Namibia’s medical aid industry is struggling to expand its membership base, with beneficiary numbers growing by less than 1% in the second quarter of this year.
The country’s seven registered medical aid funds had 226 777 beneficiaries at the end of June 2026, up just 0.8% from the previous quarter and 2.1% from a year earlier, according to Namibia Financial Institutions Supervisory Authority (Namfisa).
The slow growth comes against a labour market where 6.9% of people in the labour force were unemployed in 2023, according to the Namibia Statistics Agency’s latest Labour Force Survey.
Youth unemployment was about 44%.
This matters for medical aid schemes, because much of the country’s private healthcare cover is linked to employment.
Namfisa describes closed medical aid funds as generally being restricted to particular groups, usually through an employer, while open funds are available to individuals who can afford membership.
The result is a relatively small pool of people with access to formal medical aid, while the industry also has to cater for members who remain on their funds after retirement.
Closed funds recorded a 4.6% pensioner ratio in the second quarter, more than double the 6.5% recorded by open funds.
“Closed funds have a higher proportion of continuation members than open medical funds, mainly because pensioners experience more difficulty in affording medical aid coverage,” the authority says.
The figures also show that closed funds have more dependants.
There were 1.53 dependants for every principal member in closed funds, compared with 1.14 in open funds.
Namfisa says this difference has persisted over the past four years.
“… owing to closed fund principal members having more generous contribution subsidies than open fund principal members,” it says.
Despite the slow growth in membership, the industry improved its financial position during the quarter.
Medical aid funds recorded a N$178.8 million surplus, while accumulated funds and reserves increased by 25.4% year on year to N$3.1 billion.
The industry’s claims ratio also improved from 90.7% in the first quarter to 86.8% in the second quarter, returning it to Namfisa’s preferred range.
“An ideal claims ratio is considered to be between 65% and 87%,” the regulator says.
The loss ratio also fell from 100.1% to 96.6%.
“Maintaining a loss ratio lower than 100% indicates the industry’s ability to settle all its expenses without needing to rely on investment returns, other income, or liquidated investments to settle claims and non-healthcare expenses.”
However, the industry’s overall financial position masks pressure at individual fund level.
Namfisa says one open medical aid fund, representing 0.1% of total industry membership, failed to meet the minimum reserve requirement and is being closely monitored.
The fund has been required to submit a strategy to restore its reserves and provide monthly management accounts to the regulator.
