Medical Aids and the COVID-19 Vaccine in South Africa

covid 19 vaccine

South Africa is on track to roll out the first phase of the COVID-19 vaccine. The question is – when can the bulk of South Africans expect the jab and how are medical aids going to cover the costs?

Which COVID-19 vaccine will be used in South Africa?

Following the news that the AstraZeneca vaccine is not optimally effective against the 501Y.V2 variant first discovered in South Africa, the government has secured alternative doses of the Johnson & Johnson vaccine.

Negotiations are ongoing to procure a mix of vaccines that will be used to inoculate the 40 million South Africans required to reach herd immunity.

When will ordinary South Africans be vaccinated against COVID-19?

The state is forging ahead with its three-phase Vaccine Rollout Strategy. Healthcare workers are first in line to be immunised. The focus then shifts to essential workers, the elderly and people living with co-morbidities.

Healthy South Africans under the age of 60 are the third and final group to get the vaccine.

If all goes according to plan, 67% of the population will be immunised by the end of 2021. This should mean person-to-person transmission is sufficiently allayed.

How will the COVID-19 vaccine be distributed?

On arrival, vaccine doses are counted and checked. They’re distributed from a central point to either the provinces or the private sector.

It’s envisaged the vaccine will be administered to medical aid scheme members at doctors’ rooms, places of work and at participating pharmacies and clinics.

A centralised vaccination data base has been set up to streamline the process. Scheme members will have to register electronically on the system and then book an appointment at a vaccination point located nearby.

How do medical aid schemes cover the COVID-19 vaccine in South Africa?

The Council for Medical Schemes has added COVID-19 to an existing list of 271 prescribed minimum benefits (PMBs).

As a result, all medical aid schemes in South Africa are obliged, by law, to cover the costs relating to the screening, testing and medical management of the virus. This includes vaccination against the disease.

All scheme members and their beneficiaries are eligible for COVID-19 vaccination benefits, notwithstanding the type of plan they belong to or the level of cover they enjoy.

The cost of the vaccine will be covered by the scheme’s risk pool and not the member’s savings or day-to-day benefits. The only caveat is members may have to use network doctors or designated service providers (DSPs) in order to qualify for vaccine cover.

Why are medical schemes paying more for the vaccine?

Medical aid schemes in South Africa have agreed to subsidise the cost of one extra dose per member, which is built into the price. The surplus dose will be administered to a person who is not a member of a scheme.

In total, the private healthcare sector will cover the cost of 14.4 million vaccine doses. Half of these are earmarked for members and their beneficiaries.

It’s encouraging that South African medical aids and the COVID-19 vaccine are set to help us finally get the upper hand over this nasty virus.

Independent advice about medical aids at IFC

At IFC, we offer informed, objective advice about South African medical aids. We can assist you in joining the scheme that best suits your needs and budget. Contact us for more information or to discuss your needs.

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