Bonitas - Parenting Hub

New Head of Operations for Bonitas

Bonitas Medical Fund has announced the appointment of Dr Morgan Busuku Mkhatshwa as Head of Operations. Dr Mkhatshwa is a medical doctor with extensive experience in the healthcare sector. He has a proven track record of spearheading the introduction of enhanced comprehensive healthcare services and programmes including occupational healthcare services. In addition, he has led organisational restructuring efforts within highly unionised environments, launching accelerated business expansion and improvement initiatives to maximise revenue growth. Compassionate about management, business development and stakeholder engagement, he began his career as a science teacher before he pursued his medical studies. He worked as a medical officer before progressing to principal medical officer in the public service. He spent some time as Hospital Manager at Life Healthcare and went onto become MD of one of the divisions in the company. After Life Healthcare he joined Lenmed Health as Group Business Development Manager and later became Group Head of Operations. ‘We are delighted to have Dr Mkhatshwa joining our management team,’ said Lee Callakoppen, Principal Officer. ‘He brings with him a wealth of knowledge and expertise, not only as a medical doctor but also years of experience in strategic planning and execution, general operations management, project management, coaching and mentoring. We know he will be a valuable asset to our team and our members.’ Dr Mkhatshwa has a BSc. (Biological Sciences), Bachelor of Medicine and Surgery (MBChB), Hons BSc (Limnology), Master of Science (Medical Microbiology) and Master of Business Administration (MBA). Oher achievements include the completion of the Harvard Business School – General Management Program.

February 26, 2021

The low down on Covid-19 test protocols

As South Africa finds itself starting to move out of the second wave of a Covid-19 outbreak, over 8 million Covid tests have been carried out in the public and private sector since the start of the pandemic. The global gold standard method to diagnose Covid is the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. It is currently the most accurate way to detect SARS-CoV-2, the virus that causes Covid-19. Will your medical aid pay for the test? According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘Funding is in accordance with the Council for Medical Schemes (CMS) guidelines, all clinically appropriate and referred diagnostic testing for suspected Covid-19 cases will be funded as a Prescribed Minimum Benefit (PMB) condition.’ Bonitas pays for up to three Covid-19 diagnostic tests from risk, whether the result is positive or negative. However, this is subject to the member or beneficiary being referred by a registered healthcare practitioner (doctor or nurse). This referral is dependent upon whether the member is showing symptoms, has been in contact with anyone who has Covid-19 and prior to hospitalisation. It should be noted that laboratories will not normally accept walk-ins for testing and require a referral or request from a healthcare practitioner. This is to ensure that we don’t test unnecessarily and jeopardise the availability of these tests for those who really need them. ‘Despite the PCR being arguably the most accurate laboratory methods for detecting, tracking and studying the Coronavirus, there are limitations in its widespread use,’ says Callakoppen. ‘These include: Access to the test kits; the complexity of performing them; the need for specialised staff to administer them; potential global shortages; high costs; the requirement for laboratory equipment and the delayed turnaround times. For this reason, testing should only be done when it is clinically necessary.’ What about Rapid Antigen Tests Immunoassay devices that detect the SARS-CoV-2 antigen within 15-30 minutes have also been promoted as a possible solution when access to PCR tests is a challenge. An antigen – detected in the blood or any other fluid – is any substance that makes the immune system produce antibodies. Viruses and bacteria are antigens. However, these tests are not as accurate as the PCR tests and have shown variable performance during evaluations, with sensitivities ranging from 0 to 94%. Test specificity has been high, but sensitivity has been erratic, which we need to bear in mind. Why is specificity and sensitivity critical? Sensitivity is the percentage of true positives (e.g. 90% sensitivity = 90% of people who have the target disease will test positive). Specificity is the percentage of true negatives (e.g. 90% specificity = 90% of people who do not have the target disease will test negative). These allow you to rule conditions in or out but not definitively diagnose a condition. What does the Council for Medical Schemes (CMS) say? The CMS currently still advocates the PCR test to diagnose Covid-19. The World Health Organisation (WHO) has also previously advised that the role of these rapid antigen tests must be evaluated and are “not currently recommended for clinical diagnosis pending more evidence on test performance and operational utility”. However, the WHO has now approved the use of antigen tests (and this is the South African approach as well) as an alternative to the more expensive PCR tests. This is however, in certain defined scenarios such as testing confirmed people in communities where infections have been detected, screening of high risk groups and individuals and for contact tracing purposes. They have also provided conditional recommendations for the use of these tests such as screening at ports of entry, routine screening for employees at their place of work, schools, prior to certain urgent medical procedures, etc. The challenge with these tests is that they are most accurate in patients between 5 and 7 days after showing symptoms – therefore the timing of testing becomes critical in order to ensure accuracy of the result. What about Rapid Antibody Tests? Many countries, including South Africa, are using antibody or serology tests such as the ones offered at various drive-throughs. These can detect whether someone has previously been infected and estimate how widespread the infection is but they are not recommended for diagnosis of Covid-19. For this reason, these are not funded by Bonitas Medical Fund as the use for these tests is limited for purposes of government surveillance and research rather than diagnosing Covid-19. If individuals want to know whether they have previously had Covid-19, for their own information, this test would be able to confirm that – but it is not used to identify whether you currently have the infection. If these tests are done too soon after the infection, they produce incorrect results as the antibodies (IgM and IgG) will not be detectable. There is also no scientific evidence that it provides any immunity to another Covid infection. ‘What is clear is that laboratory testing plays a vital role in the diagnosis and the prevention of the spread of the virus,’ says Callakoppen. ‘Nevertheless, it is important to understand that the timing and correct use of the different types of tests is crucial to gain the best results. We reimburse up to three PCR or rapid antigen tests done in or out of hospital for our members and recommend that this protocol for testing remains, until further research is conducted and evidence provided.’

