Platinum
starting from
N$ 3,402
per individual principal member
starting from
N$ 3,402
per individual principal member
Comprehensive benefits with a generous Overall Annual Limit and high day-to-day benefits. This benefit option is better suited to members whose health risk can best be described as moderate
For Employer Groups, all family members use principal member’s age category
For Individuals, all family members use the eldest member’s age category
| Age | Principal Member |
Adult/ Special dep |
Child dep |
|---|
| Age | Principal Member |
Adult/ Special dep |
Child dep |
|---|
The Platinum benefit option offers comprehensive benefits for both major and day-to-day medical expenses. The Platinum benefit option is ideal for members wishing to enjoy comprehensive cover for their medical expenses. With a generous Overall Annual Limit and high day-to-day benefits, this benefit option is better suited to members whose health risk can best be described as moderate
Please note: All services are paid at 100% of the NAMAF benchmark tariff, unless indicated to the contrary.
For diligent management of your healthcare expenditure:
| Principal | N$ 6,040.00 |
| Adult/Special dependant | N$ 1,550.00 |
| Child | N$ 1,550.00 |
| 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 | 200 % | – | – | – | – |
| 1.2 | Procedures: In-hospital | 200 % | – | – | – | – |
| 2. | Chronic Medication | – | 19,100 | – | 35,200 | – |
| 2.1 | Chronic approved – Min levy of N$30: Subject to prior registration | 80 % | – | – | – | – |
| 3. | Hospital services | – | – | – | – | SPA |
| 3.1 | Accommodation and theatre | 100 % | – | – | – | – |
| 3.2 | Blood transfusions | 100 % | – | – | – | – |
| 3.3 | Dialysis | 100 % | – | – | – | – |
| 3.4 | Medication | 100 % | – | – | – | – |
| 3.5 | Accommodation in private wards | 100 % | 17,400 | – | 35,100 | – |
| 3.6 | Accommodation other than a recognised hospital or medical institution: SA only | 100 % | – | – | 835 per day | – |
| 3.7 | Appliances and prosthesis: Surgical | 100 % | 69,200 | – | 82,700 | – |
| 3.8 | Refractive surgery: Full procedure – A waiting period of 12 months will apply | 100 % | 25,000 | – | 32,900 | – |
| 3.9 | Organ transplants: Full procedure | 100 % | – | – | 344,000 | – |
| 3.10 | Private nursing | 100 % | 51,800 | – | 51,800 | – |
| 3.11 | Oncology | 100 % | – | – | 650,000 | – |
| 4. | Radiology | – | – | – | – | SPA |
| 4.1 | Radiology: Specialised MRI and CT scans in-and-out of hospital combined | 100 % | – | – | 37,800 | – |
| 4.2 | Basic radiology: In-hospital | 100 % | – | – | – | – |
| 5. | Pathology | – | – | – | – | – |
| 5.1 | Pathology: In-hospital | 100 % | – | – | – | – |
| 6. | Dentistry | – | – | – | – | SPA |
| 6.1 | Oral surgery: Full procedure | 100 % | – | – | 60,400 | – |
| 6.2 | Maxillo facial surgery: Non-elective only | 100 % | – | – | – | – |
| 6.3 | Dental implants | – | – | – | – | OAL |
| 6.4 | Hospitalisation | 100 % | – | – | 14,300 | – |
| 6.5 | Implant: Consultation, procedure and cost | 100 % | – | – | 16,200 | N$ 4,220.00 per implant |
| 7. | Psychiatric treatment | – | 28,900 | – | 52,600 | 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 | – | – | 54,800 | – | OAL |
| 10.1 | HIV/AIDS: Including the cost of pathology tests | 100 % | – | – | – | SPA |
| 10.2 | Sexually transmitted diseases | 100 % | 5,160 | – | 6,880 | 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 % | 4,920 | 4,920 | – | – |
| 11.4 | Other transportation | 80 % 1st transfer or subsequent | – | – | – | – |
| 12. | Artificial limbs and eyes | – | – | – | – | SPA |
| 12.1 | Artificial limbs | 100 % | – | 49,800 | – | – |
| 12.2 | Artificial eyes | 100 % | – | 25,000 | – | – |
| 13. | Heart surgery rehabilitation | 100 % | – | – | 19,900 | OAL |
| 14. | Insertion Mirena Device: All Inclusive – Every 3 years | 100 % | – | 7,080 | – | OAL |
| 15. | Stoma Care products | 100 % | – | – | 33,200 | 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 | – | 14,600 | 3,350 | – | – |
| 1.1 | Consultations or visits: Out-of-hospital | 100 % | Unlimited, max 5 virtual GP consultations | Unlimited, max 5 virtual GP consultations | – | – |
| 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 | – | 10,400 | 2,570 | – | – |
| 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 % | 1,710 | 285 | – | 245 per claim |
| 2.1.4 | Vitamins, homeopathic and phytotherapy medication – Min levy of N$30 | 80 % | 820 | 240 | – | 245 per claim |
| 2.2 | Chronic medicine | – | – | – | – | – |
| 2.2.1 | Chronic approved: Subject to prior registration – Min. levy of N$ 30 | – | – | – | – | – |
| 3. | Dentistry | – | 15,900 | – | 28,900 | – |
| 3.1 | Basic dentistry: Subject to sub-limit | 100 % | 8,660 | 1,990 | – | – |
| 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 – 5.3 | Refer to OAL – 5.3 | Refer to OAL – 5.3 | – |
| 4. | Optical | – | 5,820 | 1,450 | – | – |
| 4.1 | Eye tests | 100 % | – | – | – | – |
| 4.2 | Spectacles and lenses: Frames every 2nd year | 100 % | – | – | – | Frame limit to N$ 2,070 |
| 4.3 | Orthoptics | 100 % | – | – | – | – |
| 5. | Auxiliary services | – | 17,700 | 5,690 | – | – |
| 5.1 | Chiropody | 100 % | – | 15 visits | – | – |
| 5.2 | Clinical psychology | 100 % | – | 15 visits | – | – |
| 5.3 | Dietician | 100 % | – | 15 visits | – | – |
| 5.4 | Homeopathy: Consultation only | 100 % | – | 15 visits | – | – |
| 5.5 | Occupational therapy | 100 % | – | 15 visits | – | – |
| 5.6 | Social workers | 100 % | – | 15 visits | – | – |
| 5.7 | Appliances: Non-surgical | 100 % | – | – | – | SPA |
| 5.8 | Physiotherapy | 100 % | – | 15 visits | – | – |
| 5.9 | Biokinetics | 100 % | – | 15 visits | – | – |
| 5.10 | Audiology and speech therapy | 100 % | – | 15 visits | – | – |
| 5.11 | Chiropractic | 100 % | – | 15 visits | – | – |
| 5.12 | Podiatry | 100 % | – | 15 visits | – | – |
| 6. | Diabetic devices benefit | – | – | – | – | OAL |
| 6.1 | Insulin Pumps/Glucose Monitoring System/Glucose reader | 80% | – | – | 41,700 | – |
| 6.2 | Diabetes related consumables for insulin pumps/Glucose Monitoring System/Glucose reader | 80% | 40,000 | 40,000 | – | – |
| 7 | Smart Saver benefit | – | – | – | – | – |
| 7.1 | Health Risk Assessment | 100% | – | – | 1,000 | – |
| 7.2 | Preventative Care Incentives | 100% | 150 | 150 | – | – |
| 8 | Roll-Over Benefit | 100% | 7,990 | 2,040 | 2,040 | – |
by V5 Digital in sunny Namibia. Proudly powered by 