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(Photo by Gallo Images/Darren Stewart)
    • The state will not pay for uninsured people who receive Covid-19 vaccinations at a private vaccine site without an appointment, the national department of health says.
    • That means walk-ins with medical aid have access to every vaccine site, while those who are not part of a medical scheme are limited to the smaller subset of public health facilities.
    • The only exception is people over 80, but then only if there aren't too many of them.
    • The management of each site can decide whether to accept walk-ins, in the over-60 group currently being vaccinated.
    • Uninsured people referred to a private site by the EVDS are not affected by the payment policy.
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    South Africans without medical aid will not be allowed to walk into a private Covid-19 vaccine site without an appointment, under a department of health policy sent to such sites on the weekend.

    Instead, the uninsured must be referred to one of the smaller set of public healthcare facilities administering jabs, unless they are at least 80 years old – and then only if there aren't too many.

    Medical aid members older than 60, on the other hand, can try their luck at any of the now nearly 500 points where vaccines are being given, without an appointment.

    "The NDOH [national department of health] will not pay for uninsured walk-ins to private sites," such sites were told in a circular. "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."

    But even then, the 80-plus group may not be more than "5% of the site’s vaccine allocation".

    For the likes of Clicks pharmacies, which target 50 people per day, that means two over-80s without medical aid may be helped every day.

    There is no way for the uninsured to pay directly for a vaccine from a private site; under strict rules no money may change hands. And private sites have no discretion in who they inject, under a system designed to account for every dose of vaccine.

    Sites started to accept walk-ins when trouble with the Electronic Vaccination Data System (EVDS), responsible for scheduling appointments, saw a large number of no-shows on some days. 

    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.

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    "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. No appointments will be made for those who do not have a registered address within a catchment area of an active vaccine site. 

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