Silver
starting from
N$ 2,529
per individual principal member
starting from
N$ 2,529
per individual principal member
Members can choose how to allocate an annual amount for day-to-day expenses. This benefit option is best suited to members whose health risk can be described as low
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 Silver benefit option offers reasonably priced, yet comprehensive benefits for both major and pooled day-to-day medical expenses. The Silver benefit option offers an annual monetary amount allowing members to choose how to allocate these funds for day-to-day expenses. This benefit option is best suited to members whose health risk can be described as low.
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$ 4,070.00 |
| Adult/Special dependant | N$ 840.00 |
| Child | N$ 840.00 |
| NAMAF tarriff or % thereof | Principal Member | Per Additional Beneficiary | Per Family | Conditions | ||
| Overall Annual Limit | 1,220,000 | 1,940,000 | ||||
| 1. | Healthcare provider and medical specialists | – | – | – | – | SPA |
| 1.1 | Consultations and visits: In-hospital | 200 % | – | – | – | – |
| 1.2 | Procedures: In-hospital | 200 % | – | – | – | – |
| 2. | Chronic Medication | – | 9,060 | – | 14,300 | – |
| 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 % | 12,100 | – | 23,600 | – |
| 3.6 | Accommodation other than a recognised hospital or medical institution: SA only | 100 % | – | – | 835 per day | – |
| 3.7 | Appliances and prosthesis: Surgical | 100 % | 53,700 | – | 62,000 | – |
| 3.8 | Refractive surgery: Full procedure – A waiting period of 12 months will apply | 100 % | 7,110 | – | 9,250 | – |
| 3.9 | Organ transplants: Full procedure | 100 % | – | – | 116,000 | – |
| 3.10 | Private nursing | 100 % | 28,100 | – | 28,100 | – |
| 3.11 | Oncology | 100 % | – | – | 616,000 | – |
| 4. | Radiology | – | – | – | – | SPA |
| 4.1 | Radiology: Specialised MRI and CT scans in-and-out of hospital combined | 100 % | – | – | 22,300 | – |
| 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 % | – | – | 53,600 | – |
| 6.2 | Maxillo facial surgery: Non-elective only | 100 % | – | – | – | – |
| 6.3 | Dental implants | – | – | – | – | – |
| 6.4 | Hospitalisation | 100 % | Subject to Advanced Dentistry – Day-to-Day | Subject to Advanced Dentistry – Day-to-Day | Subject to Advanced Dentistry – Day-to-Day | – |
| 6.5 | Consultation, procedure and cost of implants | 100 % | Subject to Advanced Dentistry – Day-to-Day | Subject to Advanced Dentistry – Day-to-Day | Subject to Advanced Dentistry – Day-to-Day | – |
| 7. | Psychiatric treatment | – | 23,700 | – | 43,900 | 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 | – | – | 41,000 | – | OAL |
| 10.1 | HIV/AIDS: Including the cost of pathology tests | 100 % | – | – | – | SPA |
| 10.2 | Sexually transmitted diseases | 100 % | 3,540 | – | 4,680 | 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 and subsequent | – | – | – | – |
| 12. | Artificial limbs and eyes | – | – | – | – | SPA |
| 12.1 | Artificial limbs | 100 % | – | 28,400 | – | – |
| 12.2 | Artificial eyes | 100 % | – | 14,300 | – | – |
| 13. | Heart surgery rehabilitation | 100 % | – | – | 17,200 | 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 | 18,000 | 3,700 | ||||
| 1. | Healthcare provider and medical specialists | – | – | – | – | OAL |
| 1.1 | Consultations or visits: Out-of-hospital | 100 % | Max 5 virtual GP consultations | 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 | No benefit | – | – | – | – |
| 2. | Medicine and injections | – | – | – | – | – |
| 2.1 | Acute medicine | – | – | – | – | – |
| 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 % | 1,160 | 230 | – | 245 per claim |
| 2.1.4 | Vitamins, homeopathic and phytotherapy medication – Min levy of N$30 | 80 % | 570 | 200 | – | 245 per claim |
| 3. | Dentistry | – | 9,980 | – | 19,700 | – |
| 3.1 | Basic dentistry: Subject to sub-limit | 100 % | – | – | – | – |
| 3.2 | Dental technicians | 100 % | – | – | – | – |
| 3.3 | Advanced dentistry | – | – | – | – | – |
| 3.3.1 | Orthodontics | 100 % | – | – | – | – |
| 3.3.2 | Dental Implants: Full procedure | 100 % | – | – | – | – |
| 4. | Optical | – | 3,420 | 855 | – | – |
| 4.1 | Eye tests | 100 % | – | – | – | – |
| 4.2 | Spectacles and lenses: Frames every 2nd year | 100 % | – | – | – | Frame limit to N$ 1,310 |
| 4.3 | Orthoptics | 100 % | – | – | – | – |
| 5. | Auxiliary services | – | – | – | – | – |
| 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 | Smart Saver benefit | – | – | – | – | – |
| 6.1 | Health Risk Assessment | 100% | – | – | 750 | – |
| 6.2 | Preventative Care Incentives | 100% | 100 | 100 | – | – |
| 7 | Roll-Over Benefit | 100% | 4,070 | 840 | 840 | – |
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