Bonitas - Parenting Hub

Intermittent fasting and pregnancy, is it dangerous?

Your baby’s health during your pregnancy solely depends on you – what and when you consume is important to both of you. Intermittent fasting is a diet that many turn to to lose weight and improve health. This is a time restricted form of fasting and you may wonder if it’s healthy to keep up this kind of eating while trying to get pregnant or when you are pregnant. Is it safe to fast while I am pregnant? Fasting during your pregnancy is not recommended. While there is research that shows this may be a good way to help with weight loss and potentially reduce the risk of type 2 diabetes, this is not ideal when your body needs more calories than normal. While pregnant your nutritional focus should be to make sure that your baby is getting all the right vitamins and minerals. While in the initial stages of pregnancy you might not need more calories than normal, as your pregnancy progresses you will need to eat more – making fasting a less viable option. However, if you are struggling with morning sickness (most prevalent in the first trimester), you’ll find that eating bland foods little and often can help ease the nausea, which isn’t compatible with fasting for hours at a time. Not only will snacking help keep the nausea at bay, but it’ll also keep your blood sugar stable. While there aren’t studies that look at intermittent fasting throughout pregnancy, it has been found that moms-to-be with lower glucose levels had lower fetal movement, which can be a warning sign of potential issues during your pregnancy. Can I start intermittent fasting straight after birth? If you’ve decided to eat regularly during your pregnancy, you may wonder if you can return to your old lifestyle after having your baby. However, while you are breastfeeding it’s best to stick to a regular eating schedule. Even after birth your body will be needing extra calories for breastfeeding – restricting these can lead to reduced milk supply

November 9, 2022

Handling Childhood Illness Effectively

Most parents know that during the course of raising a child you will have to deal with different bouts of illness. Here is some information, from Bonitas Medical Fund, which should help you to manage common early childhood illnesses successfully.

October 24, 2022

Bonitas Medical Fund: 2023 Product Launch round up

At a glance: 340 119 Principal members 709 881 Total beneficiaries 190 000 new members over the past 36 months Average age of beneficiary: 33.9 Average age of new members is 15 years younger than existing members R7.4 billion in reserves 36.5% solvency ratio AA Credit rating Plans Bonitas offers a wide range of plans that are simple and easy to understand. There are 15 options in five categories: Savings, traditional, hospital, Edge (virtual) and income-based. Increases A three-month price freeze will apply in 2023: From January to March contributions remain the same as 2022 The average increase, across all plans, is 5.9%. However, factoring in the three-month price freeze, the average increase drops to 4.8% Plan increases range from 0% to 9.4% BonStart has a 0% increase By applying very low contribution increases since December 2020, the Scheme has effectively passed R1.4 billion in savings back to members Nine plans are priced under R3 000 per main member’s monthly contribution The most popular plans, with newer members, include Primary, Primary Select, BonFit, BonEssential, BonEssential Select, BonStart and BonStart Plus Note: Contributions from April 2023 What’s new? Bonitas has introduced a mental health app – in partnership with Panda. It’s a free to download mental health and wellness mobile app that uses scientifically validated assessment tools and appropriate treatment to provide the right care at the right time. Panda will be available from October 2022 The Hospital-at-Home initiative has been successful and the offering is being extended to include: A programme for re-admissions Screening and disease prevention Alternative to stepdown facilities Kidney dialysis at home An improved programme for chronic kidney disease Restructured benefits are unlimited for PMB cancers across all plans. With a set Rand amount where non-PMB cancer cover is available. Once the Rand limit is exhausted, a 20% co-payment will apply Cover for two doses of the vaccine Human Papillomavirus (HPV) for girls aged between 9 -14 years, on BonComprehensive, BonClassic, BonComplete, Standard and Standard Select Introduction of one booster vaccine for Pertussis or whooping cough, per beneficiary aged between 7 and 64 years on Standard, Standard Select, BonComplete, BonClassic and BonComprehensive. The savings component across the savings plans have been increased from between 5% to 9.4% and amended rules allow members to use their savings as they deem fit for the new year The Benefit Booster – introduced in 2022 which unlocked R446million in additional benefits – has been adjusted according to utilisation Footprint and networks Our footprint extends across all 9 provinces, with our membership concentrated in Gauteng, KwaZulu Natal, the Western Cape and the Eastern Cape. A GP network of over 4 400 An extensive Pharmacy network, with around 2 500 practices located in all nine provinces to dispense chronic, acute and over-the-counter medicine through Scriptpharm Dental network, through DENIS, provide access to around 3 000 practices across SA Optical network through PPN gives members access to over 2 300 practices

October 19, 2022

PUTTING YOUR KIDS ON A PATH TO GOOD NUTRITION

For many parents, nothing is as stressful as getting your kids to eat all the food on their plate, especially when it comes to veggies. Eating a variety of healthy foods is essential for your children’s wellbeing. Here are some tips on how to get your kids to eat better.

October 17, 2022

Don’t misjudge generics

Even though generic drugs have been around for more than half a century, many patients in South Africa are unreasonably suspicious of what is. In essence it’s a ‘carbon copy’ of the original brand of drug or medicine. Bonitas Medical Fund believe it may be because consumers think that if they are cheaper they must be inferior. This lack of understanding costs consumers and medical aids millions of Rands each year.

October 10, 2022

Mental health post pandemic

The Covid-19 pandemic and the resultant lockdowns affected people across the world – mentally, emotionally and physically. These included feelings of isolation, work stress, frustration at rules and regulations, fear for close family and friends and a loss of control over your life. So, it is not surprising that we have seen an increase in mental health related issues. 1 in 6 South Africans suffer from anxiety, depression or substance use disorder. Over the last two years the prevalence of anxiety and depression disorders has increased by 36.4% and 38.7% respectively. 970 million people worldwide have a mental health or substance abuse disorder. A study by the Global Happiness Council (GHC) shows that mental illness is the main ailment among people of working age. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund says, ‘This has a massive effect on employers as they try to cope with keeping their businesses going, preventing job losses and maintaining a happy and motivated workforce. The economic uncertainty, political instability and poor socio-economic conditions in South Africa have also added to the burden of mental health issues in South Africa.’ To make matters worse, according to South Africa’s National Mental Health Policy Framework, ‘up to 80% of South Africans who need mental health support are unable to easily access it’. In addition to a comprehensive mental health programme, Bonitas is the first medical aid to offer Panda to its members. It’s a free to download mental health and wellness mobile app that provides scientifically validated assessment tools to enable users to objectively measure their mental wellbeing. A gamified tracking tool allows you to document and monitor the progress you’re making on your personal mental health journey. This includes: Engaging in interactive, audio-only sessions with peers and mental health experts in the ‘Bamboo Forest’ Learning new skills through assignments and videos to help you live a more fulfilled life Tracking your mental health progress to measure how you are feeling Getting text-based chat support from an accredited wellness counsellor Booking 1:1 virtual consultations with accredited and registered counsellors, social workers, psychologists and other mental health professionals ‘The level of support depends on the degree to which you need help,’ says Dr Mkhatshwa. ‘This ranges from level one, where there is an easy access point to community, information and support, through to level 5 where Panda will notify you to contact emergency services. We know how tough it can be to go through difficult times all by yourself, but with Panda, you will be able to find the support and resources that you need. In a nutshell: The right care at the right time for a healthy mind, using your phone.’ What is mental illness? Mental illness is defined as ‘any behavioural or mental pattern that causes significant distress or impairs normal functioning’. It can occur as a once off, be persistent or recur. The common denominator being the debilitating nature of the condition. It is a medical condition A mental illness affects the way a person experiences and behaves in the world around them. It is a recognised medical condition in the same way as chronic diseases, such as diabetes and high blood pressure and can affect anyone, regardless of race, religion, income or age. It is not a sign of weakness or madness and is nothing to be ashamed of. The good news is, it’s a condition that that can be managed and treated successfully. Anxiety disorders and depression are the most common mental health problems but others include eating disorders, Post-Traumatic Stress Disorder (PTSD), obsessive compulsive disorder (OCD), bipolar mood disorder as well as psychotic disorders such as schizophrenia and personality disorders. Substance abuse, such as drugs and alcohol, is also classified under mental illness. Battling the stigma The Mental Health Society acknowledges, ‘The social stigma attached to mental ill-health and discrimination exacerbates patients’ condition. It often prevents people from seeking treatment. And, if they do, makes it harder to recover.’ Dr Mkhatshwa says, ‘Fortunately, increasingly well-known and influential people who are suffering from or have overcome mental illness, are being more open about it. This will go a long way to debunk myths, negativity, discrimination and judgement’. Recognising the signs These can vary but, in general, these include: Being frequently sad, depressed and gloomy for long periods and feeling overwhelmed by life’s problems Major changes in eating habits, resulting in weight loss or gain Struggling to concentrate and make decisions Loss of energy and lack of motivation Constant stress and anxiety over work, finances, life, friends and family Emotionally distant Frequently tearful Having difficulty sleeping or sleeping more than usual Loss of interest in activities Easily irritated and more aggressive than usual Having thoughts of death or suicide Drug or alcohol abuse may also be a sign of underlying mental illness Help is at hand There are specialised mental health programmes in place through most medical aids and most mental illnesses can be effectively treated by health professionals and community-based services or NGOs. This may include access to medication, therapy and counselling. The Mental Health Programme (MHP) from Bonitas, which forms part its Managed Care initiatives, is aimed at improving quality of life and empowering people with mental health issues to manage their condition. It is education driven and offers support for loved ones too. ‘The introduction of Panda will dovetail neatly with our MHP,’ says Dr Mkhatshwa. ‘Mental illness cannot be wished away,’ says Dr Mkhatshwa. ‘We can’t expect someone to ‘pull themselves together’, they simply can’t. But with the right support and help, symptoms will be relieved and the recovery rate is encouraging with patients getting back to being happier, more productive members of society.’

October 7, 2022

Bonitas 2022 contributions continued for 2023!

