A healthcare worker gets vaccinated for Covid-19 at Gatesville Melomed vaccination centre in Athlone. Picture: Ayanda Ndamane AFrican News Agency (ANA)
A healthcare worker gets vaccinated for Covid-19 at Gatesville Melomed vaccination centre in Athlone. Picture: Ayanda Ndamane AFrican News Agency (ANA)

Medical aids cannot force members to get the Covid-19 vaccine

By Xolile Bhengu Time of article published Aug 3, 2021

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DURBAN - THE Board of Healthcare Funders (BHF), South Africa’s biggest medical member body, says existing health laws prohibit any medical aid scheme from forcing members to vaccinate.

The BHF comment follows an announcement by insurer Discovery Life, that from July 29, all new clients who take insurance policies would be asked if they had been vaccinated against Covid-19.

The BHF represents 5.5 million lives, from 38 of South Africa’s 78 medical schemes. Charlton Murove, BHF head of research, said medical aid schemes applied community ratings.

“Regardless of your health status or age, members pay the same amount. Whether you are 60 or 25, if you are in the same benefit package then you pay the same rate.”

Murove said life insurance laws were not the same: “They can ask for a medical exam and, based on that, then they can determine the premium that you are supposed to pay.

“We expect that other life insurers will follow the same route to mitigate their risk.”

Responding to The Mercury, Discovery Health said there were no underwriting changes for its current or prospective medical aid members, adding that the benefit was available only to people applying for life insurance through Discovery Life from this point onwards.

“Discovery Health members are reminded that their treatment for Covid-19 is fully covered, as a Prescribed Minimum Benefit, and their vaccine is also fully covered and paid for (not from their medical savings account).

“We strongly encourage everyone to get their Covid-19 vaccine, with evidence showing that getting vaccinated can reduce the risk of hospitalisation and death by as much as 96%.”

Responding to The Mercury query about whether Discovery Life would give its life insurance members a higher premium based on their refusal to vaccinate, Discovery Life chief executive Riaan van Reenen said not necessarily.

“New Discovery Life clients are eligible to receive the Vaccination Max Payback offer, up to their full first year’s premiums back, if they are vaccinated or commit to being vaccinated.

“New Discovery Life clients who don’t want to be vaccinated will get a fair risk rating based on their age and underlying health conditions, but will unfortunately miss out on the added benefits that our vaccinated Discovery Life clients will get,” said Van Reenen.

He said they believe that policyholders who choose to vaccinate and reduce their risk of dying should benefit from their healthy choices, rather than pay for the relatively higher risk of policyholders who choose not to get vaccinated.

“The principle is similar to applying discounts to non-smokers and loadings to smokers – everyone ends up paying a fair premium,” said Van Reenen.


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