Up to 33% surcharge for anaetheologists
Medical funds reduce hospital benefits
Anaesthetic services independent of surgeons' and hospitals' bills.
Medical funds' reduction of hospital benefits for various procedures means patients will have to pay between 25% and 33% out of their own pockets for anaesthesia services.This comes after members of the Anaesthesiologists Society of Namibia (ASN) adjusted their rates in response to medical funds' decision to reduce hospital benefits.
Effective 1 January, these benefits were reduced by up to 33% over 12 months, with some of the funds sharing "a significant reduction and reduction in benefits", including hospital visits with health service providers.
The Namibian Association of Medical Aid Funds (Namaf) announced late last year that 2023's standard rates would remain unchanged until at least the end of the first quarter in 2024 - and possibly longer. However, members of medical funds' contributions have been increased by up to 12% with effect from 1 January.
According to Namaf, this is in an attempt to bring normalcy to the financial state and sustainability of medical funds in Namibia whose reserves currently stand at 23.8% versus the mandatory 25%.
Given the "unprecedented financial pressure" that the financing industry for medical funds is currently experiencing, Namaf said in December that the decision had been taken to put the increase in the standard rates on ice until the end of the first quarter in 2024. This will amongst others, give the Namibia Financial Institutions Supervisory Authority (Namfisa) time to decide on the requests of various medical funds for the increase of members' monthly premiums.
In response, the Namibian Private Practitioners Forum (NPPF) said the unchanged standard rates are essentially a reduction in members' benefits because funds will not compensate members for medical inflation.
The ASN's president, Dr Jesse Mumba, emphasised that anaesthetic services are provided independently of surgeons' and hospitals' bills.
"Patients are personally responsible for paying this bill because our practice currently has no contractual agreements with any medical aid," Mumba explained.
Patients can first request a quote for these services before the scheduled surgery to get an idea of the related costs.
Mumba says that these services are based on time and cost estimates and may be subject to changes due to unforeseen circumstances, as well as unexpected complications that may lead to a change in the duration of the procedure.
The account for the relevant services will be submitted to the medical fund on behalf of the patient. When the latter has paid its share, patients are expected to pay the outstanding balance within a reasonable time as determined by the service provider.
"The ASN recognises the importance of providing transparent information to patients to ensure clarity about the financial responsibilities associated with narcotic services."
Mumba emphasised that the ASN's members remain committed to the highest standards of patient care and therefore recognise the need for fair compensation for their professional services. – [email protected]