FIMA and your medical aid
The financial services industry in Namibia is entering a new era with the implementation of the Financial Institutions and Markets Act, 2021 (FIMA). While the legislation introduces significant changes for financial institutions, including medical aid funds such as Namibia Health Plan (NHP), one question remains top of mind for many members: 'What does FIMA mean for me?'
The simple answer is this: FIMA strengthens the way NHP is governed and regulated, while your medical aid benefits, contributions and access to healthcare remain unchanged.
What is FIMA?
FIMA is Namibia's new legislative framework governing non-banking financial institutions and financial markets. It was introduced to modernise the financial services sector by strengthening governance, improving accountability, enhancing consumer protection and promoting greater transparency across the industry.
All medical aid funds in Namibia are required to comply with the Act.
The biggest change: claims assessing will become an NHP function
One of the most significant requirements introduced by FIMA is that, from 30 April 2027, every medical aid fund in Namibia must take ownership of its claims-assessing function.
But what exactly does that mean?
Whenever you visit a doctor, specialist or pharmacy, a claim is submitted to your medical aid. Before that claim can be paid, it needs to be assessed to determine whether it qualifies for payment in accordance with your benefit option and the NHP Fund Rules.
Today, this assessment is performed by a service provider on behalf of the Fund. Under FIMA, that responsibility must now sit with NHP itself.
In simple terms, NHP will become directly responsible for assessing claims, ensuring that decisions are made in accordance with the Fund Rules and under the direct oversight of the Fund.
Why we launched the NHP FIMA Information Hub
Rather than communicating only when changes occur, NHP has chosen to take an educational approach by launching the NHP FIMA Information Hub.
The hub has been created to serve as a single, trusted source of information where members can access plain-language explanations of FIMA, member circulars and updates, important announcements and regulatory developments.
Our goal is to make FIMA easier to understand by providing information that is practical, relevant and easy to follow.
As we continue implementing FIMA over the coming months, we will regularly update the FIMA Information Hub with new resources and important developments.
We invite all members to join us on this journey by visiting the NHP FIMA Information Hub regularly for the latest updates, educational resources and answers to your questions.
Visit the NHP FIMA Information Hub today at www.nhp.com.na/fima and stay informed as we continue building a stronger, more transparent and sustainable Namibia Health Plan.
