| | 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 | 225 % | - | - | - | - |
1.2 | Procedures: In-hospital | 225 % | - | - | - | - |
2. | Chronic Medication | - | 29,600 | 59,800 | - | - |
2.1 | Chronic approved - Min levy of N$30: Subject to prior registration | 80 % | - | - | - | - |
3. | Hospital services | - | - | - | - | SPA |
3.1 | Accommodation and theatre | 100 % | - | - | - | - |
3.2 | Blood transfusions | 100 % | - | - | - | - |
3.3 | Dialysis | 100 % | - | - | - | - |
3.4 | Medication | 100 % | - | - | - | - |
3.5 | Accommodation in private wards | 100 % | 25,000 | - | 50,400 | - |
3.6 | Accommodation other than a recognised hospital or medical institution: SA only | 100 % | - | - | 750 per day | - |
3.7 | Appliances and prosthesis: Surgical | 100 % | 69,400 | - | 112,000 | - |
3.8 | Refractive surgery: Full procedure - A waiting period of 12 months will apply | 100 % | 29,800 | - | 36,800 | - |
3.9 | Organ transplants: Full procedure | 100 % | - | - | 594,000 | - |
3.10 | Private nursing | 100 % | 67,300 | - | 67,300 | - |
3.11 | Oncology | 100 % | - | - | 740,000 | - |
4. | Radiology | - | - | - | - | SPA |
4.1 | Radiology: Specialised MRI and CT scans in-and-out of hospital combined | 100 % | - | - | 37,200 | - |
4.2 | Basic radiology: In-hospital | 100 % | - | - | - | - |
5. | Pathology | - | - | - | - | - |
5.1 | Pathology: In-hospital | 100 % | - | - | - | - |
6. | Dentistry | - | - | - | - | SPA |
6.1 | Oral surgery: Full procedure | 100 % | - | - | 60,800 | - |
6.2 | Maxillo facial surgery: Non-elective only | 100 % | - | - | - | - |
6.3 | Dental implants | - | - | - | - | OAL |
6.4 | Hospitalisation | 100 % | - | - | 16,100 | - |
6.5 | Consultation, procedure and cost of implants | 100 % | - | - | 17,400 | N$ 3,470 per implant |
7. | Psychiatric treatment | - | 32,200 | - | 59,500 | 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 | - | - | 49,500 | - | OAL |
10.1 | HIV/AIDS: Including the cost of pathology tests | 100 % | - | - | - | SPA |
10.2 | Sexually transmitted diseases | 100 % | 6,220 | - | 8,350 | 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 % | 4,440 | 4,440 | - | - |
11.4 | Other transportation | 80 % 1st transfer and subsequent | - | - | - | - |
12. | Artificial limbs and eyes | - | - | - | - | SPA |
12.1 | Artificial limbs | 100 % | - | 64,300 | - | - |
12.2 | Artificial eyes | 100% | - | 25,700 | - | - |
13. | Heart surgery rehabilitation | 100 % | - | - | 21,500 | OAL |
14. | Insertion Mirena Device: All Inclusive - Every 3 years | - | - | 6,400 | - | OAL |
15. | Stoma Care products | 100 % | - | - | 30,000 | OAL |
16. | Back and Neck Rehabilitation Programme | 100 % | Subject to DBC protocol | Subject to DBC protocol | Subject to DBC protocol | OAL |