Bonitas Medical Fund, one of the leading medical schemes in South Africa, announced its 2023 product line up today. Lee Callakoppen, Principal Officer of Bonitas says, ‘Our average increases for the year would have been 5.9% – well below the current inflation rate of 7.6%. The good news is that we’ve put a price freeze on contributions for the first quarter of 2023, to offer our members some respite. This effectively means an increase of 4.8% over the 12 months. We have also shared exactly what members can expect to pay from 1 April 2023, so that they can make informed decisions. Bonitas celebrated its 40th anniversary this year and has evolved and expanded its capabilities over the past four decades in response to the needs of a growing membership base. ‘It’s always a delicate balancing act between keeping increases as low as possible while maintaining the stability of the Scheme,’ says Callakoppen. ‘The guidelines, set out by the Council for Medical Schemes (CMS) in Circular 44 of 2022, requested medical schemes to keep contribution increases for 2023 below CPI. However, over the past decade medical scheme contribution increases have outpaced inflation by around 4%. We are delighted to have kept these well below CPI itself. In fact, by applying very low contribution increases since December 2020, the Scheme has effectively passed R1.4 billion in savings back to members. And, with the challenges we’ve seen recently in the healthcare industry, we know that promoting sustainability is key. So, we’re happy to boast excellent financial indicators from high solvency ratios, strong reserves and a high claims-paying ability. Not only is the Scheme financially sound with over R7.4 billion in reserves but, over the last 36 months we have signed up 190 000 new members. This figure is significantly higher than the size of most schemes in the industry. Even better for sustainability is that the average age of our new members is around 15 years younger than the current membership. It reinforces the fact that we are succeeding in attracting a younger, healthier profile, which is coveted across the industry. The future of healthcare is anchored on primary and preventative care as well as sustaining well-being, as opposed to responding to illness. One of the key healthcare trends is the rise in non-communicable or lifestyle diseases, such as diabetes, high blood pressure and cancer. 80% of these conditions are caused by lifestyle risk factors which is why we offer a range of Managed Care programmes aimed at assisting members understand and manage their conditions. Cancer care Cancer prevalence is one of the key concerns facing South Africans and is increasing year on year. Last year, we announced our partnership with the South African Oncology Consortium – the largest network of oncologists in the country to enhance the offerings of our cancer programme including screening for early detection, treatment and palliative care. For 2023 we have restructured benefits to be unlimited for PMB cancers, on all options. Diabetes The latest data from the South African Health Quality Assessment, shows that Bonitas has an effective disease management programme and better outcomes than the industry standard for diabetic members, with improved metrics for Hb1Ac, statins and cholesterol. But, as we always look for ways to improve, we are proud to introduce a benefit of R51 000 per family per year for an insulin pump or continuous glucose monitor for type 1 diabetics over 18 years. Mental health We are pleased to announce that we’ve introduced an innovative new digital solution, called Panda, to support our members in managing their mental wellness. Panda, a free to download app, offers everything from audio sessions with peers and mental health experts to one-on-one virtual consultations with mental health professionals. We encourage our members to complete a mental health questionnaire in the Bonitas Member App to assess their mental health status. Panda will be available from October 2022. Benefit Booster Launched last year, the Benefit Booster was one of the most innovative changes to hit the medical schemes industry and aimed at supporting our preventative care strategy. It unlocked R446 million in additional benefits for members to extend their day-to-day benefits. For 2023, we’ve opted to adjust the benefits limits in line with utilisation with enhancements seen on several plans. Designated Service Provider (DSP) We implement networks to negotiate the most favourable tariffs for our members so they can avoid out-of-pocket expenses and get more value. These networks are carefully selected to maintain high levels of healthcare, aligned with our brand promise of providing quality healthcare. We have restructured our options to include a wider hospital network component. In 2023, 85% of our members will be within a 30km radius of a network hospital – with a presence across all nine provinces in line with the footprint of our member base. This includes a GP network of over 4 400 of the most efficient practices in the country, an extensive pharmacy network, with around 2 500 practices to dispense chronic, acute and over-the-counter medicine through Scriptpharm. Our dental network, through DENIS, is one of the largest on the continent – providing access to around 3 000 practices while our optical network through PPN gives members access to over 2 300 practices. Medicine formulary We have aligned our medicines formulary to the WHO’s Essential Medicines List (EDL) to promote affordability and accessibility to clinically approved medicines, in support of Universal Health Care and promotion of medicine adherence for our members. Hospital-at-home The technology-enabled Hospital-at-Home service brings all the essential elements of in-hospital care to a patient’s home, without moving away from evidence-based clinical protocols and state-of-the-art 24hr vital sign monitoring. 1 200 members have used the offering to date – equating to around 6 000 days in hospital. We are extending the offering to include: A programme for re-admissions, screening and disease prevention, alternative to stepdown facilities and kidney dialysis at home. Savings We’ve amended our rules to allow members to use their savings as they deem fit for

September 30, 2022

Essential check-ups for women

Non-communicable diseases (NCDs), known as lifestyle diseases, pose some of the biggest threats to the health of South Africans. They are a result of the way we live, combined with genetic, physiological, environmental and behavioural factors. The most common are hypertension (or high blood pressure), diabetes and obesity. It is imperative to have regular or annual check-ups. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, offers advice about these tests and others specifically for women. Weight and BMI Almost 70% of women in South Africa are overweight or obese. The Body Mass Indicator (BMI) is used to check if you are a healthy weight. To calculate your BMI: Divide your weight in kilograms (kg) by your height in metres (m) Then divide the answer by your height again Good to know Underweight <than 18.5 Normal weight 18.5 to 24.9 Overweight 25 to 29.9 Obese 30> Diabetes With over 4.6 million people in South Africa living with diabetes, it’s important to check your blood glucose. There are two main types of diabetes: Type 1 and Type 2. They are different conditions but are both serious and need to be treated and managed properly. One of the biggest problems with diabetes is when it remains undiagnosed. This can lead to blindness, heart attackstroke, kidney failure, impotence and amputation so it’s vital to be checked. Blood pressure Hypertension (high blood pressure) is when blood pressure stays elevated over time. It is often referred to as the ‘silent killer’ since nearly 33% of people who have it, don’t know it. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and if it’s not treated, hypertension can cause kidney failure, eye problems and heart disease. Good to know Range Normal 120/80 to 129/84 Upper end of Normal 130/85 to 139/89 Mild hypertension 140/90 to 159/99 Moderate hypertension 160/100 to 179/109 Severe hypertension More than 180/110 Besides testing for these three main NCDs, Dr Mkhatshwa also advocates specific checks for women. A Mammogram From the age of 18 you should do regular self-examination of your breasts, if you see or feel any changes, consult your doctor immediately. Early detection increases the chance of survival and can save your life. Some doctors recommend having a mammogram, every two years from the age of 40, others believe you only need to start at 50 years of age. A mammogram is a low-dose X-ray which radiologists analyse to look for changes in breast tissue. Although the greatest risk for breast cancer is age, women can get breast cancer from a very early age. Cervical cancer South Africa has a high rate of cervical cancer, this has been attributed to the fact that not enough women are screened regularly. Screening can detect early changes in the cervix which can be treated and save your life. Screening includes: Pap test (pap smear) which looks for cell changes (pre-cancers) in the cervix that may progress to cancer if not treated. The Human Papillomavirus (HPV) test. Looks for the virus that causes most cervical cancers It is recommended that between the ages of 21and 65, women should have a pap smear every two years and, from the age of 30 onwards, a pap smear and HPV test can be done every 5 years A vaccine has been developed to protect women from getting HPV. It is administered free of charge, annually, to girls between Grade 4 and 7 (9 to 12 years of age) in all government schools. The HPV vaccination can be a cost-effective strategy in lowering the cervical cancer risk among women in South Africa. Bone Density As you age, your bones become thinner and weaker. Over time this can lead to a condition called osteoporosis. If you’re aged 65 or older a bone density test is recommended. Called a DEXA scan, the frequency of this screening varies depending on your bone density and other risk factors. Your doctor may suggest you have this test earlier if you: Broke a bone in the past Have taken steroids for a long time Have rheumatoid arthritis Are underweight Have a parent who has broken a hip after a minor injury Treatment for osteoporosis is available – usually the first choice is Bisphosphonates. Colorectal Cancer Screening These tests look for cancer in the colon or rectum by checking for tissue growths, called polyps. If you don’t have an elevated risk for cancer, then you should start having these tests when you turn 45. A colonoscopy, where the doctor looks at your entire colon, should be done every 3-10 years depending on what is found during your exam. A Faecal Immunochemical Test (FIT) should happen annually. The FIT is also a screening test for colon cancer which tests for hidden blood in the stool, which can be an early sign of cancer. Skin Checks Skin cancer is caused by the abnormal growth of skin cells – usually on the skin that has been exposed to the sun but not always. There are three major types of skin cancer: Basal cell carcinoma, squamous cell carcinoma and melanoma. Examine your skin carefully at least once a month and, if you are prone to getting lots of moles, go to a dermatologist and have the mole ‘mapped.’ If skin cancers are found early and treated, they are almost always curable. If you have a history of skin cancer in your family have your skin checked regularly by a doctor. Remember early detection of any of these conditions can save your life, so remember to go for regular check-ups with your doctor.

