All Benefits Options | Namibia Health Plan

About Gold

NHP Gold offers the most comprehensive benefits. As our premier option, consider yourself covered for both major incidences and any day-to-day health expenses. This package is highly recommended for the elderly and people whose health risk is considered high.

Note: All services are paid at 100% of the NAMAF benchmark tariff, unless indicated to the contrary.

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 4,778 3,710 1,942
26-30 5,366 4,510 1,942
31-35 6,010 4,947 1,942
36-40 7,003 6,168 1,942
41-45 7,472 6,737 1,942
46-50 8,060 7,037 1,942
51-55 8,338 7,429 1,942
56-60 8,737 7,837 1,942
61-65 9,902 8,547 1,942
66+ 10,350 8,877 1,942
Age Principal Member Adult / Special dep Child dep
0-25 3,927 2,936 1,632
26-30 4,466 3,603 1,632
31-35 4,889 4,010 1,632
36-40 5,677 4,816 1,632
41-45 6,153 5,421 1,632
46-50 6,485 5,635 1,632
51-55 6,708 5,948 1,632
56-60 7,051 6,183 1,632
61-65 7,846 6,687 1,632
66+ 8,156 6,883 1,632
Principal Adult/Special dependant Child
8,350 2,130 2,130

Example Roll-over Benefit: (Principal member + spouse + two children) = N$ 14,740.00 per year.

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     Unlimited    
1. Healthcare provider and medical specialists SPA
1.1 Consultations and visits: In-hospital 150 %
1.2 Procedures: In-hospital 150 %
2. Chronic Medication 34,200 69,100
2.1 Chronic approved – Min levy of N$30: Subject to prior registration 80 % No benefit without prior registration
3. Hospital services SPA
3.1 Accommodation and theatre 100 %
3.2 Blood transfusions 100 %
3.3 Dialysis 100 %
3.4 Medication 100 %
3.5 Accommodation in private wards 100 % 28,800 58,300
3.6 Accommodation other than a recognised hospital or medical institution: SA only 100 % 875 per day
3.7 Appliances and prosthesis: Surgical 100 % 80,300 130,000
3.8 Refractive surgery: Full procedure – A waiting period of 12 months will apply 100 % 34,400 42,500
3.9 Organ transplants: Full procedure 100 % 694,000
3.10 Private nursing 100 % 77,900 77,900
3.11 Oncology 100 % 905,000
4. Radiology SPA
4.1 Radiology: Specialised MRI and CT scans in-and-out of hospital combined 100 % 45,500
4.2 Basic radiology: In-hospital 100 %
5. Pathology
5.1 Pathology: In-hospital 100 %
6. Dentistry SPA
6.1 Oral surgery: Full procedure 100 % 70,300
6.2 Maxillo facial surgery: Non-elective only 100 %
6.3 Dental implants OAL
6.3.1 Hospitalisation 100 % 20,400
6.3.2 Implant: Consultation, procedure and cost 100 % 22,000 N$ 4,410 per implant
7. Psychiatric treatment 37,200 68,800 SPA
7.1 Hospitalisation or institutionalisation 100 %
7.2 Rehabilitation: Alcohol and drug addiction or abuse 100 % SPA
8. Maternity
8.1 Confinement: Full procedure 100 % SPA
8.2 Antenatal consultations (total consultations) 100 % 12 visits OAL
8.3 2D Sonar scans (total scans) 100 % 2 Scans OAL
8.4 Amniocentesis 100 % SPA
8.5 Panorama Prenatal test 100 % SPA
9. Preventative care OAL
9.1 Vaccinations: As per list 100 %
10. Specified illness conditions 57,300 OAL
10.1 HIV/AIDS: Including the cost of pathology tests 100 % SPA
10.2 Sexually transmitted diseases 100 % 7,190 9,660 SPA
11. Ambulance services: Only for medical or trauma emergencies SPA
11.1 Air evacuation 100 %
11.2 Ambulance services 100 %
11.3 Ambulance services: Inter-hospital transfer 100 % 5,140 5,140
11.4 Other transportation 80 %
12. Artificial limbs and eyes SPA
12.1 Artificial limbs 100 % 74,300
12.2 Artificial eyes 100% 29,700
13. Heart surgery rehabilitation 100 % 24,800 OAL
14. Insertion Mirena Device: All Inclusive – Every 3 years 7,400 OAL
15. Stoma Care products 100 % 34,700 OAL
16. Back and Neck Rehabilitation Programme 100 % Subject to DBC protocol Subject to DBC protocol Subject to DBC protocol OAL

