Hoe werk my mediese voordele?

Klagte:Hiermee wil ek graag hoor wat ander te sê het oor NMC mediesefonds. Hoekom moet so baie dinge teen die dag-tot-dag voordele geëis word, en dan is dit in 'n paar maande uitgeput en ons moet bly geld uithaal, terwyl ons glad nie vir al die jare nie in hospitale opgeneem word nie. Wat word van ons hospitaalvoordele wat elke jaar onaangeraak teruggaan? Hulle kan mos maar dit aanlas. Hulle moet op hul sisteem kyk en dinge begin in orde sit. Ons ly daaronder.Reaksie:Alison Begley, Principal Officer of Namibia Medical Care writes:The member has asked whether it is possible to transfer the hospital benefits provided by her plan to her Day-to-Day benefits, since she has not used her hospital benefit for a few years.As you may be aware, medical aid funds work on the same principles as insurance. In other words, the pooling of risks and cross subsidisation are critical to ensure a reasonable level of premiums. The reason for this pooling (or sharing) of risks is to spread the risks of large financial losses (or medical expenses) across many participants.All of the members that are on the same NMC plan as the member, pool their money (contributions) together to cover the medical expenses incurred by all of the members that are on that plan. The limits are set and adjusted according to which of the available benefits get utilised most/least on that particular plan. Should one have the option to transfer the limits from one benefit to another, the overall limit for all the members on that plan as a whole will change. Thus all members would elect to move their limits in such a way so as to reflect their own personal risk. Those with severe heart disease will move all benefit limits to In-Hospital procedures and so on. This should in all likelihood lead to the sum of all contributions being far less than the sum of all claims.Should each member be charged a premium that reflects his/her own personal risk, the central theme of pooling of risks won’t be present. For these reasons it is unfortunately not possible to transfer one’s limits.

Hoe werk my mediese voordele?

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Republikein 2026-04-02

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Hoe werk my mediese voordele?

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Republikein 2026-04-02

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