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Guidelines

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Additional Hospital Benefit Cover (AHB)


The Additional Hospital Benefit Cover (AHB) pays the excess of NAMAF Tariffs for General Practitioners and Medical Specialists should a member or dependant be hospitalized. The AHB is applicable to NMC and Bankmed only. The funds pay 100% of NAMAF Tariffs PLUS a maximum of 125% additional cover for any excess of the NAMAF tariff that the General Practitioners and Medical Specialists may charge.


When consulting a doctor (General Practitioner or Medical Specialists) prior to hospitalization, a member should ask the following:

1. Ask the doctor if he/she is claiming directly from the Fund. If not, the member should pay the doctor directly and submit the claim / invoice with proof of payment.

2. Ask the doctor if he/she has an AHB contract with the Fund. If the doctor has an AHB contract, it means that he/she is registered to claim directly to the Fund but can only charge the NAMAF tariff + maximum of 125%.

3. If a doctor is contracted-in with AHB and yet you received an excess to pay, it means the doctor is charging more than the NAMAF Tariff + 125%. Please report the doctor to Methealth and one of our Client Service Advisors will engage with the doctor.


SUPPORTING DOCUMENTS
BankmedNMCPsemas
AHB Form (member)
AHB Form (HP)
AHB Form (member)
AHB Form (HP)