The Board of Healthcare Funders (BHF), a not-for-profit representative body of the healthcare funding industry, representing   56 medical schemes, administrators and managed care organisations have confirmed that it has been engaging with its members to chart a way forward on the R6.8 billion government has requested from medical schemes to fund the Covid-19 Vaccines.

The BHF has confirmed 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.

Funding will be prioritised for vaccinations in line with the targeted population groups to support efforts to achieve herd immunity for the country.

Regarding the additional funding required to support health citizens who are not medical scheme members, the BHF has noted with concern that several reports have indicated that medical schemes have made this funding available. However, there are several restrictions to this as the Medical Schemes Act does not allow for funding healthcare services for non-medical scheme members.

Dr Katlego Mothudi, Managing Director of the Board of Healthcare Funders, clarified that, “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.”

He said, “We are also engaging with our members to consider a framework within the Medical Schemes Act and medical scheme rules to support government.

Dr Katlego Mothudi, Managing Director of the Board of Healthcare Funders, said, “In principle, BHF member schemes support the concept of social solidarity, however several considerations need to be made around the proposed funding mechanisms, to ensure that this can be done above board, following a sound governance framework and within the prescripts of the Medical Schemes Act as well as the individual medical scheme rules.”

Dr Mothudi noted that medical schemes function under the Medical Schemes Act and their rules registered through the Council of Medical Schemes (CMS), and these guide and control their businesses’ functioning. The Act and scheme rules are binding and are designed to ensure that medical schemes act in the best interest of their members.

“At this point, the government still has not provided a clear indication of the cost of each dose of the vaccine and the price at which medical schemes will procure the vaccine from the Department of Health, however, funds are available to provide cover for medical scheme members,” noted Mothudi.