Platinum - All Benefits Options | Namibia Health Plan

About Platinum

NHP Platinum prioritises comprehensive benefits with a generous overall annual limit and high day-to-day benefits. This package is better suited for those whose health risk can best be described as moderate.

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 3,742 3,042 1,610
26-30 4,205 3,510 1,610
31-35 4,765 4,279 1,610
36-40 5,270 4,662 1,610
41-45 5,865 5,174 1,610
46-50 6,377 5,520 1,610
51-55 6,980 6,002 1,610
56-60 7,449 6,235 1,610
61-65 7,904 6,662 1,610
66+ 8,807 7,601 1,610
Age Principal Member Adult / Special dep Child dep
0-25 3,305 2,441 1,242
26-30 3,633 2,661 1,242
31-35 3,913 2,830 1,242
36-40 4,406 3,251 1,242
41-45 4,836 3,743 1,242
46-50 5,256 3,952 1,242
51-55 5,594 4,492 1,242
56-60 6,037 5,133 1,242
61-65 6,282 5,524 1,242
66+ 6,791 5,800 1,242
Principal Adult/Special dependant Child
6,310 1,620 1,620

Example Roll-over Benefit: (Principal member + spouse + two children) = N$ 11,170.00 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 (OAL) Unlimited
1. Healthcare provider or medical specialists SPA
1.1 Consultations or visits: In-hospital 150%
1.2 Procedures: In-hospital 150%
2. Chronic medicine 20,000 36,800
2.1 Chronic medicine approved: Min levy of N$ 30 - subject to prior registration on Chronic Care programme 80% No benefit with- out 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: Private wards 100% 18,200 36,700
3.6 Accommodation other than a recognised hospital or medical institution: SA only 100% 875 per day
3.7 Appliances and prosthesis: Surgical 100% 72,300 86,400
3.8 Refractive surgery: Full procedure - a waiting period of 12 months will apply 100% 26,100 34,400
3.9 Organ transplants: Full procedure 100% 359,000
3.10 Private nursing 100% 54,100 54,100
3.11 Oncology 100% 679,000
4. Radiology SPA
4.1 Radiology: Specialised MRI and CT scans - In-and-out of hospital combined 100% 39,500 SPA
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% 63,100
6.2 Maxillo facial surgery: Non-elective only 100%
6.3 Dental Implants OAL
6.3.1 Hospitalisation 100% 14,900
6.3.2 Implant: Consultation, procedure and cost 100% 16,900 4 410 per implant
7. Psychiatric treatment 30,200 55,000 SPA
7.1 Hospitalisation or institutionalisation 100%
7.2 Rehabilitation of alcohol and drug addiction or abuse 100% SPA
8. Maternity
8.1 Confinement: Full procedure - subject to pre-authorisation 100% SPA
8.2 Antenatal consultations 100% 12 Visits OAL
8.3 Sonar scans: 2D 100% 2 Scans OAL
8.4 Amniocentesis 100% SPA
8.5 Panorama Prenatal test 100% SPA
9. Preventative care OAL
9.1 Preventative care benefits: 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% 5,390 7,190 SPA
11. Ambulance services: Only for medical or trauma emergencies SPA
11.1 Emergency evacuation: Air 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 or eyes SPA
12.1 Artificial limbs 100% 52,000
12.2 Artificial eyes 100% 26,100
13. Heart surgery: Rehabilitation 100% 20,800 OAL/SPA
14. Insertion Mirena device: All inclusive - every 3 years 100% 7,400 OAL/SPA
15. Stoma Care products 100% 34,700 OAL/SPA
16. Back and Neck Rehabilitation Programme 100% Subject to DBC protocol OAL/SPA

NAMAF tarriff or % thereof Principal Member Per Additional Beneficiary Per Family Conditions
Out-of-hospital: Sub-limit OAL
1. Healthcare provider or medical specialists 16,100 3,350
1.1 Consultations or visits: Out-of-hospital 100% Unlimited Unlimited
1.1.1 Virtual consultations 100% 5 5
1.2 Procedures: 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 OAL
2. Medicine and injections
2.1 Acute medicine 10,900 2,690
2.1.1 Acute medicine: Pharmacy dispensed - min levy of N$ 30 80%
2.1.2 Acute medicine: Doctors dispensed - min levy of N$ 30 80%
2.1.3 Self medication: Over-the-counter - no levy. Subject to acute medicine limit 100% 1,790 300 255 per claim
2.1.4 Vitamins, homeopathic and phytotherapy medicines: min levy of N$ 30 - subject to acute medicine limit 80% 855 250 255 per claim
3. Dentistry 16,600 30,200
3.1 Basic dentistry: Subject to sub-limit 100% 9,050 2,080
3.2 Dental technicians 100%
3.3 Advanced dentistry
3.3.1 Orthodontics 100%
3.3.2 Dental implants: Full procedure 100% OAL: Refer to 6.3
4. Optical 6,080 1,520
4.1 Eye tests 100% Frame limited to 2 160
4.2 Spectacles or lenses: Frames every 2nd year 100%
4.3 Orthoptics 100%
5. Auxiliary services 18,500 5,950
5.1 Chiropody 100% 15 Visits 5 VC
5.2 Clinical psychology 100% 15 Visits 5 VC
5.3 Dietician 100% 15 Visits 5 VC
5.4 Homeopathy: Consultation only 100% 15 Visits 5 VC
5.5 Occupational therapy 100% 15 Visits 5 VC
5.6 Social Workers 100% 15 Visits 5 VC
5.7 Appliances: Non-surgical 100% SPA
5.8 Physiotherapy 100% 15 Visits 5 VC
5.9 Biokinetics 100% 15 Visits 5 VC
5.10 Audiology or speech therapy 100% 15 Visits 5 VC
5.11 Chiropractic 100% 15 Visits 5 VC
5.12 Podiatry 100% 15 Visits 5 VC
6. Diabetic devices benefit OAL
6.1 Insulin Pumps/Glucose Monitoring System/Glucose reader 80% 43,600
6.2 Diabetes related consumables for insulin pumps/Glucose Monitoring System/Glucose reader 80% 41,800 41,800
7. Smart Saver benefit
7.1 Health Risk Assessment 100% 1 050
7.2 Preventative Care incentives 100% 155 155
8. Roll-Over benefit 100% 6,310 1,620 1,620

  • 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 authorised 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-authorised travelling costs for specialist referrals in Namibia partly covered if residing more than 150km from Windhoek - accommodation included, limited to N$ 875 p/night, max of 2 nights p/family per annum.
  • No basic dentistry will be covered under the Oral Surgery benefit.
  • Intra ocular 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 specialities. Subject to available benefits.
  • A Smart Saver benefit is added to a family’s Accumulated Roll-Over benefit on completion of: (1) A Health Risk assessment by the principal member or an adult dependant at any of the Fund’s Wellness Days or at a qualifying pharmacy. (2) 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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