February 12, 2021

Pregnancy and Medical Aid

Motherhood and pregnancy are times of great anticipation and joy. Each experience is unique but what is probably high on the agenda is that you have a trouble free pregnancy, a healthy baby and then know and anticipate the cost involved for pre-natal check-ups and the birth. ‘Choosing the right medical aid is critical in ensuring the healthcare needs of you and your loved ones are taken care of. More so, when you’re looking at expanding your family. For those who are on a medical scheme or wish to join one, here are some important points to consider when you fall pregnant,’ says Lee Callakopen, Principal Officer of Bonitas Medical Fund. When you are already a member of a medical aid scheme When should you advise your medical aid of your pregnancy? If you are already a member, you can access the out-of-hospital maternity benefits without advising your medical aid that you are pregnant. However, please ensure that your doctor uses the correct ICD-10 codes on your claim to ensure that it is processed correctly. Bonitas pays for maternity benefits in addition to savings and day-to-day benefits, which help members get the care they need during pregnancy while limiting out-of-pocket expenses. Remember that pre-authorisation is needed for the delivery of the baby, which can usually, be done from 20 weeks onwards. Pre-authorisation will help you understand the benefits you have available on your plan and ensure that you are aware of what is covered. Bonitas members can also register for the Bonitas baby bag once pre-authorisation is obtained. The baby bag is packed with of useful goodies for the baby to make parenthood a little easier. When do you advise the medical aid that your baby has been born and needs to be added onto your medical aid? For our members, the baby needs to be registered within 30 days from the date of birth to ensure there is no break in cover and that your child will be covered from the first day of life. Are there Designated Service Providers (DSPs) in terms of gynaes and hospitals for childbirth? We strongly advise members to use DSPs to get maximum value and avoid co-payments. We agree special rates with these providers, which are covered within a member’s benefits so that they can focus on taking care of their health and wellbeing during pregnancy. What is normally covered in the maternity benefit? This differs from scheme to scheme and according to the plan you are on. Bonitas pays for up to 12 maternity consultations (paid for from a separate benefit), an amniocentesis, antenatal classes, 2x 2D ultrasounds and the delivery. In addition, there are additional benefit for newborn hearing screening tests and childhood vaccination. Does Bonitas cover the cost of a Caesarian birth? Yes, medically necessary Caesarians are covered on all plans. Some expectant mothers do prefer home births – is this covered? Yes the cost for a home delivery is covered. Are all the childhood vaccinations covered by Bonitas and if so, are there any conditions attached ie where the vaccinations should be done? Vaccines are covered as per the EPI schedule on immunisation. Please note this benefit is available on specific plans. The vaccines can be done at any clinic or pharmacy. If an administration fee is charged by these providers, it will be paid from your savings or day-to-day benefits. The vaccines covered are as follows: The Bonitas Babyline – a dedicated children’s health advice line In 2016, Bonitas introduced Babyline – a 24-hour children’s health advice line manned by paediatric trained registered nurses. They are on the other side of the phone to assist with any parental concerns, vaccination schedules and health related issues, 24/7, 365 days of the year. How does Babyline work? Bonitas parents, or their caregivers, simply call the Babyline number on 0860 999 121 to speak to paediatric trained nurse. Through a series of questions asked regarding the health issue, parents will be provided with professional advice on what to do next. Depending on the symptoms, the advice might be to head straight to the ER or to see a doctor or specialist. The nurse will advise which healthcare provider is the most appropriate, given the health issue. The services offered by the Babyline include: Home care advice Clinic/primary care/GP referral for the same day Clinic/primary care/GP referral for the following day After-hours care within the next six hours Immediate referral to the ER The Babyline service is available to members across all the Bonitas plans, for children under 3 years. Joining a medical scheme when you are already pregnant It is very common for women to apply to join a medical aid scheme when they fall pregnant. But according to the Medical Schemes Act 131 of 1998, medical aid schemes are entitled to impose a 12-month condition specific waiting period for any pre-existing medical condition, such as pregnancy. These waiting periods must be imposed for specific pre-existing conditions to protect the interests of current members of the scheme. When a waiting period is applied to pregnancy, then the pregnancy and birth will not be covered but your baby will be covered from the first day of life – if you register them on your medical aid within 30 days. This will allow you to ensure the needs of your child and the healthcare will be covered. Bonitas has different plans and expectant mothers will be able to select the one most suitable for their needs. Informing the medical aid of your pregnancy Prospective members need to inform their medical aid upon application or within 30 days after you complete the application. What is the policy regarding a member joining Bonitas when they are pregnant? What sort of cover can they expect, if any? The pregnancy would be considered pre-existing and therefore not covered. The baby will be covered if registered within 30 days post-delivery. What happens if someone signs up for medical aid not realising they are already pregnant? At what point is

