WELCOME to your HERITAGE HEALTH MEDICAL AID FUND Newsletter.

We publish Newsletters at regular intervals to keep our members informed, to motivate new readers to join Heritage Health Medical Aid Fund and to be of service to you. In the Newsletters we will be addressing issues such as improving your health, how to manage your benefits and the associated costs, how risk is managed, and your responsibilities as a member and our service to you. You may also contact us on topics that you wish to be addressed.

MAKE 2017 YOUR HEALTHY YEAR

Having and maintaining a healthy weight is important for overall health and can help you prevent and control many diseases and conditions.

If you are overweight or obese, you are at higher risk of developing serious health problems, including heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers. That is why maintaining a healthy weight is so important as it will help you lower the risk for developing these problems, help you feel good about yourself and gives you more energy to enjoy life.

Learning to calculate your BMI (Body Mass Index) is a valuable tool to use as it measures your body-fat. BMI is a value derived from the weight and height of an individual. There are several online BMI calculators available or manually use the below.

1. Multiply your height by itself
2. Divide your weight in kilograms by the value of your height
3. Resulting number is your BMI

BMI CATEGORIES:

• Underweight = <18.5
• Normal weight = 18.5–24.9
• Overweight = 25–29.9
• Obesity = BMI of 30 or greater

Under Heritage Health you are encouraged to see a Dietician and use Bio kinetics to assist you where you may require weight management.

TRAVEL INSURANCE: Compulsory when Travelling

All members under Heritage Health must complete a travel insurance form and provide the necessary copies of a valid passport prior to leaving Namibia. To acquire the necessary travel insurance prior to leaving Namibia is a pre-requisite to enable applicable cover where an incident may arise. Where no form is completed prior to leaving Namibia this will influence your cover. Please contact the Heritage Health office for further assistance.

GYM REBATES/CROSS FIT

Why does Heritage Health not pay for gym rebates or Cross Fit?

To include gym rebates or Cross Fit under the payable monthly contributions will not be fair as few members actually use a gym or subscribe to Cross Fit. At the same time not all members have access to a registered gym or Cross Fit classes and will it not be fair to include the gym costs in the monthly contributions where only a selected few will benefit and while all the other members are funding it.

CLIENT SERVICE

At Heritage Health’s office the employees are multi-skilled thereby ensuring that all our clients are being helped immediately. Having one contact person will not allow the same level of service as employees go on leave and sick leave and which will jeopardise our current level of service to you.

PHARMACY CLAIMS

Heritage Health has a live switch at all the pharmacies, which enables “live claims switching” and which enables your pharmacy to validate the membership and the available benefits immediately. Because the system is live it is sensitive to all information being entered and it remains important for pharmacies to ensure that the correct information is being submitted to enable approval. Make sure that you provide your membership card to the pharmacist to verify the details of the beneficiaries and the membership number. In the event where you have paid an invoice at the pharmacy (perhaps when you are in South Africa) it is important to receive a detailed invoice to enable Heritage Health to refund you – always request a detailed invoice.

HEALTHCARE COSTS VS YOUR MONTHLY MEMBERSHIP CONTRIBUTION

Your monthly medical aid contribution for your membership under Heritage.

Health is actuarially calculated yearly. Healthcare costs include hospital fees and relating costs, chronic medicine costs, oncology treatment etcetera. The older we become the higher our health risk becomes. Sadly monthly contributions are calculated in terms of our age as the age determines the risk. It is thus not possible to allow for discounts for our older or senior members under Heritage Health.

VIEW YOUR BENEFITS AND PAYMENTS

Did you know that you may view available benefits, the payments of your invoices and all other communication by registering under the website of Heritage Health at www.heritagehealth-namibia.com under the top icon “Service” and then on the side panel under the icon “member login” We encourage you to register and to manage your medical aid cover.

DIRECT PAYMENTS: YOUR DOCTOR

Healthcare   providers   are   not compelled to claim directly from the medical aid funds. Each practice of each registered healthcare provider opts for direct submissions of invoices, on behalf of their patients, to the respective medical aid funds. Although healthcare providers in Namibia are encouraged to claim directly from Heritage Health some of the healthcare providers have opted not to submit their claims directly. Heritage health is the only medical aid fund to pay at 100% of the actual amount being charged by the respective healthcare providers and who does not use the NAMAF tariff and Heritage Health is currently rated as the fastest payer of valid invoices. Only 3.19% turnaround time on claims older than 30 days.

SUBMISSIONS OF VALID INVOICES

It always is important for you to ensure that HERITAGE HEALTH does receive a detailed invoice (and not a receipt) to enable processing of the claim in terms of your records and to make the necessary refunds to you or to your healthcare provider. Claims must be submitted within four months from the date of service and not the date that you receive the invoice. Healthcare providers who claim directly are also required to submit their invoices within four months from the date of service. Ultimately you remain responsible to ensure that the invoices are submitted so please check outstanding payments to your healthcare provider.