August 19, 2022

ASTHMA

Asthma is one of the most common chronic illnesses, affecting over 339 million people worldwide. According to the World Health Organisation (WHO), asthma kills around 1 000 people every day and the prevalence is rising. South Africa is ranked 25th worldwide for asthma prevalence and is ranked fifth for asthma mortality. The lack of appropriate diagnosis, treatment or access to care may be important considerations in tackling asthma morbidity and mortality in South Africa. What is asthma? Asthma is one of the most common respiratory complaints in the world where your airways – known as bronchial rubes – become inflamed. This swelling or inflammation makes the airways extremely sensitive to irritations and increases their susceptibility to an allergic reaction. In an allergic reaction, the airways swell and the muscles around the airway tighten, making it difficult for air to move in and out of the lungs. It affects approximately one in 10 children (10%) and one in 20 adults (5%) and can occur for the first time at any age, even in adulthood. Although asthma usually begins before the age of five, a few children affected will ‘outgrow’ it during their teenage years but it usually persists if contracted in adulthood. Asthma tends to run in families, as do related allergic conditions like hay fever and eczema Signs and symptoms Asthma is often under-diagnosed and under-treated. If you fail to recognise and avoid triggers that lead to your tightened airways, you may have an asthma attack, feel respiratory distress or experience a life-threatening situation. So, it’s important that you know how to avoid the triggers and recognise the signs of this condition to enjoy a better quality of life. Symptoms can range from mild to more serious depending on the severity of the illness but include: Coughing that does not subside and gets worse at night Wheezing Shortness of breath Tightness or pain in the chest What causes asthma? The exact cause of the asthmatic process is not well understood but it is thought to be triggered off by an allergy or when the lungs are irritated by something in the air. Research shows that the risk facts are a combination of genetic predisposition and environmental exposure to inhaled substances and particles that may cause allergic reactions or irritate the airways. These include indoor allergens – such as dust mites and pet dander in the home, outdoor allergens – such as pollen and mould as well as tobacco smoke and air pollution. Other triggers can include cold air, stress or physical exercise. Certain medications, such as aspirin and other non-steroid anti-inflammatory drugs and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine) can also set off an asthma attack. Factors associated with asthma prevalence or disease severity in South African children include the adoption of an urban lifestyle, atopy (a genetic predisposition),obesity, respiratory infection, or exposure to industrial pollution or tobacco smoke. Treating asthma Asthma can be life threatening when left untreated and cannot be cured but, with the right treatment most asthmatics will lead completely normal lives. The aim of treatment should be to make the lungs and breathing tubes as normal as possible so that there are minimal symptoms and as little disruption to ordinary life as possible. Get help Bonitas Medical Fund says, ‘If you are experiencing asthma symptoms or think you might have asthma, it is important for you to talk to your GP. This will help you establish if your symptoms are linked to asthma or whether something else is causing them.’

August 8, 2022

Dealing with Postpartum Depression – plus ways to deal with mental health after pregnancy

As a new mom, the birth of your baby is a beautiful and exciting time, but there is a darker side to childbirth. Postpartum depression affects about 15% of moms after delivery, and while it is a serious disorder it can be overcome through treatment. What is Postpartum depression? Feelings of anxiety, sadness and fatigue are common after birth and are often referred to as the ‘baby blues’ and should subside within the first two weeks. However, if these feelings stick around for longer, you could be experiencing postpartum depression. Restlessness, mood swings, insomnia, irritability, disconnection from your baby and feeling of worthlessness are all red flags for postpartum depression. Some moms feel guilty or ashamed to be feeling this way, however PPD can affect any woman. Don’t be afraid to reach out for help, as PDD is treatable through both medicated and unmedicated options. What should I do if I have the symptoms of Postpartum Depression? The good news is that PPD is treatable. There are a variety of common types of treatment, which depend on the type and severity of symptoms. Treatment can include counselling, therapy groups, antidepressants and hormone therapy. Self-help groups can be helpful, as it allows you to connect with others who have experienced similar problems and stop feelings of isolation. Recovery time will also vary from mother to mother, but untreated the disorder will last much longer and can interrupt mother-child bonding. Getting help does not mean you are a bad mother, it is important to reach out if you are feeling depressed. Postpartum Psychosis In rare cases moms can develop postpartum psychosis. This should be treated as a medical emergency, and it is essential that you receive help right away. Symptoms include paranoia, delusion and erratic/disorganised behaviour. How to deal with mental health after pregnancy Your mental health is critical to you and your child’s well-being. If you are worried about PPD it is important to get professional help. However, you can help your mood by slowly getting back into exercise, setting aside time for yourself and leaning on those around you for support. It is important to stay connected to family and friends so that you don’t feel alone.

July 8, 2022

A partnership to bring help to those who need it most

When you’re looking for positive, purposeful, swift action in a time of crisis there’s one organisation you know you can rely on. The Gift of the Givers Foundation is always ready to step in when needed, getting on with the job at hand with the minimum of fuss but with maximum results. ‘The Gift of the Givers needs no introduction,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘The organisation continues to go beyond the call of duty to bring humanitarian aid where needed. It has built its reputation on the principles we, as a corporate citizen, also value: Respect, care, professionalism and dedication. Their swift and problem solving response in the face of any disaster – be it a pandemic, fire, flood, earthquake, tsunami or war – is to be highly commended. And we are proud to announce that Bonitas will be partnering with them for the year ahead.’ For 30 years this extraordinary, non-governmental disaster response organisation has been responding to global challenges, in an effort to bring hope, life and restore dignity to the most vulnerable of people. Gift of the Givers primary focus is disaster response but other key areas of assistance include hunger alleviation, water provision, healthcare, education and social upliftment. Headed up by medical doctor, turned humanitarian, Dr Imtiaz Sooliman, Gift of the Givers has repaired and restocked hospitals, run clinics, sunk boreholes, dug wells, provided food and shelter to millions … and so much more. And, more recently, during the Covid-19 pandemic, KZN riots and water shortages in the Eastern Cape, the NGO brought relief to those who needed it most. ‘Our association with Gift of the Givers goes back a few years when we supported various projects on an ad hoc basis. However, recently we reassessed and realigned our CSI strategy to be in sync with our mantra: ‘A Medical Aid for South Africa’,’ says Callakoppen. ’This means us investing in the social upliftment of South Africans. And who better to partner with than this leading philanthropic organisation. The Bonitas values align with that of the Gift of the Givers and we look forward to working with them to provide relief to the most vulnerable and marginalised communities, specifically in the field of healthcare interventions.’ ‘We joined Bonitas as our medical scheme in 2019,’ says Dr Sooliman. ‘We worked with our financial advisors to find the most appropriate scheme and plan for our staff and have been impressed with their service, professionalism and how the member always comes first. As a paypoint for the Fund, we interact with the team regularly and, through these interactions, have realised there is synergy in our ethos. This led to us working alongside them on selected projects but we are thrilled they are formalising a partnership with us.’ Sooliman says the private sector plays a vital role in helping the organisation fulfil its humanitarian vision. ‘By working in partnership with like-minded and committed corporate partners, we have the ability to make a real difference in the lives of some of the most vulnerable people across South Africa, throughout Africa and the world.’ ‘We have handed over an initial R500 000k that will be used for healthcare related disasters,’ says Callakoppen, ‘However, additional funding has been set aside for specific healthcare related projects, such as hospital revamps, that are close to the hearts of both the Fund and Gift of the Givers.’ ‘I have been fortunate to meet Dr Sooliman on a few occasions and he has engaged with our Bonitas Board,’ says Callakoppen. ’It was humbling to learn more about the healthcare interventions they have put in place, the impact these have had and also just how much they can achieve in a day. He is passionate about the work they do and has a solid belief in the common humanity that unites us. This resonates throughout the organisation, leading with integrity and honesty. We look forward to the lessons we will learn while working alongside them on future projects.’

July 7, 2022

Stretching your medical aid benefits

Everyone is feeling the pinch and looking for ways to stretch their budget. This is true of healthcare too, especially when it comes to medical cover. It’s important to manage your medical expenses if you want your benefits to last. The smart move is to know what your plan offers and what you can do to avoid unnecessary out-of-pocket expenses. That way you can save money while managing your health. Lee Callakoppen, Principal Officer of Bonitas Medical Fund, give us some tips on how you stretch your medical aid benefits. Understand your plan and what it offers Knowledge is power and when it comes to medical aid this is especially true. Firstly, it’s important to make sure you have chosen the right plan for your healthcare needs. If you’re battling to make a decision, consult an independent broker. Brokers are accredited by the Council of Medical Schemes so are qualified to offer advice and support and there’s no extra charge for this service. Then, read through the plan you’ve selected and understand all the benefits, limits as well as any additional rules, regulations or added value benefits. Use DSPs or networks Using network doctors, specialists, hospitals or Designated Service Providers (DSPs) is essential if you want to make your medical aid last longer. It means you won’t be charged more than the negotiated preferential rates. Remember this includes knowing your scheme’s key providers, such as which ambulance to call in an emergency. Not using a DSP can result in a co-payment or non-payment for the service. Ask your pharmacist Consult your pharmacist for advice on over-the-counter medicine and/or switching to generic medicines. Using generic medicine, which has the same active ingredient, strength and dosage as the original brand but is less expensive, helps save costs. In addition, consider using a clinic or nurse practitioner to get your blood pressure screened, for your flu vaccination and other primary healthcare concerns – this saves on the consultation fee charged by your GP. Managed Care benefits Most schemes offer programmes to help you manage chronic conditions such as cancer, diabetes, HIV/AIDS and back and neck problems. These programmes are usually covered from the risk portion of your medical contribution and are not funded from your savings account. They help you use your benefits to maximum advantage while ensuring you receive quality care by using specific providers. Other benefits – such as maternity consultations, wellness benefits, preventative care and dentistry – are also paid from risk by some schemes. Again giving you more value for money and are in addition to your savings and day-to-day benefits. Boosting your benefits Carefully read through what your plan offers – especially when it comes to enhanced benefits – and choose wisely. Remember, not all additional benefits are equal. For example does your plan cover childhood vaccines from risk? If so, this is a saving of thousands of Rands, especially in the first 18 months of life This year, Bonitas invested R446 million in additional benefits through a benefit booster which is available on all plans, including the hospital plan (but excluding BonCap). Members tap in by completing a wellness assessment (which can be done online) and then have access to additional benefits which range from R940 and R2 730 (depending on the plan) to cover expenses such as: GP and specialist consultations Acute and over-the-counter medicine Biokineticist and physiotherapist consultations and treatment Paramedical services Alternative healthcare X-rays Blood tests Go virtual Look out for telemedicine or virtual consultation options which are around 60% cheaper than an average consult. A doctor will engage with you in a virtual video consultation on a medical issue and advise you on the most clinically appropriate steps for further care. Be inquisitive, ask questions Ahead of any procedure, in or out of hospital, ask the right questions. Check that your healthcare provider is on your scheme’s network in order to secure a better rate. Unless the procedure is an emergency, you will need to get pre-authorisation. At the same time, request a quote so you know, upfront, what the costs will be and whether you will be covered or if you are being expected to make a co-payment. If so, negotiate. Stay healthy With Non-Communicable Diseases (NCDs) or lifestyle disease fast becoming a pandemic in South Africa, it’s important to take care of your health by eating correctly, getting enough sleep, exercising and reducing your stress levels. ‘Health is the new wealth,’ says Callakoppen. ‘Your health is important, as are your finances, don’t take either for granted. When it comes to healthcare cover, invest time in researching and understanding the medical aid plan you’ve selected. Read the information sent to you, including the fine print to understand the Scheme Rules. If in doubt, phone the call centre, your broker or financial advisor. This will go a long way in helping you know your rights and making the most of your benefits.’