February 3, 2021

What vitamins and minerals are needed during pregnancy

As an expecting mom you’ll want to do your best to make sure that your baby is as healthy as possible. What you eat is critical during this time, as everything your baby needs comes from you. Prenatal vitamins are supplements which can be taken during pregnancy which contain needed vitamins and minerals. What vitamins and minerals are essential and why? During pregnancy your vitamin and mineral needs will change as you now have a growing baby to provide for. Your food should contain much of the vitamins and minerals needed during pregnancy, particularly if you are already following a healthy, balanced diet. Folic acid and iron are typically found in most prenatal vitamins and are essential in a healthy pregnancy. Folic acids helps to prevent neural tube defects and iron supports healthy growth, helping prevent anemia and blood (in both mom and baby) carry oxygen Vitamin D, calcium and iodine are other important nutrients that are needed during pregnancy. Vitamin D aids in the development of the bones, teeth and nervous system, calcium helps bone and teeth development and iodine is important in brain development. Getting the correct micronutrients is important. Deficiencies can lead to complications such as hypertension and a low birth weight. However, it’s also important not to exceed the healthy amount of certain vitamins and minerals – too much vitamin A, for example, can cause birth defects. What foods should I be eating? Prenatal vitamins are a good idea to cover any nutritional gaps you may have, while they may supplement your diet they don’t replace a healthy lifestyle. Therefore, eating correctly also greatly benefits you and your growing baby. Foods you should try include in your diet are dairy products, such as milk and yogurt, as they contain extra protein and calcium, as well as probiotics. Legumes, such as lentils and soybeans are another good food to include – these contain protein, fibre and folate (which is very important during pregnancy). Sweet potatoes, high in vitamin A and fibre, are another good veggie to add to the shopping list. Eggs, broccoli, lean meat and berries are other wholesome foods you should be including in your diet. A healthy pregnancy benefits both you and your baby in the long run, not only does it ensure that you deliver a healthy baby, but helps your child throughout adulthood development.

January 4, 2021

Working and pregnancy – when to stop and how much is enough

As an expecting mom with a career you may be wondering when the best time would be to stop working and how you can stay comfy and productive when you are still in the workplace. Morning sickness, back pain, frequent bathroom breaks and other pregnancy related symptoms can make working as you used to a more challenging task for you. It’s important that you calculate the risks that your job could possibly have to you and your baby. For instance if you are working with chemicals, heavy metals or radiation you’ll need to either stop working or take extra precautions. Heavy lifting or labour intensive jobs and lots of travel for work are also jobs that’ll become more difficult as your pregnancy progresses. Desk work and computer work are generally regarded as safe, whereas jobs that require lots of standing will become more difficult in later pregnancy. Dealing with work and pregnancy Working can be stressful without having a growing baby in your belly. The physical and emotional changes that you experience can make meeting your body’s and workplaces’s demands a challenging task. However, some moms with healthy pregnancies are able to work almost until they go into labour, how much you can do will depend on your pregnancy. Morning sickness is something many moms have to deal with. There are ways you can help manage nausea at work. Avoiding dining areas, packing mouthwash and a toothbrush and packing in soothing lemon and ginger are all things you can do to make yourself more comfortable. Eating and drinking little and often can also help keep the nausea at bay. Be sure to dress comfortably, and try to take frequent breaks and walks, as this’ll also help you stay more comfortable. What rights am I entitled to as an expecting mom in South Africa? As a pregnant employee, you are probably wondering what rights you’re entitled to. It is a good idea to inform your employee as soon as you can, so that your employer can manage the situation as best as they can (for both of you) – they are required by law to maintain a work environment that is safe for their employees. As an expecting mom, you will be glad to hear that you’re well protected under South African law – you may not be discriminated against or dismissed due to your pregnancy. You also have the right to four consecutive months unpaid maternity leave, anytime from four weeks before your expected birth date. Unfortunately employees are not obligated to pay you during this period, however, your job will be kept open for you until your return to work after maternity leave.

