Namibia: Medical Aid Schemes Pay N$34m in Three Months

DURING the second wave of the Covid-19 pandemic, medical aid funds spent up to N$34 million on Covid-19-related costs.

This is according to the Namibia Financial Institutions Supervisory Authority (Namfisa).

Between January and March this year, Namibia battled its second Covid-19 wave of infections, with 255 people hospitalised and 39 in intensive care units (ICUs).

About 8% of Namibia's population is covered by private medical aid funds, representing roughly 200 000 citizens.

Medical aid funds split Covid-19 expenses incurred between costs related to testing and those related to hospitalisation.

"These costs amounted to N$2 326 159,18 and N$34 197 281,28, respectively, for the three months ended 31 March 2021," Namfisa spokesperson Victoria Muranda said yesterday.

On average, the funds spent about N$94 000 per day on Covid-19-related expenses.

"Treating a Covid-19 patient in hospital on a daily basis varies as it depends on the condition the patient was in when he or she was admitted," she said.

The funds spent N$2,3 million on Covid-19 tests for members in the first three months of the year.

At the time, Namibia recorded 144 Covid-19-related deaths as the country experienced an upward trend for a second month.

This averaged 36 deaths per week and five a day in January.

During the second Covid-19 wave, Namibia recorded the highest number of deaths on 6 January, when 13 people succumbed to the virus.

The country at the time recorded a consistent number of deaths daily, with the exception of a few days.

'FINANCIALLY SOUND'

Medical aid funds footed a bill of N$95,8 million in relation to Covid-19 from 1 April 2020 to 31 March 2021.

"Medical aid funds incurred Covid-19 expenditure of N$15 million for Covid-19 tests, and N$80 million for hospitalisation expenditure for the period 1 April 2020 to 31 March 2021," Muranda said.

The funds' Covid-19 expenditure include that incurred for the treatment of other conditions while treating a member for Covid-19.

Muranda said patients are usually submitted to isolation wards, which are less expensive, however, severe cases are admitted to ICUs, which are significantly more expensive.

"Despite the significant costs expended, medical aid funds are financially sound at this time," she said.

RELIEF

To continue mitigating the effects of the pandemic on Namibians, Namfisa has directed medical aid funds to provide their members some relief, but most of these measures lapsed on 31 December last year.

"On 6 April 2020, Namfisa issued a circular to the medical aid fund industry, recommending to medical aid funds to consider extending certain relief measures to their members," Muranda said.

The measures that are extended to medical aid fund members range from premium holidays, extended credit terms, and approval to downgrade benefit options which are generally only permitted at the beginning of the year, she said.

"Other relief measures which have continued to date are the temporary increases on over-the-counter benefit limits to enable members to acquire immune boosters and other medication to minimise the burden of out-of-pocket expenditure," Muranda said.

INFLATION AND INCREASES

The expected average medical inflation for 2021 was 2,47%.

This means pharmaceutical benefit limits increased, on average, with 2,47% for the 2021 financial year, which runs from January to December.

"Medical aid funds do not set the price of medicine. They pay pharmaceutical benefits based on benchmark tariffs. The pharmaceutical benefit limits of medical aid funds are revised annually in line with the expected medical inflation," she said.

FOOTING THE VACCINE BILL

The financial impact of the third wave of Covid-19 on medical aid funds will be submitted to Namfisa in August, and will be published in a quarterly industry report for 2021.

"Medical aid funds are collaborating with the government to ensure that their members get vaccinated. The medical aid fund industry has agreed to reimburse the government for every member who has been vaccinated," Muranda said.

Medical Aid Funds (Namaf) chief executive officer Stephen Tjiuoro earlier this year confirmed this, saying medical aid funds would pay for Covid-19 vaccines on behalf of their members.

This comes after the minister of finance, Ipumbu Shiimi, and the minister of health and social services, Kalumbi Shangula, approached Namaf and Namfisa last month to support beneficiaries of their schemes to access Covid-19 vaccines.

"Covid-19 infections and the hospitalisation of members come at a very high cost to medical aid funds. Therefore, if more medical aid fund members get vaccinated, it may lead to a reduction in the current expenditure incurred on the diagnosis and treatment of Covid-19,which in turn may reduce the extent of future annual contribution increases," Muranda said.

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