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South Africa’s Lock-down Explained

South Africa will be going into a 21-day national lock-down, beginning at midnight on Thursday 26th March. To clarify, Thursday will be the final “normal” workday for South Africans, and the lock-down will begin on Thursday night. The lock-down will end at midnight on Thursday 16th April, so the first standard workday will be Friday 17th April.

President Cyril Ramaphosa has made exceptions for certain businesses to remain open during the lock-down period, including drug stores, grocery stores, and banks. While people may be panic buying at present, the government has assured everyone that this is not necessary, as normal the supply of goods will remain during the period.

The South African Police Service (SAPS) and South African National Defense Force (SANDF) will be patrolling to ensure that the lock-down rules are adhered to. This is South Africa’s opportunity to “flatten the curve” – stemming the rapid spread of COVID-19. If we work together, we can reduce the infection rate, and work towards restoring normality.

Anyone found to be breaking the rules of the lock-down could be imprisoned. Please follow the President’s instructions and remain at home.

To track the spread of the virus, click here. And for information about coronavirus from the WHO, click here. Below are some infographics explaining the SA lock-down.

Please note that Relocation Africa staff will be working from home during the lock-down period. Our landline will be down, but we will be contactable via email.

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.
Sources: [1], [2]. Image sources: [1], [2].

South African COVID-19 Update

President Cyril Ramaphosa spoke about COVID-19 in South Africa last night, and has declared a national state of disaster.

“Initially, it was people who had traveled out of the country, especially from Italy, who had positively tested for the virus. It is concerning that we are now dealing with internal transmission of the virus,” the president said.

Ramaphosa was addressing the country from the Union Buildings in Pretoria on Sunday after a special Cabinet meeting to discuss matters related to the pandemic.

“We have now declared a national state of disaster. We will set up emergency and rapid response systems,” Ramaphosa said.

The following measures will be in place amongst others:

  • Limited contact with persons who may be infected.
  • Travel ban on foreign nationals from high-risk countries such as Italy, Iran, South Korea, Spain, Germany, the United States, the United Kingdom and China as from 18 March 2020.
  • Visas from those countries cancelled from today and previously granted visas are now revoked.
  • South Africans returning from high-risk countries will be subjected to testing and self-quarantine.
  • Travellers from medium-risk countries – such as Portugal, Hong Kong and Singapore – will be required to undergo high intensity screening.
  • Gatherings of more than 100 people are now prohibited.
  • Schools will be closed from Wednesday until after the Easter weekend.
  • Visits to all correctional facilities cancelled for the next 30 days.
  • All non-essential travel for all spheres of government outside of the country is prohibited.
  • We further discourage all non-essential domestic travel, particularly by air, rail, taxis and bus.
  • Strengthened surveillance, screening and testing measures at OR Tambo, Cape Town and King Shaka International Airports
  • 35 of the 53 land entry points will be closed and 2 out of the 8 sea ports.

Ramaphosa says a national command council has been established that will be meeting three times a week.

He called on everyone to change their behavior including washing their hands frequently and using hand sanitizers, covering the nose and mouth when sneezing, avoiding contact with people with flu-like symptoms and minimizing physical contact.

“We must encourage the elbow greeting,” the president said.
Ramaphosa says the government will be partnering with the private sector to set up a national tracking and monitoring system for all coronavirus cases.

Cabinet is also finalising a fiscal package to help deal with the outbreak, the president said.

To read the President’s full speech, click here. The recorded address can be viewed below.

Relocation Africa

At Relocation Africa, we are taking every effort to ensure the continued safety of our staff and our clients. We are monitoring the situation daily, and will react accordingly. We are committed to following the guidelines as set out by the World Health Organization, as well as the South African Department of Health, and the broader government. We will update our clients and business partners if we make relevant changes to our operations, as necessary.

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.
Sources: [1], [2], [3]. Image sources: [1], [2].

South African Government’s Statement on COVID-19

The first case of COVID-19 in South Africa has been officially confirmed.

In a statement, the Department of Health said:

“Fellow South Africans, this morning, Thursday March 5, the National Institute for Communicable Diseases (NICD) confirmed that a suspected case of COVID-19 has tested positive. The patient is a 38-year-old male who travelled to Italy with his wife. They were part of a group of 10 people and they arrived back in South Africa on March 1, 2020.

