Silver - All Benefits Options | Namibia Health Plan

About Silver

NHP Silver is the perfect package for comprehensive cover and day-to-day benefits. With this option, you can choose how to allocate an annual amount for day-to-day expenses. This benefit option is best suited for those whose health risk can be described as low.

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 3,049 2,057 1,100
26-30 3,355 2,388 1,100
31-35 3,768 2,792 1,100
36-40 4,215 3,117 1,100
41-45 4,584 3,523 1,100
46-50 4,912 3,789 1,100
51-55 5,141 4,031 1,100
56-60 5,700 4,361 1,100
61-65 6,026 4,755 1,100
66+ 6,467 4,940 1,100
Age Principal Member Adult / Special dep Child dep
0-25 2,767 1,709 914
26-30 2,980 2,011 914
31-35 3,289 2,096 914
36-40 3,588 2,304 914
41-45 3,962 2,604 914
46-50 4,219 2,792 914
51-55 4,448 3,140 914
56-60 4,831 3,343 914
61-65 5,182 4,052 914
66+ 5,769 4,256 914
Principal Adult/Special dependant Child
4,620 950 950

Example Roll-over Benefit: (Principal member + spouse + two children) = N$ 7,470.00 per year.

Downloads

Employer Group Application Form Membership Application Form

OAL = Overall Annual Limit
SPA = Subject to pre-authorisation

Major Medical Benefits NAMAF tarriff Overall Annual Limit (OAL): Unlimited
Main member N$1,555,500
Total family benefit N$2,210,366
1 Hospital services - SPA
1.1 Consultations: In-hospital - Healthcare providers & medical specialists 150%
1.2 Procedures: In-hospital 150%
1.3 Accommodation and theatre 100%
1.4 Accommodation: Private wards 100% Main Member N$13,720
Total Family benefit N$26,895
1.5 Accommodation in SA - non-registered hospital or medical institution 100% N$953 per beneficiary per day
1.6 Medication 100%
1.7 Blood transfusions 100%
1.8 Dialysis 100%
1.9 Appliances and prosthesis: Surgical 100% Main Member N$61,084
Total Family benefit N$70,557
1.10 Refractive surgery: Full procedure - 12 month waiting period applies 100% Main Member N$12,444
Total Family benefit N$15,037
1.11 Pathology: In-hospital 100%
1.12 Organ transplants: Full procedure 100% N$131,751 per family
1.13 Private nursing 100% N$37,044 per family
1.14 Oncology 100% N$701,219 per family
1.15 Post- hospitalisation: Related consults and treatment - 30 days after discharge 100%
2 Chronic medicine
2.1 Chronic approved medicine: Reference pricing applies
Subject to prior registration on chronic care programme
100% Main Member N$9,820
Total Family benefit N$15,451
3 Radiology
3.1 MRI / CT / PET scans - In or out of hospital SPA 100% N$25,370 per family
3.2 Basic Radiology & ultrasound: In-hospital 100%
4 Dentistry - SPA
4.1 Oral surgery - all-inclusive benefit 100% N$60,97 6per family
4.2 Maxillo-facial surgery: Non-elective only 100%
4.3 Dental Implants: In or out of hospital 100%
4.3.1 - Hospitalisation 100% Subject to Advanced dentistry - Day-to-Day
4.3.2 - Implant: Consultations, Procedure and implant costs 100% Subject to Advanced dentistry - Day-to-Day
5 Mental Health treatment - all-inclusive benefit - SPA
5.1 Mental health hospitalisation or institutionalisation 100% Main Member N$30,592
5.2 Alcohol & drug rehabilitation - in and out of hospital 100% Total Family benefit N$49,978
6 Maternity & Infant
6.1 Confinement: all inclusive: NVD: 3 days; C/S / elective C/S: 4 days, SPA 100% General ward
6.2 Antenatal consultations: Gynae / obstetrician / GP or midwife 100% 12 per family
6.3 Sonar scans 100% 2 - 2D per pregnancy
6.4 Amniocentesis SPA 100% 1 per pregnancy
6.5 Panorama Prenatal test SPA 100% 1 per pregnancy
6.6 Pathology tests - standard antenatal blood & urine tests 100%
6.7 Infant hearing screening test 100% 1 test up to 8 weeks old with audiologist
6.8 Vision screening for premature neonates if born <1.5kg or <33 weeks gestation 100% 2 tests
6.9 Congenital hypothyroidism screening 100% 1 test for infants < 1 month old
6.10 Post-natal consultations 100% 1 obstetrician / GP &
2 midwife visits within 8 weeks of delivery
7 Childhood
7 Childhood
7.1 Childhood immunisations up to 10 years of age - per EPI schedule 100% Subject to Preventative Care benefit
7.2 HPV Vaccine for girls 9 - 16 yrs 100% 2 doses per lifetime. Subject to Preventative Care benefit
8 Preventative care
8.1 Preventative Care benefits: As per list 100% Protocols & Sublimits apply
9 Specified illness conditions N$46,603 per beneficiary
9.1 HIV/AIDS: Consultations, medication & pathology tests SPA 100%
9.2 Sexually transmitted diseases 100% Main Member N$4,029
Total Family benefit N$5,325
10 Ambulance services: Medical or trauma emergencies - SPA
10.1 Emergency air evacuation 100%
10.2 Ambulance services 100%
10.3 Ambulance services: Inter-hospital transfer 100% N$5,597 per beneficiary
10.4 Other transportation 80%
11 Artificial limbs or eyes - SPA
11.1 Artificial limbs 100% N$32,339 per beneficiary
11.2 Artificial eyes 100% N$16,224 per beneficiary
12 Heart surgery: Rehabilitation 100% N$19,599 per family
13 Insertion Mirena Device: All Inclusive - Every 3 years 100% N$8,057 per beneficiary
14 Stoma Care products 100% N$37,783 per family
15 Back and Neck Rehabilitation Programme: Subject to DBC protocol 100%

