Ex Gratia is a benefit awarded to Members to cover claims if the benefit has been depleted and there is a valid reason for the depletion.
When to Apply for Ex Gratia
Members can apply for Ex Gratia when their available amount for a certain benefit has been depleted and the Member really does not have the funds to pay the outstanding amount.
How to Apply for Ex Gratia
The Bankmed Namibia Ex Gratia Application Form (available from all the Methealth Namibia branches) is completed and the Member attaches his/her payslip and the payslip of his/ her spouse, should the Member be married. Payslips need to be attached in order for the ex gratia committee to fully investigate the Member’s financial position. The Application Form is then submitted to Bankmed Namibia for further investigation.
Download the Ex-Gratia Application Form
How Ex Gratia is Awarded
Ex Gratia is awarded to Members who truly cannot afford the medical bills for a medical procedure which they need to undergo or Day-to-Day Benefits have been exceeded. The Managed Healthcare Department does a thorough investigation into each case, which is presented to the Ex Gratia Committee for a final decision. The decision is communicated to Members by means of a letter/sms.
When Ex Gratia is awarded, the following criteria are taken into consideration:
- Years of membership with Bankmed Namibia;
- Number of registered dependants;
- Combined income of the Main Member and spouse;
- Total amount of ex gratia applied for (within Tariff);
- Member claims history; including
- Other factors, for example cost-saving and cost effective treatment.
Other Important Information
If awarded, Ex Gratia will only cover the approved NAMAF Tariff amount.