Esteem
Care

Overall Annual Limit

Per family: N$ 1,600,000
Per beneficiary: N$ 1,050,000

Renaissance Health offers medical aid product plans customised to your individual needs. Your benefit option should fulfill the needs of you and your family at a monthly contribution that you can afford.

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Core Benefits

Hospital Benefits

Peace of mind with superior hospital benefits, including selected benefits with no sub-limits.

Day-to-Day Benefits

Extensive cover for your day-to-day medical needs.

Wellness Benefits

Prevent life threatening conditions from becoming severe and use your Wellness
Benefits from early detection.

Additional Benefits

Optional Benefits

Benefit Wallet

Maternity registrations, 80% of unused Benefit Builders, wellness screening and low claiming rewards.

Complementary Benefits

Make your Out-of-Hospital Benefits go further by providing extra cover and peace of mind.

Benefit Builders

Custom make your benefits for when and if you need them.

Monthly Contributions

Age INDIVIDUAL RATES
9 members or less
GROUP RATE 1
For groups with 10 – 49
Principal Members
Principal
Member
Adult
Dependant
Child
Dependant
Principal
Member
Adult
Dependant
Child
Dependant
0 – 25 1,715 1,195 770 1,495 1,030 665
26 – 30 1,865 1,280 770 1,615 1,115 665
31 – 35 2,020 1,390 770 1,745 1,205 665
36 – 40 2,225 1,650 770 1,945 1,420 665
41 – 45 2,485 1,825 770 2,155 1,590 665
46 – 50 2,765 2,190 770 2,390 1,900 665
51 – 55 3,150 2,585 770 2,750 2,255 665
56 – 60 3,475 2,945 770 3,020 2,560 665
61 – 65 3,775 3,150 770 3,285 2,720 665
66+ 4,035 3,320 770 3,500 2,870 665
Age GROUP RATE 2
For groups with 50 – 249
Principal Members
GROUP RATE 3
For groups with 250 and more
Principal Members
Principal
Member
Adult
Dependant
Child
Dependant
Principal
Member
Adult
Dependant
Child
Dependant
0 – 25 1,415 965 625 1,320 905 585
26 – 30 1,525 1,040 625 1,430 980 585
31 – 35 1,630 1,120 625 1,535 1,075 585
36 – 40 1,810 1,350 625 1,710 1,260 585
41 – 45 2,015 1,480 625 1,915 1,390 585
46 – 50 2,240 1,760 625 2,115 1,690 585
51 – 55 2,550 2,105 625 2,415 1,980 585
56 – 60 2,805 2,375 625 2,645 2,235 585
61 – 65 3,065 2,555 625 2,885 2,410 585
66+ 3,260 2,690 625 3,100 2,535 585

Monthly Contributions (Groups Only)

INCOME INDIVIDUAL RATES
9 members or less
GROUP RATE 1
For groups with 10 – 49
Principal Members
Principal
Member
Adult
Dependant
Child
Dependant
Principal
Member
Adult
Dependant
Child
Dependant
0 – 2, 000 2,140 1,370 745 1,875 1,195 645
2, 001 – 3, 000 2,235 1,700 745 1,930 1,485 645
3, 001 – 4, 000 2,460 2,015 745 2,150 1,745 645
4, 001 – 5, 000 2,765 2,295 745 2,410 2,005 645
5, 001 – 6, 000 3,050 2,580 745 2,645 2,245 645
6, 001+ 3,450 2,765 745 2,995 2,385 645
INCOME GROUP RATE 2
For groups with 50 – 249
Principal Members
GROUP RATE 3
For groups with 250 and more
Principal Members
Principal
Member
Adult
Dependant
Child
Dependant
Principal
Member
Adult
Dependant
Child
Dependant
0 – 2, 000 1,740 1,105 600 1,650 1,070 570
2, 001 – 3, 000 1,810 1,385 600 1,715 1,320 570
3, 001 – 4, 000 2,010 1,625 600 1,905 1,555 570
4, 001 – 5, 000 2,240 1,865 600 2,140 1,775 570
5, 001 – 6, 000 2,475 2,115 600 2,375 2,010 570
6, 001+ 2,790 2,220 600 2,645 2,115 570