June 30, 2022

Making changes to your medical aid

Wherever possible, consumers are tightening their belts and looking at ways to consolidate expenses and save money. Healthcare is no exception. Traditionally, members of medical aids re-evaluated their medical cover annually, to coincide with increase announcements as well as changes to plans and benefits which come into effect on January 1 each year. However due to the pandemic, a number of medical aid schemes have deferred or postponed their increase announcements. This new pricing is being introduced at different times during the year and at varying percentages – often above inflation. ‘This has caused some confusion and challenges,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund – which opted not to defer increases. ‘Members are free to change their options, once a year, during the open period. However, with deferred increases, this often falls out of the open period. This means members start paying the increased premium after to change options has closed.’ Callakoppen explains that the medical aid industry is highly regulated with specific rules and regulations that could impact changing plans and moving schemes. These include waiting periods, late joiner fees and accumulated savings – that all need to be considered when changing plans Can you change your membership any time during the year? You can change at any time but usually this happens during open period. When changing, waiting periods might apply and the savings allocation of the plan may be affected. Make sure you have not already used more than a pro-rated percentage of the benefits or you might have to replay it. This will happen if you have depleted the savings’ portion before the end of the year and switch to another medical aid. What is a waiting period? According to the Medical Schemes Act, medical aid schemes are entitled to impose waiting periods – there are two categories: General waiting period (up to three months) and a condition-specific waiting period (up to 12 months). This protects other members of the Scheme by ensuring individuals can’t make large claims shortly after joining and then cancelling their membership. When do waiting periods apply? Waiting periods generally apply if you move from one medical aid to another, you or your dependants were not on a medical aid for a period of at least 90 days before you joined, or you have never been a member of a medical aid. Can these be waivered? Waiting periods can be waivered but this depends on the medical scheme. Do you pay premiums during a waiting period? Yes, you continue to pay your full premium during the waiting period. What if you change from one scheme to another? Your specific details and medical history will be considered, for example pre-existing medical conditions, how long you have belonged to a medical aid, etc., and underwriting may apply. What is a late-joiner penalty? Schemes can impose late-joiner penalties on individuals who join after the age of 35, who have never been medical aid members or those who have not belonged to a medical aid for a specified period of time since April 2001. Can you move directly from hospital insurance to medical aid? Late-joiner penalties will apply if you are over the age of 35 and move from a hospital insurance to any form of medical aid (including a hospital plan). Does the late-joiner penal reduce over time? No, unfortunately not. Once you are paying a late-joiner penalty, it remains in place. ‘The bottom line is that members need to do due diligence if they are considering switching medical plans or schemes. They need to evaluate the monthly contribution against the benefits being offered and make sure they will cover their healthcare needs,’ says Callakoppen.

June 21, 2022

The common cold in babies

With COVID19 prevalent globally, the thought of your baby catching a cold could be one to send shivers down your spine. But don’t fret, here are the symptoms of the common cold, what is considered normal and what is cause for concern. What is a cold? The common cold is caused by a variety of different viruses, and is an infection of the throat and nose. When a baby is born they have a weaker immune system, which develops as they grow older. Understandably though, this makes it easier for them to catch a cold. Babies do build up antibodies when they are exposed to germs, however, it takes 2 to 3 months for their immunity to fully develop. There are many types of viruses that are the cause of colds, but luckily most colds will help increase your little one’s immunity against other another nasty germs. What is normal and what can I do to prevent my baby catching a cold? Unfortunately, as the cold is caused by viruses there is no cure for it, but you can try naturally calm your baby’s symptoms. Unfortunately antibiotics won’t work as viruses are the culprit. It is normal for a cold to last 7 to 10 days. Symptoms include a runny nose, cough and low grade fever. Although alarming, fever is your baby’s natural response to the virus. Don’t give over the counter medication to your baby as these can cause dangerous side effects in young children, but extra fluids, saline spray and air humidifiers are all things you can use to help your baby. When a cold causes your baby to have trouble breathing, a high fever or dehydration it is time to consult with a doctor. Additionally, if the cold lasts for an extended period of time without getting better it is also best to seek professional help. Babies often catch the virus from older siblings or daycare, so if you can limit your baby’s exposure to other people this will help prevent them picking up unwanted viruses. Ask visitors to wash their hands before touching your little one and make sure to keep the baby’s utensils and towels separate from the rest of the household. Keeping your baby up to date with vaccinations is also a very important action that can help protect your them.

June 21, 2022

Exploring male menopause

Recently there has been increased discussions around male menopause. However, research shows that not all doctors and psychologists agree that there is a definitive male menopause or andropause. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, says this is because not all men experience it and, for those who do, they often don’t express their feelings as freely as women – as a result only a few men exhibit ‘midlife crisis’ symptoms. What is ‘male menopause’? It is the decline in the levels of the male hormone testosterone in men, just as women’s levels of estrogen begin to decrease, any time from the age of 40+. Some doctors refer to it as low testosterone. It is normal to experience a decline in the production of the male hormone testosterone with ageing but this also occurs with conditions such as diabetes. This gradual decline of testosterone levels is called late-onset hypogonadism or age-related low testosterone. It is a more gradual than female menopause where ovulation ends and hormone production plummets during a relatively short time. When does ‘male menopause’ start? Andropause or male menopause can begin at about age 40 (but can start earlier) and continue into the 70s. Why is it not talked about more? There is not much research into the subject, probably because you don’t die from the reduction in gonadal hormones and the withdrawal of hormones is not as dramatic as in women. Together with the reduction in hormones, there are often other factors involved when men experience this. For example, work pressure, marital pressures, life management and lifestyles exacerbate the problem. Many practitioners believe that balanced, youthful levels of human hormones improve the quality of life. What are some of the symptoms? Decreased mental sharpness (poor concentration, depressed mood) Decreased energy and strength Weight gain, decreased muscle and increased fat Depression and/or loss of eagerness and enthusiasm Irritability Sore body syndrome (feeling stiffness) Hot flushes or sweats Cold hands and feet Itching Poor sexual function Height loss Dr Mkhatshwa says some men feel the pressing need to make major changes because they feel ‘life is too short’ or have a feeling of dissatisfaction with their career, marriage and health. This can lead to restlessness about changes in appearance and making out of character choices, such as having an affair or a sudden desire for excitement or thrilling experiences. Getting help Men cope with menopause in different ways, it depends largely on their personality. The reduction in hormones often coincides with children leaving home, friends getting sick, marriages in trouble and job horizons narrowing. Combined with physical, psychological and sexual symptoms it is critical for men to acknowledge the challenges and seek the help of their family doctor, spouse, friends and support groups. How does one test for male menopause/andropause? It’s best to make an appointment with your GP who will: Perform a physical exam, ask about symptoms, order tests to rule out medical problems that may be contributing to the condition and do blood tests, which may include measuring testosterone level. Helping your body and mind cope with andropause Diet: A healthy diet, which includes a balance of vegetables, fruits, meats, fish and dairy products Fitness: Engage in regular exercise, including aerobic, muscular and flexibility exercises Get regular health check-ups including cardiovascular, prostate and testicular cancer Check hormone levels as you get older. Generally, between 40 and 55 several important hormones in a man’s body begin to decline Reduce stress in your life. Exercise and relaxation help to reduce stress, as does talking to your partner, friends and family about your problems Although sex is still important as you go through male menopause, you will start to view sex as a part of a loving relationship which includes friendship, intimacy and sharing Get plenty of sleep What about Testosterone Replacement Therapy (TRT), does it work? Medical experts are divided on this. It may improve the sexual function to some extent but there is no evidence that it improves any other symptoms. Are there any dangers or side effects? Men should avoid TRT if they are at high risk of prostate cancer, have severe urinary symptoms from prostate enlargement, have diagnosed heart disease, sleep apnea, a combination of risk factors for a heart attack or are prone to thrombo-embolic events. TRT does have associated risks, including: Worsening sleep apnoea (a potentially serious sleep disorder in which breathing repeatedly stops and starts) Causing acne or other skin reactions Stimulating noncancerous growth of the prostate (benign prostatic hyperplasia) and growth of existing prostate cancer Enlarged breasts Limiting sperm production or causing testicles to shrink Stimulating too much red blood cell production, which contributes to the increased risk of forming a blood clot Fluid retention, etc. Unlike menopause in women, Dr Mkhatshwa believes more research is needed on andropause or male menopause to completely understand it and determine what can be done to assist men through this phase of their lives.

May 31, 2022

Morning sickness – what to expect and how to deal

Being pregnant is an exciting time of your life, but it can be a little daunting. Morning sickness is one of the aspects of pregnancy that can be difficult to deal with. It is estimated that over 70% of women deal with nausea and vomiting to some degree. The name morning sickness is also misleading, as unfortunately you can feel sick anytime of day. Morning sickness is often one of the first signs of pregnancy, beginning in the first trimester. Unless vomiting is so frequent that it leads to weight loss and dehydration (this is known as hyperemesis gravidarum), morning sickness is considered a normal (albeit unpleasant) part of pregnancy. What causes morning sickness? There is no one cause of morning sickness, and severity varies amongst women, and between pregnancies. Some women deal with feeling nauseous the entire pregnancy, whereas others will find that symptoms abate within the second trimester. Luckily, even though you may be feeling miserable, morning sickness is often seen as a sign of a healthy pregnancy and doesn’t harm your baby. Morning sickness is thought to be caused by hormonal changes during pregnancy, specifically the pregnancy hormone, known as human chorionic gonadotropin. How to deal with morning sickness? Unfortunately there isn’t anything you can do to fully alleviate the nausea and vomiting, however, there are things you can do to help fight feeling sick. Making sure you stay hydrated, eating a bland diet, such as rice, bananas and crackers, as well as eating small amounts frequently are all things that can help quell the queasiness. Try staying away from strong smells and spicy foods, as these can trigger nausea. If your morning sickness is bad, speak to your doctor, and be sure to consult with them before trying any medication or alternative remedies.

