12 October 2012

Namibia: Medical Funds Rebuff Group Therapy

PRIVATE social worker Maryn Barkhuizen has made an appeal to employers to push medical aid funds to pay for holistic group therapy.

According to Barkhuizen, medical aid funds have so far been reluctant to pay for group therapy, despite the fact that it is cheaper than individual psychotherapy.

The Namibian benchmark tariff for services by social workers, which came into effect in January, is N$289.30 per hour. The tariff for group therapy is N$102.80 per hour per person.

Barkhuizen provides psycho-social and theological counselling and offers play therapy. From next year, she intends to use group therapy to roll out her "self-image and physical health group work" to medical aid fund members.

She said the programme would provide participants with knowledge of their bodies, soul or psyche and their functioning that negatively or positively affect their general state of health.

"Officials of medical aid funds for one reason or the other did not approve group therapy, while the [Namibian Association of Medical Aid Fund, Namaf] service code is being used for group work during rehabilitation services. The Namaf service code list does not specify that group therapy is only allowed for rehabilitation services," Barkhuizen said.

One of the major medical aid funds, Namibia Health Plan (NHP), said the Namaf code that refers to therapy not specifically of a medical nature is currently an exclusion of NHP.

The medical aid fund said that preventive care is its priority at the moment, and therapy of all kinds that could prevent higher cost implications down the line would be evaluated and costed into its benefit structures during this year.

NHP did, however, point out that it did recognise that a healthy lifestyle would in the end result in a lower cost structure.

Barkhuizen urged employers and senior managers to evaluate the training material of her group work and report their findings to the medical aid funds for consideration by no later than October 30.

"Employers can change the situation to the benefit of medical aid fund members because the medical aid funds must report back to the Namibia Financial Institution Supervisory Authority [Namfisa] on suggestions received from employers and fund members on benefits, structure benefit options, and calculating contributions," said Barkhuizen.

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