Blue Diamond

starting from

N$ 687

per individual principal member

Help me choose

Applying as
Principal Member Age
Spouse Age
How many children
family peace of mind

Unlimited cover for day-to-day primary care services as long as you use the designated service provider facilities

For Employer Groups, all family members use principal member’s age category

For Individuals, all family members use the eldest member’s age category

Contributions for employer group
Age Principal
Special dep
Contributions for individual members
Age Principal
Special dep

The Blue Diamond benefit option provide affordable primary healthcare services to the lower income group who previously have not had access to subsidised private healthcare. This benefit option focuses on providing treatment and services falling within the scope and context of primary healthcare. If you are a member of this benefit option, you have direct access to a network of contracted general practitioners and registered nurses and to ensure the quality of care provided. The Fund assumes direct responsibility for the network. Blue Diamond provides unlimited cover for day-to-day primary care services as long as you use the designated service provider facilities.

Blue Diamond benefits are not pro-rated with the exception of the optical and dental benefits where sub-limits are applicable.

Please 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 options as your choice of general practitioner, nurse and healthcare facility is restricted.

  • In-hospital & out of hospital services
  • Confined to designated service providers
  • Ambulance services
  • Maternity
  • Back and Neck rehabilitation programme
  • Acute and chronic medicine
  • Primary care dentistry
  • Radiology & Pathology
  • Optical
  • HIV/Aids treatment
NAMAF tarriff or % thereof Principal Member Per Additional Beneficiary Per Family Conditions
Overall Annual Limit Unlimited
1. Doctors and Specialists SPA
1.1 Consultations and visits: In-hospital 100 % Max 5 virtual GP consultations Max 5 virtual GP consultations
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 %
2.3 Routine and scheduled and hospitalisation events 100 %
2.4 Ward Fees 60 %
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 % 4,920 4,920
3.4 Other transportation No Benefit
4. Maternity SPA
4.1 When you are pregnant, you can go visit 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 Subject to DBC protocol Subject to DBC protocol OAL
6 Preventative care 100 % OAL
6.1 Vaccinations: COVID-19 100%
6.2 Health Risk Assessment 100%
NAMAF tarriff or % thereof Principal Member Per Additional Beneficiary Per Family Conditions
Out-of-hospital: Sub-limit
1. Doctors and specialists DSP
1.1 Consultations or visits: Obtained from certain doctors, during normal working hours – N$ 15 per visit 100 %
1.1.1 Nurse: New conditions – N$15 per visit
1.1.2 General practitioner: Unlimited consultations at certain doctors – N$ 15 per visit: Ned Conditions 380 per visit
1.1.3 Medical specialist: Upon referral from doctor – N$15 per visit
1.1.4 Medical specialist: Travel assistance benefit to Windhoek or Swakopmund (Limited to 2 visits per family per year) 730 per visit
1.2 Out-of-hospital services 100 %
1.3 Limited to 2 after-hour consultations at certain doctors: Per family per year 100 %
2. Medicine and injections Unlimited DSP
2.1 Acute Medicine
2.1.1 As dispensed or prescribed by certain doctors and pharmacies: Subject to the formulary 100 % 230 per script
2.1.2 Self-medication: Over-to-counter 100 % 825 235 per claim
2.2 Antiretroviral therapy: Dispensed – Patient needs to enrol in the AFA Programme 100 %
2.3 Chronic Medicine
2.3.1 Chronic Medicine: Dispensed – As per chronic medicine formulary: Subject to prior registration 100 % 3,780
3. Primary care dentistry: N$ 15 per visit – New conditions 1,760 3,510 DSP
3.1 Subject to use of certain dentists: According to a list of approved dentist codes 100 %
3.1.1 Plastic dentures: Limited to 1 set per family per 24 months
3.1.2 Consultants, primary extractions, fillings level 1 to 3, fluoride treatment, instructions on oral hygiene scaling and polishing.
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: New conditions – N$15 per visit 1030 DSP
6.1 Optical Tests 100 % Limited to 105
6.2 Spectacles and lenses: Limited to 1 pair of glasses per family per 24 months – When joining NHP, you cannot claim for glasses for the first 6 months 100 % Claim limited to N$ 925
7. Mother and child healthcare services DSP
7.1 Family planning, immunisations, pre- and post- antenatal care 100%
8. Counselling and health education DSP
8.1 Instruction on 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 Counselling and testing, Prophylactic medicine for prevention of HIV virus, transmission in the case of needle-prick, rape or infection of mother (mother-to-child prevention) 100 % Unlimited
9.2 Sexually transmitted diseases 100 % 1,510
10 Rehabilitation of alcohol and drug addiction or abuse 100 % 1,510 DSP
  • 1 COVID-19 vaccine regimen per year are covered as part of the preventative care benefit for all beneficiaries older than 16 years.
  • Travel assistance for specialist visits in Namibia only, limited to 2 per family per year.
  • International travel benefit.
  • NHP pays for contraceptives (oral and injections) limited to N$235 per claim.
  • Immunisations are only available from designated service providers, subject to the formulary.
  • Members do not qualify for the Lifestyle Programme.
  • 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.