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NMC
(
Exclusions ) Medicines,
Products and Services that are excluded by the Fund NMC will not pay for the following MEDICINES and PRODUCTS: 1)
Preparations used specifically to treat and/or prevent obesity or
overweight or any slimming preparations. 2)
Patented and secret medicines and preparations, household remedies,
and preventative preparations generally promoted to the public to
increase consumption unless prescribed in the form of a mixture
together with any medicated cream or Ointment e.g. a topical steroid.
4)
Nutritional supplements including patented foodstuffs, baby food
and special formulas 5)
Medicines used specifically for the treatment of sterility, impotence
and infertility 6)
Aphrodisiacs 7)
Anti-smoking preparations 8)
Soaps, shampoos and other topical applications (of a cosmetic nature)
medicated or otherwise. Items other than those intended for the
treatment of lice, scabies and other parasitic infestations or fungal
infections, as indicated by the doctor's Diagnosis. 9) Sun screening and sun tanning agents.
10) Anabolic steroids unless prescribed for medical reasons (full motivation letter required). back
to Top of page 11) Vitamins, Multivitamins, Vitamin combinations and tonics. Payable by the Fund only under the following conditions:
Please
note: 12)
Single or combined mineral preparations and electrolytes.
13)
Contact lens preparations used for the care and cleaning of contact
lenses, including wetting agents. 14)
Cosmetic and toilet preparations, medicated or otherwise. 15)
Immunosuppressives unless prescribed by a medical specialist. 16)
Medicines used specifically to treat acquired immune deficiency
syndrome (aids) unless the patient is registered for case management.
17)
Contraceptive Device 18)
Preparations not easily classified. back to Top of page Namibia
Medical Care will not pay for Medical Expenses arising directly
or indirectly from the following: 1)
Suicide, attempted suicide or intentional self-inflicted injury,
whether the patient concerned is of sound mind or not. 2) Medical examinations:
3)
Medical examinations and/or treatments where no actual or presumed
illness exists. 4)
Physical fitness tests 5)
Plastic surgery and cosmetic treatments (excluding breast reductions,
dental implants and refractive surgeries) of a member's own choice
or which are recommended for psychological reasons only. 6) Examinations for and/or treatment of:
7)
Telephonic consultations/ prescriptions 8)
Appointments with a supplier of services not kept by the patient
and charged for by such supplier of services. 9)
Breathing exercises 10)
Holiday for recuperative purposes 11)
Traditional healing 12)
Forensics 13)
Acupuncture, acupressure reflexology and masseurs. 14) Accommodation in old age homes and similar institutions. back
to Top of page 15)
Hospitalisation or accommodation in an institution similar to a
hospital for breastfeeding mothers for the sole benefit of their
newborn babies. 16)
All costs pertaining to pregnancies for the first 12 months of membership
in the case of members who are registered as individuals. 17)
All costs incurred for treatment of injuries, where such costs are
the responsibility of another party unless the rules of nmc provide
otherwise. 18)
Ophthalmic examinations by anyone other than an eye specialist or
registered optician. 19)
Any instrument to correct/ enhance vision other than a pair of spectacles
or contact lenses. 20) Operations to correct vision defects, where the lack of refraction is less than:
21)
Sunglasses 22)
Tinting of prescription lenses of 35% or more. 23)
Gold in dentures and fillings. 24)
Dental devices and materials such as floss, tooth brushes and tooth
paste. 25)
Any dental procedures that are recommended for cosmetic purposes.
26)
Specific exclusions 27)
Sleep therapy and hypno-therapy. 28)
Cost incurred in respect of injuries sustained by a member or a
dependant participating in a sport as a professional or any hazardous
sport or activity which is inherently hazardous including but not
limited to active voluntary service in any military or paramilitary
organisation or the namibian police services, martial arts, parachuting,
hang gliding, paragliding, bungee jumping, advanced mountain climbing,
skydiving, water skiing, all underwater sports, (snorkeling, breath
hold diving, scuba diving, etc.), professional /diamond diving,
snow-skiing, show jumping, horse polo, river rafting, aquaplaning,
boxing, wrestling ,enduro racing, motocross racing as well as other
activities where the member or dependant of a member deliberately
exposes himself or herself to substantial danger. 29)
Any procedure or device intended to induce, enhance, maintain and
promote penile erection or to address erectile dysfunction such
as erectile appliances, auto injectors and including but not limited
to drugs such as viagra. 30)
Family and marriage counselling please consult your membership card
for the list of exclusions (if any) applicable only to you and/any
of your dependant/s. back to Top of page |
