Chamwe Kaira
Hospitals, pharmacies, medical specialists, and general practitioners received the largest share of healthcare spending in 2024, accounting for 70.9% or N$3.6 billion of total benefits paid by medical aid funds.
Hospital claims were the highest at N$1.8 billion, followed by pharmacy claims for medicines dispensed at N$802 million.
Claims by specialists amounted to N$563.2 million, while general practitioners received N$473.1 million.
The Namibia Financial Institutions Supervisory Authority (Namfisa) reported that the country’s medical aid funds industry remained unchanged in 2024, with seven active funds in the market.
Of these, five were open funds, representing about 71% of the market, while two were closed funds serving specific employer groups.
Bankmed, a closed fund, ceased operations on 31 August 2023 and is in the process of liquidation.
Healthcare expenditure in 2024 stood at N$5.1 billion, unchanged from the previous year. Gross contributions collected increased by 11.8% to N$6.1 billion.
The average healthcare expenditure per beneficiary per annum was N$23 205, which is 1.9% higher than in 2023.
“The industry’s claims experience improved during 2024, and the industry’s reserves level exceeded the minimum prudential reserves level requirement of 25%. Therefore, the industry is deemed to be financially sound,” Namfisa said.
Open funds were found to benefit from larger risk pools, enabling cross-subsidisation between low-risk and high-risk members. This improves the financial stability and predictability of claims and allows economies of scale.
Closed funds, by contrast, are smaller and more vulnerable to claims volatility. With fewer members to spread risks across, a small number of high-cost claims can create serious financial pressure.
Namfisa warned that the situation raises concerns about the long-term sustainability of smaller closed funds.
The regulator said it conducts quarterly off-site inspections of all registered medical aid funds under the Medical Aid Funds Act of 1995.
Each fund is assessed using the Namfisa ladder of supervisory intervention, a risk-based tool that guides regulatory action.
The framework allows early detection of risks and timely intervention, which Namfisa says contributes to the overall stability of the medical aid funds industry.
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Photo used for illustrative purposes.
