Civil servants to continue paying for uncontracted specialist medical care amid PSEMAS reform

WINDHOEK: The Ministry of Finance and Public Enterprises has confirmed that civil servants can expect to continue paying thousands of dollars for uncontracted specialist medical care , until the government completes the reform of the Public Service Medical Aid Scheme ( PSEMAS ) 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 . Responding to queries from Nampa on Tuesday , Ministry of Finance and Public Enterprises ‘ spokesperson , Wilson Ashikoto , said most specialists are not contracted with PSEMAS and only in – patient hospital care with contracted specialists charges in line with PSEMAS tariffs . Ashikoto added that Namaf has availed the standard benchmark tariffs for 2023 , however , PSEMAS charges are aligned with the Namaf 2013 / 2014 tariffs plus 20 per cent markup , noting that alignment to current ind
ustry standards is being addressed under the PSEMAS reforms , which are currently underway . ‘ Members are encouraged to seek medical services from providers who are contracted with PSEMAS and these service providers will claim directly from PSEMAS . The only upfront payment required from members in such cases is a 5 per cent copayment ,’ he said . He however warned that members who opt to seek services from non – contracted providers must make a full upfront payment and can later claim reimbursement from PSEMAS . Currently , civil servants have two options . For the high option , main members pay N . dollars 240 per month and N . dollars 120 for each dependent , while the standard option costs N . dollars 120 for the main member and N . dollars 60 for dependents . Ashikoto said PSEMAS membership stands at 291 243 and the ministry received queries and complaints on the issue totaling 165 000 and 95 000 during the 2023 / 24 and 2024 / 25 financial years respectively . Ashikoto noted that the government has spe
nt N . dollars 3 . 34 billion during the 2023 / 24 financial year , adding that PSEMAS 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 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 per cent , while members contribute only 5 per cent ,’ he noted .

Source: The Namibia Press Agency