May 26, 2022

NEW PARENTS AND YOUR BABY’S HEALTH

Becoming a parent is a joy but it can also be overwhelming and just a little daunting. There is no degree or diploma, you are simply propelled into it. It’s a steep learning curve. You instantly have a new life depending on you and, combined with sleep deprivation, the challenges of adjusting to being a parent and wanting to do the best for your child, you need all the help you can get.Becoming a parent is a joy but it can also be overwhelming and just a little daunting. There is no degree or diploma, you are simply propelled into it. It’s a steep learning curve. You instantly have a new life depending on you and, combined with sleep deprivation, the challenges of adjusting to being a parent and wanting to do the best for your child, you need all the help you can get.

May 11, 2022

Talking about TB

Ten people die in South Africa every hour from Tuberculosis (TB). It is and has always been, a serious public health issue that needs to be brought under control. Even though effective treatments are available and there has been considerable progress in fighting the disease – about 450 000 people develop TB every year. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, talks about the state of our nation in terms of TB, the leading cause of death in our country. Of the 450 000 people who develop TB every year, just over half are living with HIV. Although most cases are drug-sensitive and respond well to standard treatment, failure to complete the full course encourages the development of multi-drug resistant TB (MDR TB), which is difficult to treat and has poor outcomes. Is TB a pandemic like Covid-19? TB is considered an endemic but arguably has the criteria to be given pandemic status. According to the World Health Organization (WHO) a pandemic is when: The disease causes death There is persistent transmission between people It spreads in multiple countries An endemic is when the disease is still circulating but at a lower, more predictable rate. The only plausible reason is that the levels of TB are consistent and predictable, rather than the ‘boom and bust’ waves of Covid-19. That said, just because it’s endemic doesn’t mean to say it’s not serious. Smallpox, for example, was endemic for thousands of years and a third of the people who were infected, died. Malaria is also endemic and causes around 600 000 deaths a year. Dr Thandi Dlamini-Miti, senior technical advisor: TB at health NGO Right to Care says, ‘Undiagnosed TB is driving transmission of the disease. Many people with TB don’t know they have it because they don’t have symptoms but they are infecting those around them with this potentially deadly disease.’ Is there enough research and development for TB drugs? The short answer is no. Countries with resources, funds and technical capacity (developed countries) have not invested in the field of TB because the disease has not affected them. It is a disease that flourishes in developing countries, where living conditions are often poorly ventilated and over-crowded. Over 95% of cases and deaths are in developing countries. Another factor to consider is that, although the poor bear the brunt of the burden of ill-health (up to 13X greater incidence of TB), they also have access to far fewer services compared to the rich. Some good news recently came from Right to Care though. Dlamini-Miti says, ‘Since July 2020, a TB prevention treatment called 3HP has been piloted. It is considered a game changer because treatment is shorter, less toxic, promotes better adherence, has a higher barrier to resistance and is safe with first-line antiretroviral therapy.’ Latent TB, HIV/AIDS and immunity TB can be ‘latent’, in other words you have TB in your body but it is not active. You aren’t ill and you can’t spread it. However, if your immune system becomes weak for some reason, the TB becomes active and will make you ill. Having HIV/AIDS is a key factor in the TB epidemic which is why it’s imperative that the almost six million people living with HIV are screened and treated. Latent TB treatment is fairly low cost and can be taken together with anti-retroviral drugs. Despite this, the number of people on medication is only a fraction of those who are eligible. Diagnosing TB Diagnosis is quite complex (particularly for those living with HIV) since many symptoms are similar to those for other common diseases. South Africa has moved towards more intensive and active methods of identifying cases, for example by screening all those attending primary health clinics. The aim is to move from identifying fewer than 70% to 90% of all cases. Currently the process of testing most of the population is a protracted one. The TST (skin test) and blood tests do not differentiate between latent and active TB which means a sputum sample needs to be taken or a chest X-ray. This is both costly and time consuming. A quicker, cheaper method of testing would certainly assist to diagnose TB. Treating TB Current treatment for TB still includes many of the original antibiotics that were developed in the 1950s and 1960s. While newer antibiotics have been introduced, they are still used in combination with the originals whose side effects cannot be ignored. Similarly, BCG is still the only known TB vaccine administered to children in developing countries. Is there a vaccine that can protect adults? Unfortunately not, there is only the BCG for babies, which has become the most widely used vaccine and provides protection to children against miliary and meningeal TB. It provides limited protection against pulmonary TB, which is the most common form of TB. Has TB been affected by the Covid-19 lockdown? Yes, it has reversed years of global progress in tackling TB and, for the first time in over a decade, TB deaths have increased, according to the WHOs 2021 Global TB Report. How is TB contracted? It is transmitted through the air, not by surface contact. Transmission occurs when a person inhales droplets with TB nuclei and it travels though the mouth or nasal passages via the respiratory tract into the lungs to reach the alveoli of the lungs. Each person with TB can spread the disease to another 15 individuals over a year. Who is most at risk of contracting TB? People living with HIV (especially those newly diagnosed or not virally suppressed), living in the same house as someone who has had or has TB, anyone who has had active TB in the last two years, those with diabetes, residents of informal settlements, children under five, the undernourished, alcoholics, smokers, mineworkers, prisoners and pregnant women. How prevalent is TB amongst medical aid members? Protocols required by the National Department of Health dictate that all TB positive patients must be referred to the state for treatment. This means

April 8, 2022

Ten tips for flu and Covid-19 vaccines

The seasons are changing and with winter on its way, which heralds the start of the ‘flu season’. We chat to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund on why a flu vaccine is recommended, not just by the Scheme but also the World Health Organization (WHO). 1.Why should I get a flu vaccine? Although the flu vaccine will not eliminate your risk of developing flu, it helps reduce your chances of severe infection. Annually, seasonal influenza (flu) kills around 11 500 people in South Africa which is why it is a good precautionary measure to take. 2.How are Covid-19 and flu viruses similar? WHO says that Covid-19 and influenza viruses are similar in disease presentation. ‘Firstly, they both cause respiratory disease, which presents a wide range of illness from asymptomatic or mild through to severe disease and death. ‘Secondly, both viruses are transmitted by contact, droplets and any material that can carry infection. As a result, the same public health measures such as hand hygiene and social distancing is recommended.’ 3.What are the essential differences between Covid-19 and flu? Flu is an acute viral respiratory infection, transmitted by the influenza virus. There are three types of influenza, namely Influenza A, B and C. Covid-19 and influenza are essentially different viruses with SARS-CoV-2 being a newly discovered coronavirus that causes Covid-19. 4.Why do I need a flu shot every year? The flu virus changes every year, this means last year’s vaccine will not keep you safe this year. The vaccine helps your immune system fight off the virus by producing antibodies – the soldiers in your body that battle the flu virus. 5.What vaccines have been developed for 2022? The flu vaccines available for this year are: The Vaxigrip Tetra, Influvac and Influvac Tetra. 6.Can I get the flu vaccine and a Covid-19 vaccine together? As per the National Covid-19 Vaccination Programme Circular 3 of 2022, the answer is yes. However, it is recommended that if you decide to have both vaccines at the same time, then one should be on the left arm and one on the right. 7.Who should get a flu vaccine? It is recommended that anyone in the High-risk groups including: Healthcare workers Individuals over 65 years of age Individuals with chronic diseases – or comorbidities – for example: Cardiac disease, hypertension, stroke, diabetes, asthma, chronic obstructive pulmonary disease, kidney diseases, etc. Pregnant women People living with HIV/AIDS 8.Who should NOT have the flu vaccine? Individuals who are allergic to eggs or egg proteins as the manufacturing process for the vaccine involves the use of chicken eggs Infants under 6 months of age – the vaccines are not licensed for use in such young children Individuals who may have had a severe reaction to a flu vaccine in the past – if you are unsure discuss with your healthcare provider Individuals who may be suffering from flu symptoms already 9.Will the flu shot give me a mild flu? According to the Centre for Disease Control (CDC), ‘A flu shot cannot cause flu. Flu vaccines are currently made either with flu vaccine viruses that have been ‘inactivated’ and are not infectious or with no flu vaccine viruses at all. The most common side-effects from the vaccine are soreness, redness, tenderness or swelling where the shot was given. Serious allergic reactions to flu vaccines are very rare.’ 10.Still not convinced? Flu viruses spread very quickly from person to person. Even if the flu vaccine is not 100% effective against the current flu strain, it will reduce your risk of getting flu and, if you do get it, it will be a great deal milder. More importantly, by having the flu vaccine you protect others, who may be vulnerable family members, small babies, the elderly or those who are immune compromised. As with Covid-19, the more people vaccinated the closer we can get to ’herd immunity’.

