Benefit Structure

The structure provides details of your medical aid benefits and contributions.

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Contributions

Napotel Medical Aid offers competitive market related contributions.

FAQ's

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Add-On Medication Form


Kindly click on the link below to download the Add-On Medication form.

Download Add-On Medication Form


 

Benefit Booklet 2022


Download the comprehensive Napotel 2022 Benefit Booklet, for all the information on the benefit structure as well as the procedures of the Fund. 

Download Napotel Benefit Booklet 2022


 

Our News

15
Mar2021

Latest Newsletter for April 2022

Download the latest newsletter for Napotel members fo rinofrmation on the Fund for 2022. Download Newsletter

Latest Newsletter

newsletter_dec2019

New Benefit Rules Changes Effective 01 January 2016

Effective 01 January 2016, new benefit rules has been implemented on the following benefits and procedures:

1.1 Maternity Benefits: Caesarean Sections
1.2 In-Hospital Circumcisions
1.3 Chronic Formulary list

1.1 Caesarean Sections

Effective 01 January, as part of the new benefit rules changes a 10% member co-payment will be applicable on all elective caesarean-sections. All caesareans done due to an emergency or the medical condition of the member will be paid as per the current Fund Rules which is 225% of the Fund tariff.

1.2 Circumcisions
Effective 01 January 2016, circumcisions will be covered as follows on the Fund:

1.2.1 In-Hospital Circumcisions

  • As part of the new benefit rule changes, a 10% member co-payment will be applied to the GP & Specialist cost of all circumcisions done in Hospital.
  • The 10% member co-payment will only be applicable on the GP & Specialist cost and not the Hospital Fees

1.2.2 O ut of Hospital (In-Rooms Circumcisions)

  • GP & Specialist In Rooms procedures cost for circumcisions will be covered at 225% of the Fund Tariff.
  • The Fund Tariff for GP & Specialist for circumcisions has been increased from 100% to 225% for 2016, when done out of Hospital.

NB: Please take note that the 10% member co-payment will only apply on circumcisions done in Hospital.

More Articles ...

  1. New Chronic Formulary