The Public Service Employee Medical Aid Scheme (Psemas) now covers the majority of the cost of a Covid-19 test, in fact up to 95% of the tariff, if a member is booked for surgery.
However, the fund will not cover routine tests, such as suspected contact cases and people showing symptoms.
This is according to Ministry of Finance spokesperson, Tonateni Shidhudhu, who told New Era that a stakeholders meeting on the subject took place yesterday afternoon.
“The Psemas coordinating meeting is taking place this afternoon (yesterday). The committee is made up of executive directors from the Ministry of Health and Social Services and Ministry of Finance, assisted by a technical team. They are the ones who approve all the changes that have to be done,” said Shidhudhu.
The decision to cover the virus tests were communicated by the finance ministry’s Executive Director, Ericah Shafudah, after private health facilities insisted on patients being tested for Covid-19 before any surgery could be performed. In a letter to the Psemas’ administrator CEO Florian Amulungu, Shafudah “authorised the cost of the Covid-19 test to be covered” on 95% of the tariff.
This means that at PathCare, where a Covid-19 test costs N$807.50, a Psemas member will have to pay N$42.50 and at the Namibian Institute of Pathology a member will have to pay N$27.50 while the full price is N$522.50.
Psemas, at over 290 000 members, currently has more members than private medical aids who only have about 202 000 beneficiaries primarily managed by five separate administrators.
The public servant’s medical aid fund has received about N$7 billion from government since 2016 and sits on an annual budget of more than N$2 billion. In 2016, the fund received N$2.2 billion, N$2.5 billion in 2017, and N$2.5 billion in 2018.
In June 2018, Psemas embarked on a verification process to mitigate skyrocketing expenses that saw it trim its beneficiaries by over 17 000 over-aged dependants. Government policy considers a dependant to be over-aged once they reach the age of 21 but this limit can be lifted to 25 when dependants are studying.
Psemas members contribute in a ‘standard class’ at N$120 for the main member and N$60 for every dependant, and ‘high class’ at N$240 plus N$120 per dependent.
In a report on Psemas, the International Monetary Fund had suggested government considers linking workers’ contributions to their salaries.
“Improve forecasting of the cost of future benefits, and budget for it accordingly. Include a provision in the budget to manage unanticipated costs,” read the IMF report.
– ebrandt@nepc.com.na