Appointed Medical Aid Fund | Company Profiles

Your health care, your choice

The Nammed Medical Aid Fund is taking the first bold steps towards implementing the Nammed 2025 project to simplify medical aid options in Namibia, as senior officer Gert Grobler told us.

Writer: Jack Salter | Project manager: Callam Waller

The 2025 Project is working to restructure the Named Medical Aid Fund (Nammed), to make it easy for everyone to choose the right option for their specific needs.

Gert Grobler, Senior Agent at Nammed, is part of a dedicated professional team responsible for providing health care and support to all residents of Namibia.

Following Namibia’s independence from neighboring South Africa in 1990, Nammed was established by the Namibian Agricultural Union to provide medical coverage to farmers in the South African country. South West, which previously belonged to a medical aid fund based in South Africa.

Since 1995, medical aid funds in Namibia such as Nammed have been operated under the regulatory authority of the Namibian Registry of Medical Aid Funds.

“With the establishment of the Namibia Financial Institutions Supervisory Authority (NAMFISA) in 2002, the regulatory framework changed and the Registrar of Medical Aid Funds was transferred to NAMFISA,” says Grobler.

NAMFISA has a number of statutory objectives in relation to Nammed and other medical aid funds, including protecting their interests and members, and monitoring their solvency and financial soundness.

Nammed is also an affiliate member of the Namibia Association of Medical Aid Funds (NAMAF), which was established to monitor, promote, encourage and coordinate the development of medical aid funds in Namibia. Through NAMAF, Grobler recognizes the urgent need to find innovative solutions that will curb the unsustainable rise in medical service costs.

“Personally, I am very concerned about the rising cost of all medical services, which could lead to general inaccessibility of medical aid funds and the total collapse of the medical aid financing industry with disastrous consequences in the near future,” he said.

“The increase in medical costs comes down to the use of technology, the cost of regulation, demand induced by providers and members, insufficient claims settlement by administrators, as well as fraud, waste and abuse.”

“Our members are not just a number; we see them as individuals and families whose health we truly care about”

Choice of options

Despite this stern warning, Nammed has gone from strength to strength over the years, today offering a range of quality and affordable medical aid options to its members across Namibia.

At one end, members of reasonably priced basic coverage have access to a network of contracted primary health care service providers; on the other hand, Comprehensive members benefit from the premium health care benefits associated with hospitalization and daily medical expenses, ideal for those who wish to cover their medical expenses as much as possible or those who have health risks. which can be perceived as high.

With other medical assistance options including Active, Core, Trauma, Essential and Standard coverage, Nammed caters to all individual health needs and financial means of its members, applying innovative and unique methods to ensure that their needs are met.

Members often believe they should purchase the maximum amount of coverage they can afford, with little or no consideration of the specific benefits of each assistance option for their actual medical needs.

With Nammed’s new Life Stages approach, however, choosing the right option is easy, as the options are tailored to different age groups and the health needs that typically correlate with those groups.

Active coverage, for example, is aimed at young people, singles or small families in good health, while the Essential Medical Assistance option is the ideal health solution for individuals or families between the ages of 26 and 55.

“Our current client base consists of large employer groups in the mining, insurance, finance and business sectors, as well as smaller groups of SMEs and individuals across the country,” says Grobler.

When it comes to members, two major factors give Nammed a competitive advantage in the market.

“Our members are not just a number; we see them as individuals and families whose health is truly important to us. We know them by name and our interaction with them is personalized.

“Named’s service to members and healthcare providers is second to none,” says Grobler.

“The Nammed 2025 project is geared towards a solution to the complexity of healthcare, as it aims to simplify Nammed’s offerings to the market”

Project named 2025

Optimizing the options offered based on well-documented market needs, the Nammed Board of Directors is making progress in implementing the Nammed 2025 project, to meet the challenges facing the medical aid industry and to ensure the sustainability of the fund.

The Board, led by Chairman, PD Theron, is responsible for making the informed decisions necessary to ensure the fund is seen as a trusted name in healthcare across Namibia.

The trustees undertook a comprehensive strategic planning process when designing the Named 2025 project to ensure that the fund remains relevant and competitive, reflecting the determination and commitment of the entire board to meet the needs of the fund .

Thus, the overall objective of the Named 2025 project is for the organization to be competitive in different market segments, namely the basic, low, medium and high coverage markets.

Nammed’s Standard and Complete options are highly competitive in the high coverage market, while Essential coverage is on par with the medium to high offerings of other medical aid funds. But in order to increase its competitiveness, Nammed embarked on a process of designing and redesigning options, informed by research findings on Namibians’ income levels and healthcare needs.

Of the seven Medical Aid options currently offered by Nammed, the Option Consolidation Project will narrow and simplify this selection to four or five by 2025, with the consolidation of Core and Active options being the first step.

“Our market research has shown that the biggest challenge for the public is the complexity of the different product offerings in the market. They find it very difficult to compare different options and make the right choice,” notes Grobler.

“The Nammed 2025 project is geared towards a solution to the complexity of healthcare, as it aims to simplify Nammed’s offerings to the market.”

Transparency is essential for Nammed in delivering the benefits of its medical aid options, as the fund wants members to fully understand what they are receiving with their chosen coverage.

As part of the Nammed 2025 project, the fund is also restructuring the base option for the low-income market, as well as exploring a possible name change.

Meanwhile, Nammed has identified a gap in the mid-to-low market, presenting a value opportunity to increase competitiveness as options are restructured.

Nammed already offers very competitive contribution rates on all options for groups of more than 200 people, but the feasibility of offering the same contributions to groups of more than 100 people is also under study, alongside efforts in courses to attract young people to the Trauma option, which is ideal for members wishing to cover hospitalization costs only.

In addition to the Nammed 2025 project, which aims to grow the fund as quickly as possible, the Nammed board has approved a new branding strategy for the fund, which will be implemented from 2022.

“The new brand strategy is very exciting, it will definitely change the current landscape in which we operate and I really look forward to it,” adds Grobler.

“To position the fund to execute these strategies, we will be recruiting a Stakeholder Relations Manager, a Marketing Assistant and a short-term marketing consultant to augment the fund’s human capacity for the tasks ahead.”

COVID-19 support

In line with Namibia’s national targets to fight COVID-19, Nammed will continue to fund tests, vaccinations and other treatments that members may need during the pandemic.

This follows a reduction in the number of claims suffered by the fund, mainly due to blockages and limited access to facilities for elective procedures, in a year characterized by circumstances never seen before in history. of Namibia.

“The country experienced a very severe wave of COVID-19 infections between May and July 2021,” Grobler shares.

“Nammed ensured access to medical services for members and supported healthcare providers by adapting its interpretations of the rules to better respond to the crisis situation.”

With members increasingly aware of their healthcare as a result of the COVID-19 pandemic, Nammed’s informed choice of medical aid options is more important than ever.