March 25, 2022

SYMPHYSIS PUBIS DYSFUNCTION (SPD) AND HOW TO DEAL WITH IT

Symphysis pubis dysfunction or SPD is pain in your pelvis, which is caused by the relaxing of ligaments in the pelvic bones too early before birth. Many aspects of pregnancy can cause discomfort, and SPD is one of them. Here are the signs of SPD and what you can do if you think you to alleviate your discomfort if you are suffering from it. What is SPD and what causes it? Not all moms-to-be will experience SPD but it is thought to be fairly common in pregnancy. SPD is a pain in the symphysis pubis (which can range from moderate to serve) caused by the relaxing and stretching of the ligaments around the pelvic bone. Pain can be brought on by opening your legs, walking up stairs or even turning over in bed, and this may be accompanied by a clicking/grinding sensation in the pubic area. The cause of SPD in pregnancy is the hormone relaxin, aptly named as it relaxes your joints and ligaments to make it easier for your baby to come out at birth. SPD happens when these hormones come into play too early. Not only that but you’re shifting centre of as your baby grows, which can cause main in your lower back and pelvis as your body shifts to accommodate your little one. What can I do to relieve SPD Living with SPD can be uncomfortable at best, so you may be wondering what you can do to help alleviate some pain. Being fit before pregnancy can help, as stronger glute and abdominal muscles can help support your pelvis. Physiotherapy can help manage SPD pain, as a physio will be able to work with you as your pregnancy and pain levels change. Speak to your doctor first, as they may have recommendations for you. Your pelvis should return to normal between 4 and 12 weeks after birth

March 23, 2022

DEALING WITH POSTPARTUM DEPRESSION – PLUS WAYS TO DEAL WITH MENTAL HEALTH AFTER PREGNANCY

March 15, 2022

Medical aid contribution increases: The deferred increase debate

Traditionally, medical aid schemes implement fee increases from 1 January every year. However, the last two years have seen new trends emerge because of the Covid-19 pandemic. These include deferral of increases, dipping into reserves to reduce increases and announcing delayed increases above CPI. What does this mean for consumers? Globally people are feeling the financial pinch and South Africa is no different. High inflation has increased the cost of food, fuel and utilities. Salary increases, if any, are below CPI and many South Africans have lost their jobs. More so than ever, everyone is looking for value for money and better benefits, especially when it comes to healthcare. The balancing act Lee Callakoppen, Principal Officer of Bonitas Medical Fund says, ‘the delicate balancing act between maintaining the sustainability of the Scheme, while ensuring our members have access to affordable, quality healthcare is a core focus. Last year, we were the only Scheme to announce a 0% increase on one of our plans – the BonFit option. This was followed by the industry’s first ever reduction in a premium of 7,9% on our BonStart Plan in 2022.’ What using reserves meant for members ‘We opted to utilise around 3.2% – or R600 million – of the Scheme’s reserves to help limit contribution increases to below CPI for around 82% of our members for 2022. Contribution increases would have been closer to pre-pandemic levels of CPI + 4% if we had opted not to use some of our reserves. Deferred increases vs using reserves This move was in line with the Council of Medical Schemes (CMS) Circular 42 of 2021 which suggested the utilisation of reserves to cushion members against increasing costs. However, despite the guidelines, several schemes opted to defer increases from January to later in the year. These deferred increases range from 5.5 to 7.9%. In general, medical schemes need to keep their contribution increases as close to the rate at which the cost of providing healthcare escalates. The challenge is that most healthcare costs in South Africa are not regulated, which means providers are free to charge as they see fit. And the consumer bears the brunt. An example is the cost of Covid-19 PCR tests, which was finally standardised earlier this year. Consumers in for a rough ride Statistics SA cited CPI at 5,9% in December 2021, 0,4% higher than the month before. This trend is expected to continue with National Treasury projecting headline inflation (the change in CPI) at 4.8% in 2022 and 4.4% in 2023. So, consumers are in for tougher times. Is there freedom to change schemes with deferment? Callakoppen explains that the deferment of increases creates an anomaly for companies, medical scheme members and consumers. ‘Traditionally, members are free to change their options once a year during an open period. However, when a deferred increase arises, this open period does not always come with it. This complicates matters for companies which allow their staff to choose between various medical schemes. If an employee chooses to stay with a scheme offering a deferred increase, it is difficult and sometimes impossible, to switch to another plan. This is compounded by the fact that when these deferred increases take place – they are often above CPI and do not always include an increase in benefits – so members effectively pay more for less. Know what you are getting ‘By announcing our contribution increases in January, our members know what they will be paying for their medical aid from the outset of the year. This means they can plan and, if necessary, adjust their options accordingly to suit both their healthcare needs and their budgets. With the scenario of deferred increases, our advice is for companies to consider a mid-year open period to allow employees to change schemes or options to benefit already cash-strapped employees,” he added. The downside of deferred increases The past year has shown that the actual contribution increases experienced by members, after the deferment period, is typically higher than the industry average. An example is a Scheme that offered a contribution deferment for the first 6 months of 2021 but then applied a 5.9% contribution increase, when the industry average was 4.6%. Contribution increase percentages cannot be looked at in isolation without looking at the Rand value of the contribution. “Based on our analysis, we feel that a deferment strategy is not ideal. It merely utilises scheme reserves to provide a short-term contribution relief to members who subsequently experience an above market related contribution increase. This results in members being worse off compared to the scheme that applied a lower, market related contribution increase from the beginning of the year. Schemes implementing a contribution deferment are already applying above market average contribution increases. Callakoppen says that no matter whether a scheme has chosen to increase contributions or defer them, South Africans need to make sure they get the healthcare cover they need. “No two people or families are alike, medical needs differ, as do finances which is why you need to get cover that suits your health needs and budget. It’s important to interrogate what is being offered, to understand what is covered and any added benefits being offered which won’t impact your savings, before finalising your decision.”

March 10, 2022

GESTATIONAL HYPERTENSION, WHAT IS IT AND HOW CAN I AVOID IT?

Gestational hypertension is high blood pressure (the pressure of your blood on the walls of your blood vessels) during the later part of pregnancy, as opposed to chronic hypertension which is high blood pressure outside of pregnancy. Hypertension affects about 6 – 8 % of pregnant women, and unfortunately can negatively affect you and your baby. How will I know if I have gestational hypertension? You are more at risk if you’re carrying twins, are overweight, had high blood pressure, kidney disease or diabetes before becoming pregnant or are older than 40 or younger than 20.Gestational hypertension is high blood pressure in the second half of pregnancy and some moms may not even realise that they have it – which is why regular check ups are important. Unfortunately, high blood pressure during pregnancy can develop into preeclampsia. If left untreated, preeclampsia can lead to serious complications and even death. The most effective treatment of this is delivery of your baby (if possible). Symptoms of preeclampsia include headaches, nausea and excessive protein in your urine, with the most common first sign being a rise in blood pressure. How can I avoid or treat hypertension? Although there isn’t anything you can do to prevent hypertension(some variables such as age and number of babies you’re carrying is uncontrollable), you can try to keep yourself (and your baby) as healthy as possible during your pregnancy to help you control your blood pressure. Knowing your blood pressure level before getting pregnant, reducing your salt intake and regular exercise are all things you can do to help stay healthy and aware of your body’s condition. Going for regular checkups during your pregnancy will also help let you catch any problems early.

March 8, 2022

Obesity considered a global epidemic by WHO

Obesity is one of the biggest health challenges facing the world today, affecting around 800 million people, with millions more at risk. The prevalence of obesity has tripled over the past four decades, imposing an enormous burden on people’s health as well as the healthcare system. According to a World Health Organization (WHO) report, more than a quarter of South Africans live with obesity, making the country among the top 20% of the most obese nations in the world! Studies by the SA Medical Research Council indicate that nearly half of all South Africans are overweight. Even more shocking, is the fact that 22% of children between 1 and 9 are overweight or obese. The pandemic, lockdown and increased sedentary lifestyle has made the situation worse Dr Morgan Mkhatshwa,Head of Operations at Bonitas Medical Fund says, for overweight or obese people it’s not just an issue of vanity or fitting into a pair of jeans. ‘Risks associated with obesity include: Significantly contributing to the development of cardiovascular disease, type 2 diabetes, hypertension (high blood pressure), cancer (particularly colon, prostate and breast), sleep apnoea, degenerative joint disease, digestive tract diseases (gallstones), mental health and dermatological disorders. What determines if you are obese or not? Your Body Mass Indicator (BMI) calculator checks if you’re at a healthy weight. Here’s how to calculate yours: Divide your weight in kilograms (kg) by your height in metres (m²) If your BMI is over 25 you are considered overweight, at 30+ you’re classified as obese. There are detractors of BMI on its own The BMI screening may not be the best option for bulky, body-builder or stocky men for example. This is because it does not distinguish between lean muscle mass and body fat. Best practice is to measure body fat percentage along with the BMI calculation. This provides a better indication of one’s body composition. ‘Obesity is a chronic and progressive disease,’ says Dr Mkhatshwa,‘Urbanisation and the lifestyle associated with it, is one of the main contributing factors.’ There are two reasons for this: Lack of exercise: Cities are often over-populated, there are too few public spaces for physical activity and many residents use transport to commute Poor nutrition. Changes in diet include more processed and refined food, an increase in high-fat and high-sugar diets, less fruit and vegetables, less complex carbohydrates and fibre Although obesity is often associated with poor lifestyle choices, lack of motivation or unhealthy habits – it isn’t always the case. In America, where 40% of adults are obese, obesity has been recognised as a disease by the American Medical Association for nearly a decade. Despite this, they are still seeing most treatment approaches for obesity focus solely on behavioural therapy. The stigma and assumptions like this continue to create barriers that have limited better obesity care. The origin of obesity is complex and poorly understood, but includes nutritional, physiological, psychological and genetic factors. Environmental factors such as a sedentary lifestyle and excess calorie consumption can cause obesity Genetic studies with adopted children have demonstrated that they have similar BMIs to their biologic parents but not their adoptive parents. Twin studies also demonstrate a genetic influence on BMI Secondary causes of obesity can result from medications (eg. antipsychotics, steroids and anti-viral drugs) and endocrine disorders like Cushing’s syndrome and hypothyroidism According to the International Journal of Obesity, adults with obesity (BMI ≥ 30) incur 42% higher medical costs per capita and are nearly two times more likely to die before age 70 than adults with a healthy weight. They also say that health care providers play a vital role in the prevention, treatment and control of obesity. They recommend that multicomponent behavioural interventions, pharmacotherapy and bariatric (stomach shrinking) surgery are all effective strategies that support clinically significant weight loss. Obesity as with other co-morbidities, was also a poor prognostic factor for Covid-19 hospitalisations The general consensus regarding self-monitoring though is through: Calorie restriction: Reducing your intake by 500-1000 kcal per day will reduce total body weight by an average of 8% over a year Exercise: 30 minutes a day will yield health benefits, but 60 – 80 minutes will assist in weight loss and additional benefits Behaviour modification: Goal setting, self-monitoring and modification of one’s environment to enhance behaviours that will support weight management ‘The reality’, says Dr Mkhatshwa, ‘is that obesity and concomitant lifestyle diseases have become a pandemic in South Africa. Diabetes 2 is amongst these and has significant health implications. Managing this disease is imperative. We offer a diabetes management programme to help people understand this long-term condition and empower them to make the right decisions to stay healthy. This includes access to specialised diabetes doctors, dieticians, podiatrists and diabetic educators to effectively manage of diabetes. However, if you are not on a medical aid, there are several diabetic support groups.’ ‘Everybody needs to act’. It’s time to increase awareness of the root causes of obesity and encourage advocacy for change.

