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
0-25 756 628 306
26-30 784 661 306
31-35 848 682 306
36-40 880 716 306
41-45 923 762 306
46-50 962 793 306
51-55 1,004 836 306
56-60 1,014 895 306
61-65 1,100 946 306
66+ 1,178 1,044 306
Age Principal Member Adult / Special dep Child dep
0-25 670 561 268
26-30 700 577 268
31-35 745 599 268
36-40 777 642 268
41-45 806 664 268
46-50 836 672 268
51-55 863 704 268
56-60 880 760 268
61-65 946 806 268
66+ 1,022 861 268

Downloads

Employer Group Application Form Membership Application Form Benefit Guide 2024 User Guide 2024

    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%
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% 5 140 5 140
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 Virtual GP consultations 5 5
1.1.2 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
1.1.3 General practitioner: 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 425 per visit
1.1.4 Medical specialist: Upon referral from doctor - N$ 15 per visit 100%
1.1.5 Medical specialist: Travel assistance benefit - Windhoek or Swakopmund 100% 765 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% Limited to 2 scripts p/m and 12 p/a Limited to 2 scripts p/m and 12 p/a 240 per script
2.1.2 Self medication: Over-the-counter 100% 860 245 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% 3,950 No benefit with- out 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 1,840 3,670 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 1,075 DSP
6.1 Optical test 100% Limited to 110
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 965
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% 1,580
10. Rehabilitation: Alcohol and drug addiction or abuse 100% 1,580 DSP

  • Travel assistance for specialist visits in Namibia only, limited to 2 per family per year.
  • 1 COVID-19 vaccine regimen per year is covered as part of the Preventative Care benefit for all beneficiaries older than 16 years.
  • International Travel benefit.
  • NHP pays for contraceptives (oral and injections) limited to N$ 245 per claim.
  • Immunisations are only available from designated service providers, subject to the formulary.
  • 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.
  • No Mirena benefit available.
  • No contact lenses benefit available.
  • Acute medication script limit is N$ 240.
  • The Out-of-Hospital (OOH) benefit in respect of consultations with doctor’s/specialists and nurses will be limited to 2 per beneficiary per month (p.b.p.m) up to a maximum of 12 per beneficiary per annum (p.b.p.a), and scripts for medicines and injection materials also limited to 2 per beneficiary per month (p.b.p.m) up to a maximum of 12 per beneficiary per annum (p.b.p.a).

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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