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Medical aid to cover vaccinations for members in full

All South Africans who belong to a medical aid scheme will not have to pay a cent to receive their COVID-19 vaccine jabs. The Board of Healthcare Funders confirmed that all medical aid schemes, regardless of their membership size, are expected to cover their clients at 100% when the vaccination rollout begins in a few weeks.

Currently, only 16% of South Africa’s adult population belongs to a medical aid scheme.

“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, to SowetanLIVE.

The Council of Medical Schemes defines a PMB as a set of defined benefits to ensure all medical aid members have access to a specific number of minimum health services regardless of their scheme option.

“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.

Thus far, South Africa has already paid a deposit of R283-million for the COVAX programme to procure 12-million vaccinations. This will cover 10% of the population. A further 1.5-million doses will be bought from AstraZeneca, and another 9-million from Johnson&Johnson.

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