March 4, 2022

NHI – more questions than answers

In July 2019, the Minister of Health published a draft ‘National Health Insurance Bill’, which attracted a great deal of attention and the scrutiny hasn’t stopped. Despite several engagements, the Department of Health (DoH) has failed to provide clarity or explanations on several key issues within the ‘Bill’, which are of major concern to all stakeholders. ‘That fact that universal healthcare is desperately needed in South Africa is not being debated. Having only around 16% of the population on private medical aid, with the rest relying on public health, is unsustainable,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘What is worrying is the lack of detail around the implementation of this national health blueprint. Before discussing concerns about the implementation of NHI, we should discuss the ramifications of curtailing the role of medical aids. Medical aids and associated services make an enormous contribution to the annual fiscus. The industry also contributes significantly to employment and, in turn, to the economy of the country. Healthcare administration is a massive undertaking that requires, skills, experience and expertise. State of the art technology is needed to comply with international best practices. South Africa’s medical administrators are world class, it is simply not feasible to consider having one administrator in charge of the healthcare of millions of South Africans. Private healthcare is also a source of excellence in terms of innovation and development, which benefits the public sector. This essential role of private healthcare will be strangled if it is not able to continue in a private setting. A few additional concerning NHI issues include: Funding of the NHI There is a proposed health financing system – designed to pool funds – but nowhere has detail been provided on this funding model. When first presented, the estimated cost of NHI was R256 billion, with it due to be rolled out in 2026. It is not known how this figure was reached. The Institute of Race Relations (IRR) recently stated that NHI is likely to cost around R700 billion a year when fully operational in 2026, as the government now envisages. According to the IRR, ‘The increased tax burden will fall particularly heavily on the 700 000-odd individual taxpayers who currently pay about two thirds of all personal income tax and a hefty chunk of VAT’. What will NHI offer? The Bill defines ‘comprehensive health care services’ as: Healthcare services that are managed to ensure a continuum of health promotion, disease prevention, diagnosis, treatment and management, rehabilitation and palliative care services across the different levels and sites of care within the health system in accordance with the needs of users. However, no further indication of the details of these services / benefits is provided except to indicate that medical schemes will offer what is referred to as ‘complementary cover’. This is defined as third party payment for personal healthcare service benefits, not reimbursed by the Fund, including any top up cover offered by medical schemes or any other private health insurance fund. Single purchaser, single payer? The Bill states that the NHI will serve as the single purchaser and single payer of healthcare services, ie., that there can be no other legal entity that can purchase and pay for healthcare services. This doesn’t distinguish between complementary and duplicative services. Which means it would be illegal for medical schemes (or health insurance firms) to exist, even in a complementary form which contradicts other sections of the Bill. Constitutional rights Bonitas does not agree or support the proposed amendments to the Medical Schemes Act (MSA) as set out in the Bill, we believe allowing medical schemes to provide only complementary cover is unconstitutional. Bonitas does, however, support the healthcare reforms as recommended by the Health Market Inquiry. The Constitution requires the State to protect, respect, promote and fulfil the rights in the Bill of Rights. The State must protect the rights to access that people already have. The right of access to healthcare is much wider than the right to obtain healthcare through the public sector. It includes the right to purchase healthcare from the private sector, if one can afford it. The purchasing power of the consumer is a legitimate means of access to healthcare. Consumers must have the right to apply their purchasing power as they deem fit. The Bill, in its current form, makes it unlawful for people to purchase healthcare services not covered by NHI. The proposed Bill is fraught with illegalities and is in direct conflict with the Medical Schemes Act 31 of 1998 (MSA) and prevailing regulations. The administration of the proposed central system of healthcare will need strict governance as existing medical aids are strictly regulated. Sound corporate governance is of critical importance in preventing mismanagement of assets, corruption, inefficiency, illegality, unethical conduct, abuse of the Fund’s resources and the collapse of the Fund. The way forward The notion of NHI is commendable, but it’s a case of the ‘devil is in the detail’. Detail which is yet to be unpacked and specified. The only way for the healthcare system to evolve is through inter-dependent relationships. Medical schemes should be allowed to assist the NHI administratively and take over some of the risk and burden which would lie with the NHI in respect of members of medical schemes. This would ensure that the funds deployed in the procurement of healthcare services are not unnecessarily exploited through duplication of services and functions. Lee Callakoppen, Principal Officer, Bonitas Medical Fund

February 25, 2022

Postpartum recovery – How long does it take and what can you expect?

As a new mom, or a potential new mom, you are probably wondering how long your body will take to recover post birth and pregnancy. The postpartum period is generally regarded as the first six weeks after childbirth. This is an important time for both you and your baby, as you there are lots of emotional and physical adjustments that happen in this period. Recovering from having a baby can be a long process, especially considering that you now have a new baby to look after as well. What can I expect postpartum? Postpartum recovery will differ between moms and pregnancies. If you have opted for a vaginal birth, your vagina will hurt postpartum, and recovery can take 3 to 6 weeks depending on if you had an episiotomy or your perineum tore. C-section incisions can be painful and you can expect a recovery period of 4 to 6 weeks. Initially you may find moving difficult, but it’s important to move a little bit to avoid blood clots. Some new moms can experience difficulty urinating, perineal discomfort or soreness, vaginal bleeding, contractions, constipation and breast tenderness post birth. During the postpartum period you may also feel irritable, anxious or have sudden mood swings, this is also known as the ‘baby blues’ and is caused by hormonal changes in the first few weeks. However, if this period is extended you could be suffering from postpartum depression, and should speak to your doctor about this. How can I help my postpartum recovery? Be aware of pushing yourself to return to ‘normal’ as soon as possible, even if you have had an easy pregnancy and birth, your body has still been through an ordeal and you will need time to recover. Avoid over exercising (even if it’s tempting to get straight back into it!) and trying to socialise too much with friends and family eager to meet the new baby. Don’t be afraid to ask people for space and to limit your baby’s visitors.

February 10, 2022

Covid – how and when might it all end?

Covid-19 has disrupted the world in so many ways, including the uncertainty of what the future holds. The Bonitas Medical Fund clinical and actuarial teams unpack some of the pandemic versus endemic terminology and offer scenarios for the future. Since the start of Covid-19, the word ‘pandemic’ has been on everyone’s the lips. What is a pandemic and what is the difference between an outbreak, an epidemic and a pandemic? According to Harvard Medical School, ‘An outbreak is a sudden increase of an infectious disease in a particular place, an epidemic is a larger outbreak in a restricted country or community, while a pandemic means a global epidemic.’ Do the governments of various countries decide there is a pandemic? It is the World Health Organization (WHO) which declares a global pandemic as was the case on March 11, 2020, when the virus was present in over 110 countries. WHO will also decide the degree of severity and communicate this to the world? The declaration gives governments time to prepare for the pandemic, legislate laws and restrictions – such as travel and trade – and begin emergency procedures to protect their citizens. What are the criteria for a pandemic? There is no universally agreed definition of when a disease outbreak should be called a pandemic but there are three reasons WHO can declare a pandemic, when: The disease causes death There is persistent transmission between people It spreads in multiple countries The Centre for Disease Control (CDC) explains it as a ‘term most often applied to new influenza strains’ and says it’s used when viruses can infect people easily and spread from person to person in an efficient and sustained way in multiple regions. The declaration refers to the spread of a disease, rather than the severity of the illness it causes. What are examples of other pandemics? Past pandemics, which had a profound effect on the world, were the Plague or Black Death in the 14th Century, the outbreak of flu in 1918 each killing around 50 million people. Both the AIDS pandemic and Covid-19 are more recent. Who keeps a finger on the pulse of the pandemic? During pandemics, epidemiologists work as profilers. They are experts in the branch of medicine which deals with the incidence, distribution and possible control of diseases. Epidemiologists are scientists who: Trace, monitor and predict the movement and behaviour of a pathogen to create a detailed portrait. Key epidemiological questions include: What is the spectrum of disease severity? How transmissible is the virus and who is most likely to spread it? What are the risk factors for severe illness and death? How does the behaviour of the infection vary by location and does it change over time? Answers to these questions can determine what public health measures should be implemented and what resources should be allocated. These choices have a profound effect on the outcomes. Who decides that a pandemic is over? The pandemic may be widely considered over when WHO decides the virus is no longer an emergency of international concern. It is generally when the infection is mostly contained and rates of transmission drop significantly throughout the world. The expert committee reassess every three months and the world are waiting for a decision from WHO regarding the end of the pandemic as we know it. However, they are still anticipating a 5th wave. Despite this the organisation is calling for travel bans to be lifted as they have proved to be ineffective in stopping the spread of the Omicron variant. Downgrading from pandemic to endemic There is a consensus that Covid-19 will eventually settle into becoming a more predictable virus, like the flu. This means there will be seasonal outbreaks but not the huge numbers the world is experiencing now. It will transition from a pandemic phase to endemic phase and the world will adapt to living with it. What is the difference between endemic and pandemic? Endemic means the disease is still circulating but at a lower, more predictable rate — and with fewer people being admitted to hospital. Epidemiologists would consider a disease endemic when levels are consistent and predictable – unlike the ‘boom and bust’ waves we have seen so far in the pandemic. That said, just because it’s endemic it doesn’t mean to say it’s not serious. Smallpox, for example, was endemic for thousands of years and a third of the people who were infected, died. Malaria is also endemic and causes around 600 000 deaths a year. What are the hypotheses for the way in which the pandemic will end? It is difficult to predict when the pandemic will end but three scenarios emerge as the most probable. It is important to note that these will be determined by WHO and governments around the world. 1.Getting through it as quickly as possible This means the government allows people and communities to be exposed as quickly as possible so that most people have been infected or developed immunity. At some point herd immunity will be reached – when the virus cannot find new hosts -and the pandemic slowly peters out. The problem with this is that hospitals reach peak capacity very quickly and millions may die. 2.Slow it down or delay it and vaccinate As happened with most countries’, governments used various methods to slow down the spread. This reduces the number of lives lost but the virus still spreads slowly and many of these measures have a devastating effect on the economy. 3.Co-ordinate globally to crush it This is achieved by introducing travel bans, quarantining, social distancing and restricting travel. In this scenario the world should co-ordinate efforts to reduce transmission. In the best-case scenario this could end the pandemic swiftly with low loss of life. The virus will not be eliminated through this means alone but reduced transmission and spread. Each has its pros and cons but it’s generally accepted that vaccination, assisted by as much global coordination as possible, is the best possible scenario. What is