The patient consulted a private general practitioner on March 3, with symptoms of fever, headache, malaise, a sore throat and a cough. The practice nurse took swabs and delivered it to the lab. The patient has been self-isolating since March 3. The couple also has two children.

The Emergency Operating Centre (EOC) has identified the contacts by interviewing the patient and doctor. The tracer team has been deployed to KwaZulu-Natal with epidemiologists and clinicians from NICD. The doctor has been self-isolated as well”.

The South African Parliament is busy debating South Africa’s preparedness for COVID-19.

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.

Sources: [1], [2]. Image sources: [1], [2].

Major South African Medical Schemes, and What They Offer

A new year brings higher prices and some big changes to South Africa’s medical aid schemes. Below is what the five biggest schemes in the country have on offer for 2020 – and how much they’re charging.

South Africa is home to 80 different medical aid schemes, with 4.02 million registered members, serving a total of 8.87 million beneficiaries.

Among these schemes, 21 are open schemes (that anyone is free to join) and 59 restricted schemes (for companies, or specific sectors or industries).

The largest scheme by some margin is Discovery Health, which has 1.335 million members (33.2% of the total) and 2.79 million beneficiaries (31.5% of the total).

Among the open schemes, Discovery is followed by Bonitas, with 331,955 members and 713,190 beneficiaries, and Momentum Health, with 156,761 members and 298,071 beneficiaries.

This is followed by BestMed (93,635 members and 197,088 beneficiaries) and MediHelp (92,884 members and 201,944 beneficiaries).

Medical aid users would have noted price increases across all medical schemes in 2020 – though some schemes have raises prices more than others.

Discovery’s medical plan increases ranged between 9% and 11%, while Bonitas saw an overall weighted increase of 9.9% among its schemes. Momentum’s weighted increase was 8.2%, and BestMed saw price increases of 8.9% among options.

MediHelp’s price increases average at 11.9%.

What’s the same

By law, South African medical schemes are non-profit trusts, owned by their members. In this sense, they are all functionally the same – members’ contributions are pooled and used to pay relevant medical costs where necessary, while keeping a legislated surplus to prevent the scheme from collapsing.

Some medical plans have a savings option, which creates a savings pool from a member’s monthly contributions which is for exclusive use by that member.

Medical aid schemes are also required by law to cover a set list of chronic illnesses, known as the Prescribed Minimum Benefits (PMB). This is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected.

Beyond this, medical aid schemes are free to differentiate themselves through their product offerings, usually targeting specific demographics.

Things like annual limits, specialised benefits, family cover, day-to-day coverage and networked doctors and hospitals all vary across the different plans – both internally across a single group’s plans, and from company to company.

This article not a comprehensive review of each individual plan offered by the medical aids, and if you’re looking to change schemes, upgrade or downgrade, you should read through the information provided by the respective groups to ensure your health needs are covered.

Discovery

  • Offers 29 plans Across 7 scheme categories.
  • No overall limit for hospital cover on any Discovery Health Medical Scheme plan. You can go to any private hospital on most plans;
  • Access to screening and prevention benefits that cover tests to detect early warning signs of serious illness;
  • Above Threshold Benefit (ATB) that gives further day-to-day cover once the Annual Threshold has been reached;
  • Day-to-day Extender Benefit (DEB) for essential healthcare services in its network once medical savings are used up;

In 2020 Discovery said that co-payments and deductibles will be increased by 9.5%. It added that benefit limits will be increased by 9.5% with the exception of things like the oncology threshold, international travel benefit, among others, where there is no increase for 2020.

From 1 January 2020, certain formulary changes and chronic drug amount updates will be applied, and the the Day-to-day Extender Benefit will now cover video call consultations with a network GP as well as pharmacy clinic consultations in the group’s wellness network. More information on the major Discovery changes can be read here.

One of the biggest changes to Discovery in 2020 is the Vitality programme – more specifically, the Vitality Rewards Points, which will be converted into the group-wide Discovery Miles.

You can read more about the changes being made to the Vitality points system here.

Bonitas

  • Offers 13 plans across 9 scheme categories.
  • Cover for 27 to 60 chronic conditions and free medicine delivery;
  • Free cover for your fourth and subsequent children so you only pay for a maximum of three children;
  • Has Managed Care programmes to help manage chronic conditions including cancer, mental health, HIV/AIDS and diabetes;

Key changes for Bonitas in 2020 come by way of enhances maternity benefits and support, additions to the Wellness Extended benefit, the introduction of a pharmacy network, as well as changes to co-payments and hearing-aid cycles.

