What can I use my Roll-Over benefits for?

Whilst being a member of NHP, any positive balance accumulated in their Roll-Over benefit account can pay for:

  • Routine medical costs.
  • Outstanding member’s portions.
  • Treatment normally excluded from your benefits.
  • Medical expenses with a valid chargeable Tariff or Nappi Code which are usually excluded by the Fund. These medical services must be provided by a registered healthcare provider.
  • The difference between the actual medical costs and the NAMAF benchmark tariff for medical services covered by the rules of the Fund.
  • Medical aid contributions.
  • Claims in respect of benefits for sickness conditions, medical procedures or medicines excluded (Including exclusions from the Optical and Dental benefits) may be paid from a positive balance on the accumulated Roll-Over benefit.
  • Medical expenses in respect of new dependants where a waiting period may apply. Claims not eligible for payment from the Roll-Over benefit:
  • Non-medical expenses without a valid chargeable code and Nappi code which is not rendered by a registered healthcare provider.
  • Any medical or non-medical expenses claimed for beneficiaries not actively registered as dependants of the main member.
  • Green Cross shoes.
  • Sunglasses, whether or not prescribed by a registered optometrist or ophthalmologist

 

Claims for conditions, procedures or medicines excluded by the Rules, including exclusions from optical and dental benefits may be paid from the balance of your Roll-Over Benefit.

Attach proof of purchase and the payment will be reimbursed from the Roll-Over Benefit account. Payments made from the Roll-Over Benefit will not accumulate towards reducing the next year’s Roll-Over Benefit.

Any non-medical expenses without a valid chargeable Nappi Code which are not provided by a registered healthcare provider will not qualify for benefits under the accumulated Roll-Over Benefit.