Hospital Benefits

Tariff % Benefits
Total all-inclusive overall annual limit Part of the Overall Annual Limit
Hospital Benefit Group (Subject to clinical risk management protocols) Part of the Overall Annual Limit
Private hospital (Including medicines, materials, hospital apparatus and seven days Take-Out Medication). 100% Part of the Overall Annual Limit
Accommodation in private wards. 100% N$ 18, 900 per family
N$ 10, 000 per beneficiary
State hospitals (Including medicines, materials, hospital apparatus & seven days, Take-Out Medication). 100% Part of the Overall Annual Limit
Sub-acute facility ward fees. (Admission in lieu of hospitalisation). 100%
Consultations including treatment and services. 180%
Blood transfusion. 100%
Radiology and Pathology. 100%
Physiotherapy. 100%
Post Operative Extended Benefit (Following major surgery). Part of pre-authorisation and clinical protocols. 100% Following surgery limited to 6 weeks treatment or 12 sessions
Surgical procedures done in rooms / Unattached theatres Part of the Overall Annual Limit
Doctors’ rooms – Selective surgical and endoscopic procedures, circumcisions. Inclusive benefit – Admissions, surgery,
treatment and services. Part of pre-authorisation and clinical protocols.
180% Part of the Overall Annual Limit
Admission to unattached operating theatres and sub-acute facilities. 100%
Selective surgical and endoscopic procedures, circumcisions – unattached operating theatres, doctors’ rooms and subacute
facilities. Including surgery, treatment and services. Part of pre-authorisation and clinical protocols.
180%
MRI / CT / Pet scan / Bone density (In – and out-of-hospital) N$ 33, 000 per family
N$ 16, 500 per beneficiary
In- and Out-of-Hospital Benefit. Part of pre-authorisation and clinical protocols. 100% Part of the sub-limit
Maxillofacial and dental surgery (In – and out-of-hospital) N$ 37, 500 per family
N$ 25, 000 per beneficiary
Non-elective maxillofacial / oral surgery – Trauma, including dental extractions of more than three teeth or multiple fillings in children under the age of ten and disabled dependants / removal of impacted wisdom teeth. (All-inclusive benefit – surgery, treatment and services). Part of clinical protocols. 180% Part of the sub-limit
Dental and oral surgery N$ 5, 900 per family
N$ 4, 300 per beneficiary
Admission. 100% Part of the sub-limit
Elective dental and oral surgery, including dental implant surgery, excluding the cost of the dental implant. (All-inclusive
benefit – surgery, treatment and services). Part of clinical protocols and applicable Medical Aid Fund Rules.
180%
Eye Surgery Part of the Overall Annual Limit
Admission. 100% Part of the Overall Annual Limit
Including cataract surgery, glaucoma surgery, eye muscle surgery, corneal surgery, eye removal, vitreo-retinal surgery, etc. (All-inclusive benefit – admission, surgery, treatment and services). Part of clinical protocols and twelve month waiting period. 180%
Excimer laser and radial keratotomy only after two years membership. (All-inclusive benefit – admissions, surgery,
treatment and services). Part of clinical protocols.
N$ 15, 000 per family
N$ 10, 000 per beneficiary
Reconstructive Surgery N$ 12, 800 per family
N$ 8, 500 per beneficiary
Admission. 100% Part of the sub-limit
Reconstructive Surgery – After two years membership, including breast reductions. (All-inclusive benefit – admissions,
surgery, treatment and services). Part of clinical protocols.
180%
Alternative Services N$ 22, 500 per family
N$ 15, 000 per beneficiary
In- and Out-of-Hospital Benefit including occupational therapy, private nursing, palliative care (end stage terminal
diseases) and frail care.
100% Part of the sub-limit
Mental Health 21 days per beneficiary
In- and Out-of-Hospital treatment and services, including psychiatric hospital accommodation, treatment and services, alcohol & drug addiction, addiction therapy and related pathology. (Part of treatment plan protocols). Excluding auxiliary services, which is part of the day to day benefit limits. 100% 21 days per beneficiary
Internal Prosthesis Subject to RHMAF protocol
Internal prosthesis – example: knee / hip / pacemakers. Part of pre-authorisation and clinical risk management protocols. 100% Subject to RHMAF protocol
Trauma Treatment Part of the Overall Annual Limit
Oncology (Including chemo and radiation treatment), organ transplant, acute renal and peritoneal dialysis (In hospital). 180% Part of the Overall Annual Limit
Oncology (Including chemo and radiation treatment), organ transplant, acute renal and peritoneal dialysis (Out of hospital). 180%
Motor Vehicle Accidents (MVA). 180%
Health is vital Part of the Overall Annual Limit
Hospital and treatment. 100% Part of the Overall Annual Limit
HIV / AIDS visits. 100% N$ 3, 500 per family
HIV / AIDS pathology. 100% N$ 12, 700 per family
HIV / AIDS medication. 100 NRP% N$ 41, 600 per family
HIV counselling. 100% N$ 4, 900 per family

