The Health Department says while the National Health Insurance (NHI) is designed to provide quality health care to every patient in South Africa, it will have some limitations on what conditions it will cover.
Deputy Director General in the Health Department, Doctor Anban Pillay said this while addressing a National Health Insurance Conference in Johannesburg on Thursday morning.
Pillay says there will be a committee of experts that will determine the kinds of illnesses to be covered and treated under the NHI.
He says, “The treatment that will not be funded, so clearly the NHI will not cover everything for everybody so clearly there will be a benefits package, the package will define what those limits are.”
“In terms of those limits the general rules that will be applied are firstly if there is no medical necessity for that condition it will not be funded, secondly if it’s not cost effective it will not be funded or if it’s not on the formula, so generally those are some of the rules that will be applied,” Pillay adds.