Currently the Wellness Extender benefit can be accessed after competing a wellness screening test. It can be used for consultations and treatment with a GP, physiotherapist, dietician or biokineticist, or to participate in a stop smoking programme. In 2020, the benefit will be extended to include blood tests and x-rays.

With the new pharmacy network, members will be able to access chronic, acute, over-the-counter and oncology medicine from a network of providers which will avoid having to pay additional dispensing fees.

Expecting mothers will gain access to lactation specialists, and also get major discounts from Baby City, as well as a mother and child support network.

A full breakdown of the major changes to Bonitas for 2020 can be found here.

Momentum

  • Offers 35 plans across 6 scheme categories.
  • No overall annual limit for hospitalisation;
  • Covers 26 to 62 chronic conditions – with the base 26 conditions carrying no annual limit;
  • Offers highly flexible plans with the option of state, networked or open hospitals;
  • Health platform benefit for preventative care and screening;
  • Offers additional products like HealthSaver to help make medical saving easier;
  • Works in conjunction with the Momentum Multiply rewards programme.

Aside from price increases, 2020 changes for Momentum Health include the introduction of the Evolve option, and the falling away of the Impact option.

The major medical benefits on the Evolve option differ to the benefits that were available on the Impact option. For example, there is no longer an annual limit for maternity confinements and
neonatal intensive care.

The Evolve Option provides cover for hospitalisation at the Evolve Network of private hospitals. There is no overall annual limit for hospitalisation.

Associated specialists are covered in full. Non-Associated specialists are covered up to 100% of the Momentum Health Rate.

A co-payment of R1 570 will apply per hospital authorisation, except in the case of motor vehicle accidents, maternity confinements and emergency treatment.

You can view a detailed breakdown of changes to all Momentum Health plans here.

BestMed

  • Offers 15 plans Across 3 scheme categories.
  • Self-administered which means more of your money goes towards benefits and less towards administration;
  • No self-payment gaps;
  • Fewer co-payments – 75% fewer than competitors, the scheme claims;

For 2020, all limits and sub-limits have been increased by 5.2% across all options, and new benefits have been added to relevant plans.

For example, mammary surgery has been included as a benefit (up to R35,000) on Pace and Pulse 2 plans, while Diabetes Primary Care Consultations have been added to out-of-hospital benefits at 100% Scheme tariff.

For detailed changes to the schemes, you can view this document.

MediHelp

  • Offers 11 plans Across 5 scheme categories;
  • Full cover for 270 PMBs and 26 chronic conditions;
  • No annual limit on hospital cover;
  • Unlimited cover for trauma and emergencies;
  • On Prime options, you only pay for 2 children – the rest are covered for free;
  • Children can remain dependents until they are 26;
  • Access to online wellness programmes and emergency app.

On top of the sizeable increase of 11.9% on schemes for the year, MediHelp members will see an average limit increase of 5.4% in 2020. One of the biggest changes will be seen in the Necesse band of plans, which has been collapsed to two bands, which will result in some members seeing their fees increase by 30%. Other changes vary across the different plans, including more maternity consultations for members on Prime 2 and additional hospitals being added to the Prime network.

A breakdown of changes can be read here.

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email info@relocationafrica.com, or call us on +27 21 763 4240.

Sources: [1], [2]. Image sources: [1], Natasha Spencer [2].

South African National Health Bills Outlined

The Department of Health has set a target of 2026 to have a new national health system rolled out in South Africa, in many ways akin to the UK’s NHS, with the goal being equal access to healthcare, regardless of socio-economic status.

The first set of enabling legislation paving the way for universal healthcare in South Africa has been gazetted by Cabinet, Health Minister Aaron Motsoaledi announced on Thursday.

Motsoaledi presented two bills to the media on Thursday that would lead to massive changes in the way public health and medical aid coverage are handled in the country: the National Health Insurance (NHI) Bill and the Medical Aid Schemes Amendment Bill.

The minister said that the essence of the NHI is that the “rich will subsidise the poor, the young will subsidise the old, and the healthy must subsidise the sick”.

“Currently, it’s the opposite. At present, the poor subsidise the rich, and we will attempt to show that.”

Only 10% of South Africans could afford what was being charged in private healthcare, he said.