Day-to-Day Benefits

Tariff % Benefits
Professional Services N$ 18, 300 per family
N$ 9, 200 per beneficiary
General Practitioner, specialist consultations and primary healthcare consultations. 100% Part of Professional Service limit
General Practitioner and specialist administration fee for chronic patient applications and medical reports. Agreed Tariff
Pharmacist and telephone consultations. 100%
General Practitioner / primary and specialist procedures in rooms including equipment, materials and
injections.
100%
Psychiatric treatment. 100%
Radiology. 100%
Pathology. 100%
Paramedical Services N$ 5, 600 per family
N$ 3, 700 per beneficiary
Including physiotherapy, social workers, speech therapy, audiology, acousticians, dieticians, occupational
therapy, clinical psychology, biokinetics, homeo / chiro / osteopathy, podiatry, acupuncture, etc.
100% Part of the sub-limit
Auxiliary services – Biokinetics, homeo / chiro / osteopathy, podiatry, acupuncture, etc. 100%
External Prosthesis and medical appliances N$ 22, 500 per family
N$ 12, 500 per beneficiary
Prosthesis external – Artificial arms / legs / eyes every two years. Part of pre-authorisation and approval. 100% of cost Part of the sub-limit
Special external medical appliances – Wheelchairs every three years; hearing aids apparatus every two years.
Part of pre-authorisation and approval.
90% of cost
General external medical appliances – Including glucometers, blood pressure monitors, stockings, braces etc.
Part of pre-authorisation and approval.
80% of cost
Optical Benefit N$ 4, 800 per family
N$ 2, 500 per beneficiary
Eye tests. 100% Part of the sub-limit
Lenses / contact lenses. 100%
Frames, once every two years. 100% N$ 1, 050 per beneficiary
Dentistry Benefit N$ 12, 400 per family
N$ 6, 600 per beneficiary
Conservative dentistry – Fillings, extractions and oral hygiene. 100% Part of the sub-limit
Special dentistry – Dental implants, crowns, bridges, dentures and orthodontic treatments. Part of preauthorisation and approved treatment plan. 100%
Medical Benefit N$ 12, 200 per family
N$ 6, 200 per beneficiary
Acute medication – Preferred and non-preferred 80% NRP Part of Medication Benefit sub-limit
Pharmacy initiated therapy and OTC medication. Maximum of N$ 200 per script. 80% NRP N$ 1, 400 per beneficiary
Homeopathic medication. 80% NRP Part of Acute Medication sub-limit
Primary health scripts. 80% NRP
Chronic medication – Preferred and non-preferred. Preferred 90%
Non-preferred 80%
Extended Medication Benefit N$ 68, 700 per family
In- and Out-of-Hospital: Extended Medication Benefit cover for oncology, renal care and organ transplant
(excluding chemo and radiation therapy and treatment). Part of registration and treatment plan protocols.
Chronic medication related to severe illness conditions may be extended to this benefit, where Medication
Benefit has been depleted. Part of registration and treatment plan protocols.
Part of the sub-limit
Preferred medication. 90% NRP
Non preferred medication. 80% NRP
Specialised medicines such as biologicals (In terms of defined conditions and part of managed care protocols
– excluding off-label medication. In- and Out-of-Hospital).
80% NRP

Maternity Benefits

Tariff % Benefits
Maternity and baby benefit Part of the Overall Annual Limit
Gynaecology / obstetric – In hospital. 180% Normal birth / Caesarean Section
Gynaecology / obstetric – Out of hospital. 100% Part of the Overall Annual Limit
Maternity scans. 100% 2 scans per beneficiary
Antenatal visits. 100% 12 visits per beneficiary
Amniocentesis – AHB excluded. 100% Part of the Overall Annual Limit
Neonatal ICU / ward fees. 100%
Paediatrician visits – Postnatal. 100% 2 visits per family, per annum

