors, during normal working hours - N$ 15 per visit 100%
1.1.1 Nurse: N$ 15 per visit - new conditions Limited to 2 visits p/m and 12 p/a Limited to 2 visits p/m and 12 p/a
1.1.2 General practitioner: N$15 per visit: New conditions 5,352 13,380 446 per visit
1.1.3 Medical specialist: Upon referral from doctor - N$ 15 per visit
1.1.4 Medical specialist: Travel assistance benefit - Windhoek or Swakopmund 100% 803 per visit
1.2 Out-of-hospital services 100%
1.3 Limited to 2 after-hour consultations at certain doctors: Per family per year 100%
2. Medicine and injections Unlimited DSP
2.1 Acute medicine
2.1.1 As dispensed or prescribed by certain doctors and pharmacies 100% 3,024 7,560 252 per script
2.1.2 Self medication: Over-the-counter 100% 903 257 per claim
2.2 Chronic medicine
2.2.1 Chronic medicine: Dispensed - As per chronic medicine formulary - Subject to prior registration on chronic care programme 100% 4,148 No benefit without prior registration
2.3 Antiretroviral therapy: Dispensed - patient needs to enrol in the AfA Programme 100%
3. Primary care dentistry: N$15 per visit - New conditions 1,932 3,854 DSP
3.1 Subject to the use of certain dentists: According to a list of approved dental codes 100%
3.1.1 Consultations, primary extractions, fillings level 1 to 3, fluoride treatment, instructions on oral hygiene scaling and polishing
3.1.2 Plastic dentures: Limited to 1 set per family per 24 months
3.1.3 Surgical removal of teeth, root canal treatment and dentures: Subject to pre-authorisation
3.2 Specialised dentistry No benefit
4. Radiology Unlimited DSP
4.1 Black and white x-rays as requested by certain doctors: According to a list of approved radiology codes 100%
5. Pathology Unlimited DSP
5.1 Basic blood tests as requested by certain doctors: According to a list of approved pathology codes 100%
6. Optical: N$15 per visit - New conditions 1,134 DSP
6.1 Optical test 100% Limited to 115
6.2 Spectacles and lenses: Limited to 1 pair of glasses per family per 24 months - when joining NHP, you cannot claim for glasses for the first 6 months 100% Claim limited to 1013
7. Mother and child healthcare services DSP
7.1 Family planning, immunisation, pre- and post- antenatal care 100%
8. Counselling and health education DSP
8.1 Instruction of prevention of certain illnesses, oral hygiene, poisons, HIV/AIDS, etc. 100%
9. Specified illness conditions DSP
9.1 HIV/AIDS: Aids and HIV Positivity, Pathology, HIV councelling and testing, Prophylactic medicine for prevention of HIV, transmission in the case of needle-prick, rape or infection of mother (mother-to-child prevention) 100% Unlimited
9.2 Sexually transmitted diseases 100% 1,659
10. Rehabilitation: Alcohol and drug addiction or abuse 100% 1,659 DSP

  • 1 COVID-19 vaccine regimen per year are covered as part of the preventative care benefit for all beneficiaries older than 16 years.
  • Travel assistance for specialist visits in Namibia only, limited to 2 per family per year.
  • International travel benefit.
  • NHP pays for contraceptives (oral and injections) limited to N$257 per claim.
  • Immunisations are only available from designated service providers, subject to the formulary.
  • Members do not qualify for the Lifestyle Programme.
  • No Roll-Over benefit.
  • No preventative care benefit, including Cervarix, apart from the COVID-19 vaccine and a health risk assessment at any of the Fund's Wellness Days or at a qualifying pharmacy.

Forms

Select and download all application, registration and request forms as well as information on NHP’s designated service providers, tariffs and travel insurance.

See all forms

Information and Services

Benefit suggestions

These life stages aim to illustrate the thoughtful consideration given to the evolving healthcare needs of individuals at different points in their lives. By aligning medical aid benefits with these life stages, we ensure that our members receive targeted and effective healthcare support throughout their journey.

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