FAQ: Medical Aid Scheme Members’ COVID-19 Vaccinations

  1. How will it work? Should members register for it and if so, where? Will it be registration at the medical scheme or a national data base?

The National Department of Health (NDoH) will be responsible for the single, centralised procurement of COVID-19 vaccines. Therefore, as it stands, the sourcing and distribution of the vaccine will be a national roll-out project coordinated by the NDoH. The NDoH will contract with suppliers to purchase stock and will allocate vaccines to provincial health departments and the private healthcare sector. To our knowledge, members will register on the Electronic Vaccination Data System (EVDS), which is a centralised system.

  1. Who will be vaccinated first, and will the member know or be informed when to go and be vaccinated and where?

Bestmed, as a registered medical scheme, is a health insurer and funder, and not a procurer or provider of healthcare services. Therefore, Bestmed will abide by the NDoH’s prioritisation plan for the allocation of vaccines. The COVID-19 vaccinations will be allocated to the priority groups identified by the plan, for their administration.

i) Phase I – Healthcare workers: doctors, pharmacists, and allied healthcare workers on the front line.

ii) Phase II – Essential workers, persons in congregate setting, persons older than 60 years, and persons older than 18 years with co-morbidities.

iii) Phase III – Other persons older than 18 years. South Africans should receive notification when they qualify to receive vaccines.

  1. Where will members be vaccinated? Will they have a choice or not, about the place where they are vaccinated?

Bestmed has a large network of healthcare providers. From the onset, we have been in touch with our networks to arrange for our members to be vaccinated at the pharmacies in the Bestmed pharmacy network (e.g. Dis-Chem, Clicks and other pharmacy chain clinics), similar to our annual flu vaccine process. These pharmacies have an extensive national footprint with more than 1 000 pharmacies across the country that are ready to act as soon as the vaccines become available.

  1. Will a member have a choice to be vaccinated or not?

As is the case with all other Bestmed vaccination and preventative care benefits, Bestmed cannot force its members to take the COVID-19 vaccine, however, we do encourage that they do. The NDoH is co-ordinating the involvement of the private healthcare sector in the drive to achieve herd immunity for the country (i.e. vaccinating around 40 million South Africans). Bestmed will actively contribute to the achievement of this goal and adhere to the medical advice dispensed by our internal and regulatory experts on the matter of the COVID-19 vaccines. We, as a Scheme, strongly believe in evidence-based care and it is a paramount guide to all of the Scheme’s benefit and treatment protocols. We have been closely monitoring the unfolding of the COVID-19 vaccine research and findings, and we believe that the vaccines that are currently available in the market are supported by solid research; and will go a long way to protect our members and their families against a pandemic to which too many of us have personally lost loved ones. We will also continue to provide our members with the information that they need to make informed medical choices for themselves and their kin.

  1. Do you have a date yet when the first members of medical schemes be vaccinated?

The dates for members’ vaccinations will depend entirely on which of the identified priority group each member belongs to; and the commencement of the vaccinations for the respective prioritisation phases as outlined by the NDoH and the national vaccination programme.

  1. Will all members be vaccinated eventually? Will you be informed by your medical scheme or by government if you are going to be vaccinated in the 2nd, 3rd, or 4th phase of the national program?

Bestmed is in a good financial standing and we have allocated Prescribed Minimum Benefit (PMB) funding to allow each of Bestmed’s ~200 000 beneficiaries to be vaccinated should the vaccine availability allow. However, each member will have to adhere to the priority group roll-out plan to ensure that our country’s healthcare workers and our most vulnerable citizens are vaccinated first with the rest of our member compliment following shortly thereafter.

  1. Will a member have to pay at the point where they get the vaccine?

Members will not be required to pay for their COVID-19 vaccine as it has been included in the amended PMB regulations as per the approval by Dr Zweli Mkhize, Minister of Health. The amendment included the insertion of the Diagnosis and Treatment Pair in the list of the PMBs under the heading “Respiratory System” Treatment: screening, clinically appropriate diagnostic tests, vaccination, medication, and medical management, including hospitalisation and treatment of complications, and rehabilitation of COVID-19.

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