    NAMAF tarriff or % thereof Principal Member Per Additional Beneficiary Per Family Conditions
  Out-of-hospital: Sub-limit          
1. Healthcare provider and medical specialists 19,100 5,200
1.1 Consultations or visits: Out-of-hospital 100 % Unlimited, max 5 virtual GP consultations Unlimited, max 5 virtual GP consultations
1.1.1 Consultations or visits: Out-of-hospital: When healthcare provider or medical specialists benefit has been depleted 100 %   1 General Practitioner visit per registered beneficiary Subject to registration on chronic care programme
1.2 Out-of-hospital services 100 %
1.3 Pathology or radiology: Out-of-hospital 100 %
1.4 Chronic Lifestyle disease extender benefit 100 % Additional benefits as specified Additional benefits as specified Additional benefits as specified OAL
2. Medicine and injections
2.1 Acute medicine 11,100 6,450
2.1.1 Acute: Pharmacy dispensed – Min. levy of N$ 30 80 %
2.1.2 Acute: Doctors dispensed – Min. levy of N$ 30 80 %
2.1.3 Self medication: Over-the-counter – No levy: Subject to acute medication limit 100 % 2,050 510 255 per claim
2.1.4 Vitamins, homeopathic and phytotherapy medication – Min levy of N$30 80 % 1,100 300 255 per claim
2.2 Chronic medicine
2.2.1 Chronic approved: Subject to prior registration – Min. levy of N$ 30
3. Dentistry 22,900 45,400
3.1 Basic dentistry: Subject to sub-limit 100 % 12,900 4,420
3.2 Dental technicians 100 %
3.3 Advanced dentistry
3.3.1 Orthodontics 100 %
3.3.2 Dental Implants: Full procedure 100 % Refer to OAL – 6.3 Refer to OAL – 6.3 Refer to OAL – 6.3
4. Optical 6,920 2,580
4.1 Eye tests 100 %
4.2 Spectacles and lenses: Frames every 2nd year 100 % Frame limit to N$ 2,500
4.3 Orthoptics 100 %
5. Auxiliary services 21,600 6,370
5.1 Chiropody 100 % 15 Visits, including 5 virtual consultations
5.2 Clinical psychology 100 % 15 Visits, including 5 virtual consultations
5.3 Dietician 100 % 15 Visits, including 5 virtual consultations
5.4 Homeopathy: Consultation only 100 % 15 Visits, including 5 virtual consultations
5.5 Occupational therapy 100 % 15 Visits, including 5 virtual consultations
5.6 Social workers 100 % 15 Visits, including 5 virtual consultations
5.7 Appliances: Non-surgical 100 % SPA
5.8 Physiotherapy 100 % 15 Visits, including 5 virtual consultations
5.9 Biokinetics 100 % 15 Visits, including 5 virtual consultations
5.10 Audiology and speech therapy 100 % 15 Visits, including 5 virtual consultations
5.11 Chiropractic 100 % 15 Visits, including 5 virtual consultations
5.12 Podiatry 100 % 15 Visits, including 5 virtual consultations
6. Diabetic devices benefit OAL
6.1 Insulin Pumps/Glucose Monitoring System/Glucose reader 80% 46,300
6.2 Diabetes related consumables for insulin pumps/Glucose Monitoring System/Glucose reader 80% 44,400 44,400
7 Smart Saver benefit
7.1 Health Risk Assessment 100% 1,000
7.2 Preventative Care Incentives 100% 155 155
8 Roll-Over Benefit 100% 8,350 2,130 2,130

  • Flu vaccines are covered as part of the preventative care benefit.
  • 1 COVID-19 vaccine regimen per year is covered as part of the preventative care benefit for all beneficiaries older than 16 years.
  • Vitamins under specific conditions to be authorized from the chronic medication benefit.
  • Limited benefit for vitamins available under 2.1.4. above, without a prescription.
  • NHP pays for contraceptives (oral and injections) limited to N$255 per claim.
  • Sunblock may be purchased at pharmacies under the self-medication benefit.
  • Pre-authorized traveling costs for specialist referrals in Namibia partly covered if residing more than 150km from Windhoek – Accommodation included, limited to N$875 per night, maximum of 2 nights per family per annum.
  • No basic dentistry will be covered under the oral surgery benefit.
  • Intraocular lenses included in Appliances and prosthesis surgical benefit – limited to N$7,000 per lens. Refer to 3.7.
  • Blood pressure monitor: N$635 per beneficiary.
  • Auxiliary services – 15 consultations inclusive of 5 virtual consultations per listed specialties. Subject to available benefits.
  • A Smart Saver benefit is added to a family’s Accumulated Roll-Over benefit on completion of:
    • A health risk assessment by the principal member or an adult dependent at any of the Fund’s Wellness Days or at a qualifying pharmacy;
    • Any of the preventative care benefits offered by the Fund by a qualifying beneficiary.

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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