All 9.5m South Africans who belong to medical aid schemes will not have to pay a cent for Covid-19 vaccines.
All medical aid schemes, regardless of their membership size, are expected to cover their clients at 100% when the Covid-19 vaccine rollout finally gets under way in coming weeks. The Board of Healthcare Funders (BHF) has confirmed that no medical aid member will be expected to pay for the vaccine. Only 16% of the country’s population belong to medical aid schemes.
“The BHF confirms that medical schemes will pay for their members to fund the Covid-19 vaccine as a prescribed minimum benefit [PMB] in line with the Medical Schemes Act Regulation Amendment, that declares the medical prevention and treatment of Covid-19 as a PMB,” said Dr Katlego Mothudi, managing director of BHF.
According to the Council of Medical Schemes, PMB is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected.
“Funding will be prioritised for vaccinations in line with the targeted population groups to support efforts to achieve herd immunity for the country. The BHF recognises that we need to achieve herd immunity of at least 67% for any efforts being made with the vaccine to be of national impact. To this end, the BHF is collaborating with government to find an appropriate solution to fund health citizens who don’t belong to a medical scheme to meet the target of 67% herd immunity. We are also engaging with our members to consider a framework within the Medical Schemes Act and medical scheme rules to support government,” said Mothudi.
SA has already paid a R283m deposit to the Covax programme to procure 12m vaccines for 10% of the population, a further 1.5m will be bought from AstraZeneca and another 9m from Johnson & Johnson.
The medical schemes that Sowetan spoke to said they were happy to cover the vaccine for their members although the costs of the vaccines that SA will acquire were unclear.
“We are engaging with a number of stakeholders to understand the national vaccine rollout strategy and to ensure that our members can affordably access the vaccine. Government has defined the phased rollout of the vaccine prioritising the population that is most vulnerable, and members will receive the vaccine according to the phases and category that they fall into,” said Medshield spokesperson Thoneshan Naidoo.
Compacare and Bonitas said they would use the same rollout approach.
GEMS, a medical scheme for government employees, said it would make use of relevant facilities aligned to all directives provided by the national government to ensure that its members receive the vaccine.
Rehad Desai of the Vaccine Action Group said partnership between the state and private companies was key.
“Everyone must use their resources to ensure a full effective rollout for all people residing inside SA regardless of their ID numbers,” said Desai.
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