February 7, 2022

All about Boosters

As the COVID-19 pandemic waxes and wanes around the globe, it is universally accepted that as many people in the world as possible need to be vaccinated to develop immunity. Depending on which vaccine you received, you will either have had one or two initial vaccines doses and then, between 2 and 6 months afterwards are eligible for a booster. Kathy Malherbe speaks to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, about COVID-19 immunity, vaccines, boosters and the way forward. What do boosters and vaccines do? They develop immunity against infections. In the case of COVID-19, when we are fully vaccinated, we acquire what is called ‘vaccine-induced immunity’. However, it has been shown that the immunity created by vaccines may wane over time so an additional dose of the vaccine (full or half strength) – in the form of a booster- is then given to provide the strongest and long-lasting protection possible. What exactly is immunity? Simplified, it is your body’s ability to protect you from becoming ill when you encounter a germ (virus, parasite, fungus, bacteria). It is not a simple process but essentially your body produces cells that try to stop the invading germs. This includes cells which ‘memorise’ a particular infection or germ and then recognise it when it returns and try to destroy it. Immunity can be natural or vaccine induced Natural immunity is your body’s natural ‘fighting mechanism’ which creates antibodies to fight an infection. If you get a disease mildly (like COVID) you do not develop a powerful natural immunity and your natural immunity, regardless of how strong it is, weakens over time – faster than immunity from a COVID-19 vaccine. For this reason, it is recommended that even if you have natural immunity, you still need a COVID-19 vaccine. Why is a booster necessary when you are fully vaccinated Fully vaccinated people have proved to be well-protected from becoming severely ill or dying from COVID-19. So, you may ask why a booster then? Even though vaccines protect you, their efficacy does lessen over time, regardless of which variant of COVID, especially with people 65 years and older. This is not only in the case if a COVID vaccine. If a vaccine does not contain a live, (weakened) virus, a booster is required in most cases. The COVID vaccine does not contain any form of live viruses and, like other inactivated vaccines, will need several doses over time to remain effective. The booster is designed to help people maintain their level of immunity for longer. It is important to know that immune responses can differ in people who get COVID-19 and recover from the illness There are many vaccines which require a booster so you’re more than likely going to receive at least one in a lifetime. When should you have a booster shot? For those who received the double-dose Pfizer vaccine, you’re eligible for a booster shot at least 6 months after the final dose of the vaccine was administered If you received the Johnson & Johnson vaccine, you should get a booster if you’re 18 or older and got vaccinated two or more months ago Can you have different booster shots from the original vaccine? The South African Health Products Regulatory Authority (SAHRPA) has not licensed mix and match vaccines. However, there is good evidence that mix and match vaccines are just as effective (and sometimes better) at increasing antibody levels. SAHRPA has requested submission of evidence to support this approach, so watch their website for updates. Do booster shots use the same ingredients as existing vaccines? Yes. COVID-19 booster shots are the same ingredients (formulation) as the current COVID-19 vaccines. Some boosters have the same ingredients but it is not a full dose. J&J and Pfizer boosters are the full dose. Are there side effects from the booster shot? There is a chance you may feel like you have mild flu after your booster shot. This could include a sore and even slightly swollen arm, a temperature, a headache and fatigue for a day or two. These symptoms mean that your immune system is responding to the shots and building up immune protection against the coronavirus. Can I have a booster if I am immune compromised? Yes, but should be referred by your doctor. Persons who are immunocompromised should receive an additional Pfizer or J&J booster at least 28 days after receiving their last vaccination. Presently, persons who are considered immune-compromised should have the same booster as the initial vaccine dose (or doses). Even though there is talk that COVID-19 will move from being a pandemic to endemic, there’s no getting away from the fact that this virus will be part of our lives for a long time and we will need to learn to live with it. Which means that in order for the world to develop immunity against the virus, as many people as possible need to be vaccinated and also receive booster shots.

January 31, 2022

Health at School

The school year is in full swing and children are as busy as ever with all their activities and homework. By following a few lifestyle tips you can keep your child healthy and cut down on their sick days says Bonitas Medical Fund.

January 30, 2022

Your pre- hospitalisation check list

Waves of Covid-19 and the emerging variants meant that several elective surgeries were postponed to minimise the use of hospital beds and to avoid unnecessary exposure to the virus. As the number of infections decrease, surgeons and hospitals are catching up on the backlog of elective surgeries. So, what exactly is elective surgery? It does not mean, as the name implies, that the surgery is optional but rather that it doesn’t need to be performed immediately. It can be scheduled at the patient’s and surgeon’s convenience. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, says there are pre-hospitalisation requirements for those going in for elective surgeries. Here’s a quick checklist. Hospital networks Medical schemes negotiate preferential rates with Designated Service Provides (DSPs) who have partnered with them to ensure that members get the best quality services, at the most cost-effective rate so that benefits are optimised. If you use a network hospital, doctor or pharmacy you will not be charged more than the agreed rate. This will help you avoid co-payments and make your medical aid last longer. So, to reduce co-payments and even avoid them altogether, find a healthcare professional on your schemes network. Pre-authorisation All procedures that take place in a hospital must be pre-authorised. Essentially, it’s an agreement between the medical aid and the hospital, indicating a willingness to pay for costs associated with the visit. But even if you do have pre-authorisation your medical aid is not promising to cover 100% of the costs. All pre-authorisation requests are evaluated against the different schemes’ rules and clinical funding policies however, you remain responsible for any shortfall, including any co-payments. If you are unsure how to go about the process speak to your broker or your medical aid. Quotes A quote is not the same as a pre-authorisation. Most medical aid plans have varying hospital benefits, according to the level of cover you have chosen and they also have a ‘rate’ and which they reimburse healthcare providers. This means that even if the payment is 100% of the rate, this is not necessarily what the healthcare provider will charge, they may charge 200% of your medical aid rate. Asking for a quote prior to being admitted to hospital means you will know what your medical aid will pay and what payment you might be responsible for. It gives you an opportunity to negotiate and eliminates any additional ‘surprise’ co-payments required after the procedure. Co-payments Medical practitioners, hospitals and pharmacies often charge more than medical aid scheme rates, which could be between 100% – 300% of the medical aid tariffs. A co-payment refers to the outstanding portion of the account, for which the member is responsible. This co-payment varies from one medical scheme to another and is sometimes not required if members use DSPs or network hospitals. Day hospitals Consult with your surgeon to see if your surgery can be done in a day hospital. Globally, day surgery hospitals have changed the experience of patients by offering an alternative to acute/conventional hospital surgery. The advantages include: No overnight stay, ideal for children so they don’t have the trauma of overnight stays; there is a lower risk of infection because patients go home on the same day and there is a decreased waiting list. Step-down facilities Your medical aid will stipulate the number of days you need to stay in hospital and check whether you will need a step-down facility when you are discharged. There are several facilities where patients can be cared for and start rehabilitation in conjunction with other medical professionals, for example physiotherapists. Home-based care Find out if you are eligible for home-based care after your procedure. Many patients prefer to be discharged from hospital as soon as possible and receive Hospital-Level Care at home. This means good, clinical quality care which translates into a great patient experience and is also more affordable With Hospital-Level Care at Home, nurses, other health providers and caregivers are an essential element of the care continuum and play a critical role in recovery. GAP Cover Gap Cover is an additional insurance cover that complements medical schemes. It helps to pay the difference in cost between the amount the specialist or hospital charges and the amount paid by a hospital or medical plan. You will be required to pay any shortfalls (co-payments), after which you may claim from your Gap Cover. Keep all documentation related to the surgery and hospitalisation to submit to the Gap Cover provider. Covid-19 Test For emergency admissions, a Rapid Antigen Test is performed at the hospital but for elective surgery you are required to have a PCR test a maximum of 72 hours before admission. If your test is positive, you will have to delay your surgery by at least 10 days and then re-test. Pre-admission Pre-admission can be done a few days before you are scheduled for surgery and makes the admission process less stressful on the day. Pre-admission involves answering a series of questions and tests to eliminate the possibility of allergic reactions, drug interactions or physical complications before, during and after the surgical process. For administrative purposes the following items are required upon admission: Your identification document or passport Your medical aid card Authorisation number supplied by your medical aid, or the letter of guarantee issued by your insurer X-rays, if applicable Chronic medication, if staying overnight Dr Mkhatshwa says, ‘In addition to these, remember to take any chronic medication you are on to the hospital and make sure the doctor/anaesthetists are aware of what you are taking. By following this checklist and making sure the surgeon and hospital have all the necessary information, you will eliminate unnecessary stress ahead of your procedure and prevent unpleasant surprises when you are supposed to be recovering.’

January 19, 2022

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