Windhoek: Civil servants in Namibia will continue to bear significant out-of-pocket expenses for specialist medical care not contracted under the Public Service Medical Aid Scheme (PSEMAS), the Ministry of Finance and Public Enterprises confirmed. Despite ongoing reforms aimed at aligning with current industry standards, civil servants must pay upfront for out-of-hospital treatment from non-contracted specialists and later seek reimbursement. According to Namibia News Digest, Wilson Ashikoto, a spokesperson for the Ministry of Finance and Public Enterprises, addressed these concerns following inquiries about the financial burdens faced by civil servants seeking medical care. Ashikoto explained that while PSEMAS covers in-patient care from contracted specialists according to the scheme's tariffs, most specialists are not contracted with PSEMAS. Consequently, members must cover the full costs upfront when seeking out-of-hospital treatments from non-contracted providers. The current tariffs under PSEMAS are st ill aligned with the Namibia Association of Medical Aid Fund (Namaf) 2013/2014 tariffs, plus a 20 percent markup. However, Namaf has introduced standard benchmark tariffs for 2023, indicating a significant disparity that the ongoing PSEMAS reforms aim to address. Ashikoto encouraged members to use services from PSEMAS-contracted providers to minimize out-of-pocket expenses, noting that these providers directly claim from the medical aid scheme, requiring only a 5 percent copayment from the members. The financial implications for civil servants are substantial, with different payment options under PSEMAS. The high option requires main members to pay N$240 per month and N$120 for each dependent. The standard option costs N$120 for the main member and N$60 for dependents. Despite the high costs, Ashikoto highlighted the government's commitment to assisting its employees and their dependents with medical expenses, emphasizing that the scheme covers 95 percent of the costs, with members contributing just 5 percen t. The ministry received a significant number of queries and complaints in recent financial years, with 165,000 in 2023/24 and 95,000 in 2024/25, reflecting ongoing concerns among civil servants regarding healthcare costs. The government expenditure on PSEMAS was N$3.34 billion during the 2023/24 financial year, underscoring its scale and the financial challenges involved in maintaining such a generous medical aid scheme.