Citizens, civil society and the private sector have three months in which to comment on the new bills, which can be found HERE.

Single purchaser

The NHI Bill seeks to establish a fund – the National Health Insurance Fund – to act as a public entity governed by the Public Finance Management Act.

The fund will be a single public purchaser and financier of health services in the country, to ensure “equitable and fair distribution” and will be a mandatory pre-payment health services system.

It will purchase health care services, medicines, health goods and health-related products from certified, accredited and contracted service providers on behalf of the public.

It will “pool funds to provide access to quality health services for all South Africans based on their health needs and irrespective of their socio-economic status”, the minister explained.

The aim is for everyone to have the same access to the same standard of healthcare regardless of income, what people can afford or how frequently they need the services.

‘Terrible twins’ of the current system

Motsoaledi said there couldn’t be one set of rules for the rich and another for the poor as both groups “have the same health needs”.

He acknowledged that the move would require a massive reorganisation of the current health system, both public and private.

The National Development Plan described the exorbitant costs of private healthcare and the poor quality of public healthcare as the “terrible twins” of the health system.

Many have argued the country needs an overhaul of its health service first before changing the way it is funded, he said.

Fixing public healthcare, however, won’t be a single event, but a continuous, ongoing process, and shouldn’t be a “big stick” with which to beat back the move to national healthcare, he said.

“We are very much alive to the problems of poor quality in the public health system,” he said.

Comparison to Europe

South Africa currently spends a total of 8.7% of its GDP on both public and private health, he said.

The private sector spends 4.5% of GDP on health but only provides care to 16% of the population.

The public sector spends 4.2% of GDP on health but provides care to other 84% of the population.

Motsoaledi noted similarities in terms of spending when comparing SA to European countries, but not when it comes to the provision of healthcare. “It looks like chalk and cheese. The reason is the way the money is divided”, he said.

On top of that, South Africa is an outlier when it comes to voluntary spending on private health insurance.

South Africa spends 42.2% of total health spending on private healthcare, the highest proportion in the world. The US meanwhile spends 32%. The world average is 4.1%.

School health the ‘heartbeat’ of the new system

The NHI Bill will seek to make amendments to 12 other existing acts of Parliament in order to pave the way for an effective national fund.

For the purposes of the briefing, Motsoaledi confined himself to two acts: the National Health Act of 2003 and the Mental Health Act of 2002.

The amendment to the National Health Act will essentially give the minister’s office more direct capability in intervening in ailing provincial health departments, as it did in the North West earlier this year.

The same would apply for mental health services.

School health has been identified as the “heartbeat” of the new system under the NHI, with 12 million children in school currently.

After screening 3.5 million school children, the department found that eyesight, hearing, oral health and speech were physical barriers to learning.

The NHI would intervene in the matter, allowing for free glasses, hearing aids, oral hygienists and speech therapists. Pilot projects will be launched this year.

“We cannot wait for kids to arrive in clinics already sick. We need to know what is going on with them because they are the future.”

Co-payments to be abolished

Motsoaledi also announced the new Medical Aid Schemes Amendment Bill that will change how private medical aids operate in South Africa.

The minister said changes were necessary to pave the way for the NHI.

“The first amendment is to abolish what has become known as co-payments.”

Citizens have paid in the last financial year a sum of R29bn in co-payments from “their own pockets”.

“The patient should not be burdened with the need to pay anything,” Motsoaledi said.

“Of course there are people who say this amendment is callous and aimed at destroying the medical aid system. I assure you this has been well thought through.”

No late joining fees

He also took exception to medical aid schemes holding in reserves close to R60bn.

There is a statutory requirement that the schemes hold 25% of income in reserves to cater for emergencies.

“Our bone of contention is that R60bn is equivalent to 33% of reserves and is unnecessary accumulation.”

The bill will also abolish penalty fees for late joiners. “Under the NHI, there will be no penalty for late joining.”

In most retirement cases, a spouse cannot continue with the scheme until they themselves register as the principal member.

To see the gazetted bill, click here.

The transition is expected to take approximately 15 years in three phases. Phase two began in 2017 and will end in 2022. In theory, the system should finally be ready by 2026, Motsoaledi said.

 

Sources: News24 via AllAfrica [1]. Image sources: [1].

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, and Remuneration needs, email marketing@relocationafrica.com, or call us on +27 21 763 4240.