Health dept will NOT pay for uninsured walk-ins at private vaccination sites

A new circular sent to various vaccine sites over the country states that the health department will not pay for uninsured people who receive COVID-19 vaccinations at a private vaccine site without an appointment.

This comes amid South Africa’s current vaccination roll-out which sees healthcare workers and people 60-years-old and above receiving the jab.

Access to every vaccine site

“The NDOH [national department of health] will not pay for uninsured walk-ins to private sites,” states the circular released in June 2021 according to Business Insider. “These individuals are to be referred to public sites. The exception is that private sector sites are authorised to vaccinate uninsured walk-ins aged over 80 years, and to reclaim the cost from the state.”

It is reported that the 80-plus group may not be more than “5% of the site’s vaccine allocation”.

Scheduling your vaccine jab

The South African previously reported that the Western Cape Government announced on 27 May that it would introduce a system to manage walk-ins at vaccination sites after there were issues with the Electronic Vaccination Data System (EVDS), responsible for scheduling appointments.

Now, the publication reports that EVDS rules are set to send medical aid members to private vaccine sites, and uninsured people to public health facilities, but with top-up allocations across the two groups where necessary to fill available slots.

Those with appointments are not affected by the payment rules.

An uninsured individual

“Where an uninsured individual is scheduled by the EVDS to a private vaccination site, the state will cover the vaccine cost and vaccine administration cost,” reads the circular.

Those with appointments must be served first, and sites have been asked to set up separate queues, ideally at separate entrances, for walk-ins. 

EVDS appointments are supposed to be scheduled three days in advance, but this is not always the case. Meanwhile, no appointments will be made for those who do not have a registered address within a catchment area of an active vaccine site.