Staff Reporter
THE Namibia Dental Association (NDA) has announced that dental patients covered by the Namibia Health Plan (NHP) will now need to pay for services out of pocket, as dental institutions represented by the NDA will no longer accept NHP medical aid.
This announcement was made by the NDA’s Executive Committee (ExCO), which noted that the association represents around 80% of Namibia’s dental fraternities.
“Namibia Health Plan has been a beacon of excellence in the Namibian healthcare industry for many years, reigning in the PMR Africa Diamond Arrow Awards for 15 consecutive years since 2010. It has been known for fast claim processing and high member satisfaction, making it one of the most trustworthy medical aids in the industry, and also earning the title of ‘Best Medical Aid in Namibia’ in 2025. Sadly, in the eyes of the public and providers, all the trust and stature that took years to build has been diminished and reduced to almost nothing over the past few weeks. This is mainly attributed to the perceived incompetence and lack of planning by Universal in the takeover as administrators from Medscheme as of 1 April 2026,” the NDA’s ExCO explained in a statement.
The NDA outlined several issues raised by providers, including poor communication regarding the transition of administrative duties from Medscheme to Universal. NDA’s ExCO also pointed to the complex claims process, highlighting that Universal appears to be unfamiliar with the Namibian market, the way providers operate, and the platforms used.
“Being unable to switch, providers have been forced to revert to paper claims; however, receipts for these claims are rarely acknowledged, and timeframes communicated by Universal regarding processing have not been honoured to date,” the NDA’s ExCO explained.
Further issues raised by the Executive Committee included the rejection of claims without adequate explanation, unreasonable requests for justifications for basic dental procedures, difficulty in verifying benefits, and uncertainty about the accuracy of benefits confirmed via telephone.
The Association also noted the significant amount of time practice administrative staff are spending trying to obtain minimal information, resulting in higher telephone bills for providers. Additionally, vague communications from Universal were cited as another concern, with the ExCO emphasising that none of Universal’s promises have been fulfilled. According to the NDA, practices have also experienced a loss of income, forcing them to rely on overdraft facilities and delay payments to creditors, incurring interest charges as a result.
“Should this situation be prolonged, practices may need to cut salaries or retrench personnel, as cash flow has been significantly impacted. In a webinar hosted by Universal on 22 April 2026, it was mentioned that ‘it will take weeks to clear the backlog.’ For practices that need to purchase consumables and pay overheads, this is unacceptable,” the NDA said.
In light of these ongoing challenges, the NDA’s ExCO confirmed that they have decided to suspend treatment for all NHP patients. As a result, patients will now need to pay for services out of pocket and claim reimbursement directly from NHP. The NDA added that this decision could be revisited once all outstanding claims have been processed and paid.
The NDA also revealed plans to encourage patients and employer groups to cancel their NHP memberships and switch to alternative medical aid providers.
NHP has not responded by the time of publication.
Photo for illustrative purposes only.
