About Heritage Health
A definite need for the establishment of a new open medical aid fund driven by the needs of its members and which can bring innovation and affordability to the healthcare sector has led to the establishment of Heritage Health Medical Aid Fund.
Heritage Health will provide Namibians the opportunity to join an open medical aid fund which will primarily be driven by the needs of its members while forming partners with other role players in the healthcare sector to ensure affordable, sustainable and lasting benefits for its members.
The mission and objectives of Heritage Health can be summarised as follows:
- To give individuals and families affordable cover, helpful service and information to enable them to receive and achieve financial protection and the health care they require from preventative to chronic and critical health care
To provide the best administration service whereby both the members and the service providers benefit in terms of efficiency regarding payments and client enquiries.
- To respect and work effectively with service providers by establishing efficient processes and providing prompt claims payments and related services including useful information that helps them to provide safe, cost effective, high quality health care.
- To provide employer advice, cost effective benefits, choices and programs in order for them to improve the health status and productivity of their work forces.
In order to ensure the long term sustainability of a new medical aid fund, four very important factors remain central to the decision making and product development.
- Focus on service.
- Educate members by the various appropriate means of communication.
- The benefits are fair and innovative and it meets the clinical needs of the members.
- The contributions, given the product design, are affordable, accessible and competitive.
- Members must have direct access to their portfolio via the internet whereby they will be able to manage their claims and payments including available benefits and any other important information
- Service Providers
- Will be able to submit claims electronically or manually
- Will receive regular payments on invoices submitted to ensure that service providers do not allow for unnecessary inflation of costs in order to finance long waiting for reimbursements due to them.
- Will be able to view and manage payments and available benefits of their patients via the website and which is on a live system
- Service providers will have representation on the Board of Trustees thereby providing a more transparent and less hostile relationship between the Fund as the funder and the service providers in recognition to safeguard the interest of the members and the business of Heritage Health Medical Aid Fund
- The provision of high quality administration system to the Fund, its members and the service providers
- An administration system which provides a full range of administration, managed health care and clinical risk management services to the Fund
- A system that can truly measure and manage the financial and clinical risks of healthcare and which can ensure effectiveness, affordability, accuracy and accessibility
- An administration system is fully integrated with modern IT architectures, including internet, e-mail, mobile services, electronic document storage, business intelligence tools and managed care systems, thus improving the way in which healthcare administrators communicate with their members, suppliers, agents, employers, managed care partners and offsite staff
- Actuarial Services
- Making use of an actuary to ensure proper risk rating and relating calculations of payable monthly contributions
- to ensure long term feasibility in a competitive environment without cutting prices at the cost of the industry or the member
The Board of Trustees have appointed Janus Investments (Pty) Ltd to do the administration and relating services of Heritage Health Medical Aid Fund.
Janus Investments (Pty) Ltd is well established in the industry and has been doing the administration of Investmed Ltd healthcare plans for the past seven years. The service providers in the industry are well acquainted with the services being provided and the payment intervals of claims is viewed as the best in the industry by the service providers and the policy holders of Investmed Ltd.
Janus Investments (Pty) Ltd clients:
Rules, Terms and Conditions
Heritage Health has a set of rules which states the terms and conditions of the Fund and which has been approved by NAMFISA. The Rules are readily available for all registered Heritage Health members and may be downloaded from this website, or a copy may be obtained by contacting us.
Ex gratia benefits are not the norm and are only available for in-hospital services subject to the appropriate completion of the necessary application form.
We look forward to being of assistance to you. Thank you for choosing Heritage Health as your preferred Namibian medical aid fund.