Arrangements During State of Emergency Due to COVID-19 Pandemic and Stage 2
Dear Member and Healthcare Provider,
We refer to our letter that you received at the end of March 2020 regarding the COVID-19 pandemic affecting the norm of healthcare services and the implementation of specific measures. The President has announced Stage 2 and the importance of abiding to the country’s state of emergency and the conditions under Stage 2 remains paramount.
Accordingly, please may you take note of the following:
1. Hospital Admissions and Pre-Authorisations:
Although “elective” surgery is allowed under Stage 2 it remains of utter importance to understand the reference of “elective surgery”.
The reference to "elective" for some may imply that this type of surgery is optional but is it important to note that that is not always the case. An elective procedure is simply one that is planned in advance, rather than one that is done in an emergency situation. A wide range of surgical procedures can be considered elective, for example ear tubes, tonsillectomies, hysterectomies, joint replacements, spinal and scoliosis surgery. Although these procedures may be done "electively," they can be significant and potentially life-changing operations.
Another category is an urgent procedure. This is something that usually must be done that day (for example, an appendectomy). Some surgeries (such as when someone is bleeding a lot internally) are considered emergency procedures. It can be life threatening and hence requires immediate clinical attention.
Some procedures, investigations or surgeries can be done as an emergency or as a booked procedure but is pending the unique patient clinical history. An example is a joint replacement – where a person fell, and broke the femur head, a joint replacement will be an emergency procedure. In all such instances whereas a person who has arthritis for many years, may require a joint replacement to improve their mobility and reduce pain and is viewed as an elective procedure.
Any surgical procedure has an anesthetic risk as well as post-surgery risk. Our risk management strategy should address both. Therefore, our clinical team will apply the following “Elective Surgery Guidelines” to any beneficiary who is aged above 60 years and/or has an existing chronic condition:
- The pre-authorisation request is submitted to the office of Heritage Health within 72 hours prior to the planned procedure/surgery. This allows our clinical team to review each case individually with the importance that it requires and to manage any risk.
- Height, weight, and BMI (An increased BMI may lead to an increased risk. Where possible, some effort should be made to improve the BMI pre-operative).
- Smoking history (The patient should stop smoking prior to the elective surgery.)
- Evidence that the pre-existing chronic condition is under control (Recent blood pressure readings for hypertensive patients, HbA1C or glucose measurements for diabetics etc.).
- Evidence of conservative treatment have been considered and failed.
- A report from a physician or anesthetist prior to the surgery may be requested.
Each patient and case remains unique and our clinical team will consider each pre-authorisation request accordingly. It is important to note that although numbers of COVID-19 patients have been limited in Namibia so far the state of emergency remains and caution on all levels remains to confirm the success of our country regarding the management of this global pandemic.
2. Heritage Health Application and Access to Information via Website
Heritage Health Medical Aid Fund allows members and healthcare providers easy access to all information. Members must all please download the Heritage Health App allowing immediate information to all relevant information including taking pictures of invoices to ensure fast reimbursements and to log enquiries. If you do not have a smartphone and you are unable to download the Heritage Health Application then please register via the Heritage Health website under the icon referring to “Member Login”.
Healthcare providers for certain services such as payment confirmations, available benefits and submissions of invoices may also use the website at www.heritagehealth-namibia.com and by scrolling down on the homepage you can login under “Service Providers Login” by using the last seven digits of your practice number and your own password. Please do remember your password.
The above facility is available 24-hours allowing you to manage your interaction with Heritage Health at the time most appropriate for you.
3. Submitting Invoices, Documents and Doing Enquiries
All members and healthcare providers please always only use the following email address: This email address is being protected from spambots. You need JavaScript enabled to view it. and where you will receive a response confirming your submission. Using any other email address will result in no service. Healthcare providers are encouraged to use EDI submissions to This email address is being protected from spambots. You need JavaScript enabled to view it. and where confirmation on the success of the submission is confirmed or where additional information may be requested.
4. Visiting the Office of Heritage Health
Please be advised that Integrated Wellness Solutions (Pty) Ltd as the administrator of Heritage Health have applied the following conditions when visiting the office:
- All persons must wear a mask prior to entering the office and during the time in the office.
- Prior to entering the office at reception your hands will be sanitised.
- Prior to entering the office at the reception your temperature will be taken and where higher than 37.5 degrees then no one is permitted to enter the office and the person is required to provide contact details and go to a doctor or the State facilities handling Covid-19.
Kindly note that any special arrangement under these exceptional circumstances does not imply that the terms and conditions of the Rules will not remain applicable as they will always remain applicable and the special arrangements are in addition to the Rules of the Fund for the interim period.
We remain to be of service to you and wish you good health.