Medical Aid Funds Must Balance Affordability and Sustainability, Says NHP

By: Dantago Garosas | Principal Officer, Namibia Health Plan (NHP)

Medical aid funds must consider both the cost of contributions for members and the sustainability of the benefits they provide.

For Namibia Health Plan (NHP), developments in 2026, including a 3.5% premium increase and adjustments to selected benefits, have highlighted the relationship between members’ financial circumstances and access to medical aid services.

The Fund’s 2026 benefits and rules took effect in January following approval by the Namibia Financial Institutions Supervisory Authority (NAMFISA), alongside changes to premiums and selected benefits.

From January, NHP implemented a 3.5% premium increase, with no increase for Blue Diamond and Litunga members. According to the Fund, this was the lowest premium increase in the industry for 2026 and its lowest since 2008.

The adjustment reflects the importance of considering members’ financial circumstances when making decisions about contributions.

During the same month, chronic medication reimbursement increased to 100% for members enrolled in the Chronic Care Programme, while private nursing and home-based care benefits increased by 20% across all benefit options.

These changes formed part of the Fund’s benefit adjustments for 2026, highlighting the need to consider affordability alongside the provision of services that respond to members’ needs.

The relationship between costs and benefits remains an important consideration for medical aid funds. As NHP’s experience illustrates, decisions about premiums cannot be considered separately from the benefits available to members.

The challenge is to balance healthcare costs with the need to maintain meaningful benefits and access to services.

The Fund’s managed care initiatives also formed part of its activities during the year. Between April and August, NHP identified an additional 1,233 beneficiaries for chronic care management.

This reflected the Fund’s efforts to identify members who may require continued support and ensure that healthcare interventions respond to their needs.

Operational capacity was another area of development. Since April, NHP’s managed care administrator has appointed 67 Namibians to strengthen its managed care operations. These appointments took place alongside the Fund’s other initiatives during 2026.

In May, NHP introduced a WhatsApp channel to complement its dedicated member email addresses.

The additional communication channel was intended to support communication with members and help them access information about their benefits and healthcare services.

Looking ahead, the sustainability of medical aid provision will continue to require consideration of healthcare costs, members’ circumstances and the long-term provision of benefits.

Medical aid funds must also assess whether their initiatives are meeting members’ needs and whether their services are delivering the intended outcomes.

The developments of 2026 reinforce the importance of balancing affordability, access, quality and sustainability as healthcare needs change.

For NHP, these considerations remain central to its responsibility to members and its approach to medical aid provision.