Linea Dishena

The finance ministry says civil servants will continue paying thousands of dollars for uncontracted specialist medical care until the government completes the reform of the Public Service Medical Aid Scheme (Psamas).

This is in a bid to align it with the current Namibia Association of Medical Aid Fund (Namaf) tariffs.

Civil servants are requested to pay upfront for out-of-hospital treatment from specialists, and claim from Psemas upon providing proof of services rendered. 

Spokesperson of the finance and public enterprises ministry Wilson Shikoto noted that most specialists are not contracted with Psemas. Only in-patient hospital care with contracted specialists charges align with Psemas tariffs.

Namaf has provided the standard benchmark tariffs for 2023. 

However, Psemas charges are aligned with the Namaf 2013/2014 tariffs plus 20% markup. 

He said that alignment to current industry standards is being addressed under the Psemas reforms, which are underway.

“Members are encouraged to seek medical services from providers who are contracted with Psemas. These service providers will claim directly from Psemas. The only upfront payment required from members in such cases is a 5% co-payment,” he highlighted.

He, however, warned that members who opt to seek services from non-contracted providers must make a full upfront payment.

 They can later claim reimbursement from Psemas.

Currently, civil servants have two options. 

For the high option, main members pay N$240 per month and N$120 for each dependent.

 The standard option costs N$120 for the main member and N$60 for dependents.

Shikoto said Psemas membership stands at 291 243. 

The ministry received queries and complaints on the issue, totalling 165 000 and 95 000 during the 2023/24 and 2024/25 financial years, respectively.

He revealed that the government has spent N$3.34 billion during the 2023/24 financial year.

The scheme remains one of the most generous medical funds available to members, as their contributions are significantly lower, compared to market-related rates.

“The ministry is aware of the high costs associated with healthcare in general. However, the government is committed to assisting its employees with the cost of medical care and their dependents, hence the scheme pays 95%, while members contribute only 5%,” he pointed out.