# Five things you need to know about the new National Health Insurance Bill

- Link: https://dearsouthafrica.co.za/2019/08/08/five-things-you-need-to-know-about-the-new-national-health-insurance-bill/
- Published: 2019-08-08T18:09:43+02:00
- Author: dearSA

![DearSA - National Health Insurance](https://cdn.dearsouthafrica.co.za/wp-content/
uploads/2019/08/20191308/Screenshot-2019-08-08T180856.902.png "National Health Insurance")

# Parliament is set to release the National Health Insurance (NHI) Bill by 9am on Thursday morning. Here is how healthcare in South Africa is likely to change.

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

No. Once the NHI has been fully implemented, your medical scheme will not be allowed
to cover any health services that the NHI offers. You will have to use the NHI for
those services. Your medical aid will only be able to provide you with complementary
cover, in other words, services that the NHI doesn’t cover. By when will your medical
aid, in its current form, disappear? According to the Bill, the NHI Fund needs to
be up and running by 2026 through a system of “mandatory prepayment”.

Many experts, however, argue 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 mention 
that there will be “comprehensive healthcare services”. A benefits advisory committee,
appointed by the health minister, will decide which services will be offered. The
Bill says these services will be available for free, so there will be no co-payments

The NHI won’t pay for treatment when it can demonstrate that “no medical necessity
exists for the healthcare service in question”, when the medicine or treatment is
not included in the NHI’s list of medicines, also known as the formulary, and when“
no cost-effective intervention exists for the healthcare service”.

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 go to a specialist directly?

No — if you do, the NHI won’t pay for it. You will have to register at an NHI-accredited
primary healthcare facility, and, each time you need healthcare, you will have to
go to that facility. You will only be able to consult a specialist if the doctor
or nurse at your primary healthcare facility deems it necessary to refer you to 
one. If you’re travelling and fall ill, you’ll be able to go to an accredited facility
in the area you’re visiting.

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, as HIV is infectious and 
it is in the best interest of the country to treat everyone who is infected with
the virus to prevent its spread. The children of asylum seekers and migrants, however,
will be entitled “basic healthcare services” provided for in the Constitution.

If you’re a registered refugee, you will be entitled to all services, provided that
you have registered for the NHI by using your refugee identity card.

The NHI will also cater for ‘individual foreign nationals’ determined by the home
affairs minister, after consultation with the minister of finance.

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, the reallocation of medical scheme tax credits and general
taxes. Money that Treasury currently allocates to provinces through the ‘provincial
equitable share’ and ‘conditional grants’ will be shifted to the NHI Fund.

[Article](https://m.news24.com/SouthAfrica/News/five-things-you-need-to-know-about-the-new-national-health-insurance-bill-20190808)
from NEWS 24