Option Range


Choosing an Option

The member makes a monthly contribution to the Fund which is pooled with all other members’ contributions. All in-hospital and related expenses plus all recognised day-to-day expenses are paid out of this pool, up to the limits indicated. Full cross- subsidisation takes place as members who claim more than they have contributed are cross-subsidised by members who claim less than their contributions.

Traditional Options

All premiums are pooled in a central pool from which benefits are paid. The Traditional options of NMC are:

  • Topaz / Topaz Plus
  • Opal
  • Ruby
  • Sapphire
  • Diamond

Topaz / Topaz Plus
[Topaz Full Details] / [Topaz Plus Full Details]

[Topaz Rules] / [Topaz plus Rules]

[Health Professionals List]

[Topaz Medicines Formulary]

  • Promotes use of primary health care facilities (clinics)
  • 100% of Tariff
  • Limited individual benefit amounts
  • State hospitalisation only
  • Low monthly contributions

Opal
[Full Details]

  • Fairly comprehensive range of benefits
  • 100% of Tariff
  • Promotes use of primary healthcare facilities (clinics)
  • Limited individual benefit amounts
  • Limited private Hospitalisation
  • Low monthly contributions

Ruby
[Full Details]

  • Comprehensive range of benefits
  • 100% of Tariff
  • Adequate overall annual cover
  • Good individual benefit amounts
  • Affordable contributions

Sapphire
[Full Details]

  • Comprehensive range of benefits
  • 100% of Tariff
  • High overall annual cover
  • High chronic medication benefits
  • Good individual benefit amounts
  • Competitive contributions

Diamond
[Full Details]

  • Comprehensive range of benefits
  • 130% of Tariff
  • Unlimited overall annual cover
  • High chronic medication benefits
  • Generous individual benefit amounts
  • Market-related contributions

New Generation Options

Emerald and Essential Plus comprise of two components; major medical benefits and day-to-day benefits. Hospital benefits plus the major medical components work like a traditional option. The day-to-day component is a capped self-funding account for paying expenses such as doctors’ visits.

Emerald and Amber

The member makes a basic monthly contribution plus a predetermined optional Monthly Allocation Amount (MAA). The MAA is deposited into the member’s individual savings account, called the Accumulation Fund (AF). All in-hospital and related expenses are paid out of the Fund’s pool which consists of all the individual members’ basic contributions. All recognized day-to-day expenses are paid from the member’s Accumulation Fund. The principle of the New Generation Option is completely different to that of the Traditional Options: The member takes an active role in the management of a portion of his/her medical expenses. He/she has access to funds in his/her personal medical savings account called the Accumulation Fund (“AF”) for day-to-day expenses. This offers protection against possible abuse of the Fund and of the accumulation funds.

Emerald
[Full Details]

  • Hospitalisation expenses only
  • 100% of Tariff
  • Adequate overall annual cover
  • Day-to-Day expenses for own pocket
  • Affordable monthly contribution
  • Savings Account

Amber
[Full Details]

  • Hospitalisation expenses only
  • 100% of Tariff
  • High overall annual cover
  • Day-to-Day expenses for own pocket
  • Highly competitive monthly contributions
  • Savings Account