OAL = Overall Annual Limit
SPA = Subject to pre-authorisation

Day-to-Day / Out-of-hospital Benefits NAMAF tarriff Sub-limits
TOTAL Family benefit: N$20,470
+ Per additonal dependant N$4,247
1 Healthcare providers & medical specialists
1.1 Consultations or visits: Out-of-hospital, including 5 VC per beneficiary 100%
1.1.1 Consultations or visits: Out-of-hospital: when 1.1 above depleted 100% 1 per beneficiary. Subject to registration on Chronic Care programme
1.2 Procedures: Out-of-hospital services 100%
1.3 Pathology & Basic Radiology / Ultrasound: Out-of-hospital 100%
1.4 Chronic Lifestyle disease extender - additional benefits for hypertension, cholesterol & type 2 diabetes - once respective benefits depleted SPA No benefit
2 Medicine and Injections
2.1 Acute medicines: reference pricing applies 80%
2.1.1 - Acute medicine: Doctor or Pharmacy dispensed - Min levy of N$ 30 80%
2.1.2 - Self-medication: Over-the-counter – No levy
subject to day-to-day limit
100% TOTAL Family benefit: N$1,318
+N$261 for each dependant.
N$278 per claim max
2.1.3 - Vitamins, homeopathic, Chinese medicine and phytotherapy medicines
Min levy of N$30, subject to day-to-day limit
80% TOTAL Family benefit: N$648
+ N$229 for each dependant.
N$278 per claim max
3 Dentistry Main Member N$11,324
Total Family benefit N$22,430
3.1 Basic dentistry: Subject to sub-limit 100%
3.2 Dental technicians 100%
3.3 Advanced dentistry & Orthodontics 100%
4 Optical TOTAL Family benefit: N$3,888
+N$975 for each dependant
4.1 Eye tests 100% Frame limited to N$1,492
4.2 Spectacles or lenses: Frames every 2nd year 100%
4.3 Orthoptics 100%
5 Auxiliary services
5.1 Audiology & speech therapy
Biokinetics
Chinese medicine & acupuncture visits
Chiropody
Chiropractic
Clinical psychology
Dietician
Homeopathy consultations
Naturopathy consultations
Occupational therapy
Physiotherapy
Phytotherapy consultations
Podiatry
Social workers
100% Subject to day to day limit
6 Appliances: External / Non-surgical SPA
6.1 Wheelchair - every 3 years 100% Main Member N$6,222
Total Family benefit N$9,333
6.2 Hearing aid - every 3 years 100% Main Member N$28,518
Total Family benefit N$42,776
N$14,259 per ear max
6.3 Other external appliances 100% Main Member N$5,185
Total Family benefit N$7,778
7 Smart Saver benefit
7.1 Health Risk Assessment 100% N$854 per family
7.2 Preventative Care Incentives N$114 per beneficiary

  • Flu vaccines are covered as part of the preventative care benefit.
  • 1 COVID-19 vaccine regimen per year are 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 2.1.3. above, without a prescription. NHP pays for contraceptives (oral and injections) limited to N$278 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$953 per night, maximum of 2 nights per family per annum.
  • No basic dentistry will be covered under the oral surgery benefit.
  • All day-to-day benefits are subject to availability of pooled Day-to-Day Expenses.
  • Intra ocular lenses included in Appliances and prosthesis surgical benefit - limited to N$7 622 per lens. Refer to 1.9.
  • Blood pressure monitor: N$881 per family every 3 years. Subject to registration on the Fund's chronic care programme.
  • Auxiliary services - Subject to day to day limit.
  • "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.

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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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