Member Application Forms
Please select form from below dropdown options
(forms mark with
*
are interactive and can only be completed with the Edge browser or Adobe Acrobat, not Firefox)
Bankmed
AHB Claim (Additional Hospital Benefit)
Application for Membership 2022
Application for Membership 2023
Debit Order Form
EFT Application Form
Ex-Gratia Application Form
Hospital Pre-Authorization
Lost / Additional Card 2023
Member Record Amendment Form
Option Change Form 2022
Option Change Form 2023
Travel & Accommodation Reimbursement
Travel Insurance Policy Wording
Methealth Namibia Administrators
e-Hosp (Hospital Pre-Authorization) Application Form
e-Med (Member) Application Form
MyHealth
ARVs On-going Treatment
Membership Application Form
Post Exposure Prophylaxis (PEP)
Pre Exposure Prophylaxis (PrEP)
NMC
AHB Claim (Additional Hospital Benefit) *
Application for chronic medication benefit
Application for Membership 2022
Debit Order
EFT (Electronic Fund Transfers) *
Ex-Gratia Application Form *
Health Smartcard Lost / Additional Card Application
Member Record Amendment 2022
Option Change 2022
Pre Notification for Hospitalization *
Travel & Accommodation Reimbursement
Travel Insurance Policy Wording
PSEMAS
Application for Chronic Medication
Declaration Form
Declaration Form for Follow-Up Hospital Visit
Deviation Form
Electronic Payment Request
Member Claim Form
PSEMAS Application for Travel & Accommodation Reimbursement
PSEMAS Hospital Pre-Authorization