Patience Makwele
The Namibia Health Plan (NHP) says it remains committed to complying with the Financial Institutions and Markets Act (Fima) while stabilising operations following challenges linked to its transition to a new managed care service provider. Fima came into operation at the beginning of this month.
NHP hosted two virtual engagement sessions on Monday with members and healthcare providers to address concerns surrounding the transition, which started on 1 April 2026.
The sessions brought together the board of trustees, members and healthcare practitioners to discuss service delivery challenges and measures being introduced to improve operations.
The transition has resulted in disruptions to claims processing and administrative delays affecting some healthcare providers and employer groups.
NHP board chairperson Sabrina Jacobs said the fund remains focused on maintaining access to healthcare services during the transition period.
“We would like to assure you from the outset that the fund management and the service providers are actively working towards stability. Our vision and mission remain the same, as we continue striving to provide access to quality healthcare for our members,” Jacobs said.
She said the transition forms part of efforts to strengthen managed healthcare services and improve the long-term sustainability of the fund.
Jacobs said NHP will continue aligning with regulatory requirements under Fima while implementing the new healthcare management structure.
“We will continue to work with the managed care service provider to ensure that the coding alignment remains aligned to Namaf. The fund will continue to adhere to regulatory changes such as Fima, and the fund will ensure compliance while we continue transitioning towards implementation,” she said.
NHP acknowledged that members and healthcare providers experienced delays during the implementation phase, including challenges with claims processing.
According to the fund, corrective measures have been introduced under executive and governance oversight to improve turnaround times and stabilise operations.
NHP also highlighted benefit changes introduced for the 2026 benefit year.
Jacobs said the fund implemented a 3.5% premium increase across most benefit options, which she described as the lowest increase since 2008, while the Blue Diamond option recorded no increase.
She said reimbursement for chronic medication has been increased to 100% for members registered on the Chronic Care Programme.
Private nursing and home-based care benefits were also increased by 20% across all options.
NHP further expanded preventative healthcare screening benefits by lowering the mammogram screening age from 50 to 40 years, with screenings now available every two years.
Jacobs said the changes are aimed at improving preventative healthcare and encouraging early detection.
NHP principal officer Dantago Garosas said healthcare benefits and member contributions remain unchanged during the transition period.
“All existing benefits remain the same during this transition. There are no changes to cover or contributions. Fund rules, benefit options, benefit limits, and member contributions remain unchanged,” Garosas said.
She said the disruptions experienced were administrative and did not affect healthcare cover.
“The disruptions experienced are administrative only. The challenges experienced do not relate to benefit reductions or amendments. Members remain fully covered in line with their existing benefit option and fund rules,” she said.
Garosas said the move to transfer managed care and claims-assessing services to Universal Health Care followed a governance-led process aimed at improving accountability and healthcare management.
“While the transition brought early operational challenges, no benefits were reduced, and continuity of care remained the priority. This was a journey of responsibility, not reaction, guided by governance, transparency and a commitment to protecting members’ healthcare cover now and into the future,” she said.
The fund said members and healthcare providers were given an opportunity to engage directly with trustees, raise concerns, and receive feedback on the implementation process and ongoing interventions.
