Get rewarded in
3 easy ways
Renaissance Health is rewarding members for engaging in activities that promote their overall wellness. The reward programme encourages members to lead a healthy lifestyle by providing incentives and rewarding members for managing their health.
How does the benefit wallet reward work?
- At the end of April following each benefit year, the amount which was claimed less than the threshold limits in respect of Day-to-day Benefits, may be transferred to the member’s Benefit Wallet. This amount may be utilized to pay for additional medical treatment ordinarily excluded in terms of the Fund Rules.
- The accumulated amount in the Benefit Wallet may be available during the full membership period on the Fund. On resignation of membership, the amount in the Benefit Wallet will revert back to the reserves of the Fund. It is important to note that in accordance with the Medical Aid Funds Act, no cash refunds are allowed in terms of the Benefit Wallet structure.
- During membership on the Fund, the amount available in the Benefit Wallet may be used for the following medical expenses to name a few:
- Routine medical costs, even if the respective benefit has been depleted for the benefit year;
- Member co-payments;
- Treatment normally excluded in terms of the Fund Rules;
- Medical and clinical treatment that is allowed in terms of the definition of a medical service as defined in the Medical Aid Funds Act. The product and/or service claimed for, must be provided by a healthcare provider, registered with the Health Professions Council of Namibia (HPCNA).
- The difference between the actual medical costs and the NAMAF tariff.
The threshold limits, with respect to the
2019 benefit year are calculated as follows:
|Option||Principal Member||Adult Dependant||Child Dependant|
Upon resignation from an employer group, the member may elect to continue as a member of the Fund, either as an individual member or as a member of an alternative employer group.
In both instances the amount accrued in the Benefit Wallet may be transferred, as long as the member remains a member of RHMAF. Upon the death of the principal member, any accumulated amount may be transferred to dependants who continue membership with the Fund.
If the dependants of such deceased member decides to resign from the Fund, then the balance will be reverted to the Fund’s reserve account.
Members who have benefits available in the Benefit Wallet, will be required to first pay for the service and/or medical product and then submit the claim and supporting documentation to the Fund for payment. The same process needs to be followed where medical treatment and services are claimed, which are normally not covered in terms of the Fund Rules. Members are advised to contact the Fund’s client service department for enquiries, in order to ensure that the item or services to be procured under the ambit of the Benefit Wallet, complies with the Benefit Rules.
- To reduce the Fund’s overall claims ratio by rewarding members for appropriate utilization of elective services, such as biokinetics, physiotherapy, speech therapy etc.
- Resulting in an overall reduction in the Fund’s risk pool.
- Low claiming members may have the opportunity to utilize the accumulated amount in their Benefit Wallet, for medical services that may currently be excluded in terms of the Fund Rules.
- Early detection of a disease may result in an improved health outcome for a member and ultimately may reduce the financial and clinical risk to the Fund.
- Members need to be empowered with information and be incentivized to undergo testing on a regular basis.
- To maximize the impact of the preventative care screening programme, members may be encouraged to provide their clinical results to the Fund.
You can enjoy a good quality of life when you routinely take your chronic medication. Once a member has been diagnosed with a chronic disease, it is
important that the member adheres to taking the chronic medication, as prescribed to them by their doctor. RHMAF has implemented a chronic adherence programme that monitors and improves patient compliance over time.
Wellness reward – Benefit Wallet allocation
for preventative health behaviour
|Reward Points||Part of wellness Management|
|Preventative health tests|
|Blood sugar test, cholesterol test, BMI and blood pressure measurement.||100||1 per beneficiary, per annum|
|Dental examinations||100||1 per beneficiary, per annum|
|Mammogram (inclusive DEXA bone density scan) – Radiology||150||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.||150||1 screen per male beneficiary,
over the age of 50 years, per annum
|Chronic medication compliance.||150||Part of Wellness Management sub limit.
In accordance with an approved clinical treatment plan
– for routine follow up tests when required