New National Health Insurance Bill: Five things you need to know

By Doug Mattushek - 09 August 2019Views : 2373

 As Parliament released the new National Health Insurance (NHI) Bill on Thursday morning. Here is how healthcare in South Africa is likely to change.

1. Will you still be able to have comprehensive medical aid?

No, as once the NHI has been implemented fully, your medical aid will not be allowed to cover any health services that the NHI offers. As you will have to use the NHI for those services.

Your medical aid will only be able to provide you with complementary cover, meaning: services that the NHI does not cover.

According to the Bill, was your medical aid, in its current form, will disappear once the NHI Fund is up and running by 2016 through a system of "mandatory prepayment".

With many experts, arguing that the NHI will take much longer to take off.

2. What services will the NHI cover?

The Bill doesn't specify what services the NHI would cover, but it does make mention that there will be "comprehensive healthcare services". The Minister of health, will appoint a benefits advisory committee, which will decide which services will be offered.

The services will be available for free, cutting out the co-payments.

However, the NHI will not cover treatment when it can demonstrate that "no medical necessity exists for the healthcare service in question".

According to the Bill, the NHI will start to buy healthcare services for children, women, the elderly and people with disabilities by 2022.

3. Will you be able to see a specialist?

No, and if you do the NHI will not cover it. You will have to register at an NHI-accredited primary healthcare facility, and, each time you need healthcare, you will have to go that facility.

You will only be able to see a specialist if the doctor or nurse at your primary healthcare facility, deems it necessary to refer you to one.

4. What happens if you're an asylum seeker or an undocumented migrant?

You will only be able to access emergency medical services and services for 'notifiable conditions of public health concern', such as TB. HIV treatment is also likely to be available to asylum seekers and illegal immigrants.

5. Who will pay for the NHI?

In short, taxpayers. The Bill says the money will be collected "in accordance with social solidarity" through payroll taxes for employees and employers, a surcharge on personal income tax.

Will be seen as the reallocation of medical scheme tax credits and general taxes.