Wellness Benefits

Tariff % Benefits
Wellness Management N$ 10,000 per family
Preventative Health Benefit (Members may earn benefit rewards for participation) Part of Wellness Management
Blood sugar test, cholesterol test, BMI and blood pressure measurement. 100% 1 per beneficiary, per annum
Dental examinations. 100%
Mammogram (inclusive DEXA bone density scan) – Radiology. 100% 1 per female, over 40 years, per annum
Pap smear. Pathology including general practitioner / gynaecology visits. 100% 1 per female, over 20 years, per annum
HIV test all ages. 100% 1 per beneficiary
Prostate screening. Pathology prostate specific antigen test. 100% 1 screen per male beneficiary over the age of 50 years, per annum
Chronic disease wellness management – Follow-up test in the management of selective chronic diseases
including: chronic renal failure, diabetes mellitus type 1 & 2, HIV / Aids, hyperlipidemia and multiple sclerosis
(MS) – Excluding specialised radiology, which will be payable from the available MRI / CT Benefit.
100% Part of Wellness Management sub-limit.
In accordance with an approved clinical
treatment plan, for routine follow-up tests
when required.
Wellness Reward – Benefit Wallet Allocation for preventative health behaviour Benefit Wallet Reward Points
Blood sugar test, cholesterol test, BMI and blood pressure measurement. 100
Dental examinations. 100
Mammogram (inclusive DEXA bone density scan) – Radiology. 150
Pap smear. Pathology including general practitioner / gynaecology visits. 100
HIV test, all ages. 100
Prostate screening. Pathology prostate specific antigen test. 150
Chronic medication compliance. 150
Immunisation (Vaccines only) Part of Wellness Management
Flu vaccines. 100% NRP 1 flu vaccination per beneficiary, per annum
Pneumococcal vaccine. 100% NRP 1 per beneficiary, over 65 years, per annum
Baby immunisations 0 – 7 years. 100% NRP Vaccinations for children 0 – 7 years
HPV vaccine – Females between 9 – 30 years. 100% NRP 3 injections during the course of a year, once per lifetime
Preventative rehabilitation treatment Part of Preventative Benefit sub-limit
Orthopaedic rehabilitation and treatment relating to Chronic disease management – Part of approved treatment
plans, pre-authorisation and clinical risk management. (Note – Biokinetic treatment plans for orthopaedic
rehabilitation and chronic members disease management – may first be approved and payable from the normal
day to day Paramedical Services Benefit – additional required treatment sessions may be considered for approval
from the Preventative Rehabilitation Treatment Benefit – subject to available treatment sessions).
100% 6 weeks treatment or 12 sessions

Complementary Benefits

Tariff % Benefits
Premium Protection Period
Covers monthly Medical Aid Fund contributions on the life of the Principal Member. 100% 3 months
Travel and accommodation benefit
Transport cost when referred for specialist services not available in the area of residence. 100% of cost N$ 3, 800 per family
Benefit Rewards Low claiming threshold levels
  • Each dependant is allocated with a threshold value per annum. Should you claim less than your threshold
    value as at 31 December of each year, the remaining balance of your threshold may be transferred to your
    Benefit Wallet. (The balance is transferred after 4 months to allow for the run off of medical claims incurred in
    the previous year).
  • Members participating in wellness day initiatives and preventative testing may earn additional Benefit Wallet
    rewards, this includes early registration on the maternity program and additional rewards for normal deliveries.
  • 80% of unused benefits in the Benefit Builder may be transferred annually to the Benefit Wallet (The balance
    is transferred after 4 months to allow for the run off of medical claims incurred in the previous year).
Principal Member N$ 2, 400
Adult Dependant N$1, 700
Child Dependant N$ 900
Benefit Wallet
Accumulated Benefit Wallet benefits may be used for purchasing of medical treatment and services in terms of
the Medical Aid Funds Act, provided that the member pays first and claims back from the Benefit Wallet within
the 4 month claiming period. Allow Provider payments for excess of Benefit and tariff rejections.
100% of cost Subject to availability of Benefit Wallet benefits, medical treatment and services obtained from a registered medical facility.
Longstanding membership rewards Group Rate 1 Contributions
A member who is 65 or older and has been with the Fund for more than 20 years may qualify for Group Rate 1 contribution. Provided the member is not already on a Group Rate status
International rescue me & assistance (In addition to the overall annual limit) N$ 10, 000, 000 per family
Emergency evacuation and ambulance services (air or road). 100% Terms and conditions
Repatriation (SADC) – Return after emergency or return of mortal remains. 100% Related to emergency evacuation
Medical treatment. 100% Terms and conditions
Evacuation, repatriation, return of children. 100% Terms and conditions