December 21, 2020

Travel tips during Covid-19

With the increasing number of local Covid-19 cases – over 10 000 in the past 24 hours – we need to be mindful that the pandemic is not on vacation. The statistics are worrying. South Africans need to shake off their Covid-fatigue and get back to making informed choices about their wellbeing and adhering to the protocols: Wear a mask when you leave your home, sanitise and socially distance – if we want to flatten the second wave curve, especially over the holiday season. We have also been asked to remember the 3 Cs: Avoid crowds, confined spaces and close contact. Bonitas Medical Fund, says, ‘Internationally many countries are reinforcing lockdown rules as the cases spiral, with reports too of coronavirus symptoms changing. Some medical practitioners are also saying the second wave is even more dangerous than the first. ‘Over the past month, within our membership community, we have seen an increase in the number of tests, the percentage of positive results, people requiring treatment and those being hospitalised. Through our free virtual consultations we have noted an increase in non-members consulting with doctors around the pandemic, with our call centre load having also increased.’ Here are some tips for travel during the festive season whether within our borders, to neighbouring states or abroad. Medical aid card Remember to carry your medical aid card and details with you. In the case of an emergency, it will streamline the process of getting care quickly or being admitted to hospital. Bonitas also advises that you put the Covid-19 emergency hotline (0800 029 999) or call centre number (0860 002 108) into your mobile phone so it is at hand. Virtual consultations Bonitas continues to offer free virtual consultations to all South Africans – not just its members – until 31 December 2020. If you are on holiday and concerned about your health, download the Bonitas Virtual Care App and make an appointment. The doctor will engage with you in a virtual video consultation wherever you are. The consultation includes any medical issue, Covid-19 or unrelated and advice on the most clinically appropriate steps for further care. These consults are available 24/7. Sanitise, sanitise, sanitise Pack your own soap and sanitiser. The hospitality industry has stringent health and safety protocols in place and most establishments have enhanced their deep cleaning regimes. However, it is still recommended that you keep your sanitiser with you always. If you are taking a road trip, make sure you have waterless soap and sanitiser in the car and limit your pit stops without compromising on taking the necessary rest breaks. Perhaps pack a picnic, to avoid crowded fast food outlets and restaurants on the main routes. Travelling internationally Remember that if you are leaving the country and crossing a border you will need to produce proof of a negative Covid-19 test and will also complete a travel health questionnaire. Minister of International Relations and Cooperation, Dr Naledi Pandor, has warned South Africans travelling abroad to make sure they know what the respective countries’ Covid-19 protocols are to avoid being stranded – various countries have different protocols and some have also introduced new stricter lockdown measures. She has urged travellers to familiarise themselves with the immigration and health entry requirements of the country they are visiting, as well as South Africa’s re-entry health requirement upon their return. If you are uncertain, contact the local embassy for clarification or the Department of Health. Alert your medical aid It is important that you notify your medical aid scheme ahead of any international travel. Firstly, to check what medical conditions will be covered and, secondly to activate the international medical travel cover. Travel insurance policies Medical expenses that you might encounter when travelling in Africa or other international destinations can be prohibitively expensive. To avoid having your holiday and finances totally ruined, look at what your current medical aid scheme offers in terms of medical travel cover and, if necessary, top this up with additional travel insurance. Carry your policies Travel insurance policies give detailed information about what to do in an emergency situation and have international call centres to assist you. Make sure everyone in the family has these numbers handy. The claiming process Most medical insurance requires an invoice as well as the proof of payment or receipt in order for them to reimburse you. Make sure you are familiar with the claim process. ‘One thing 2020 has taught us, is that life is unpredictable. And although additional, tougher lockdown regulations were recently announced in an effort to curb the second wave of Covid-19 infections, the burden of responsibility remains with each and every one of us,’ says Bonitas. ‘There are real concerns around the current rate of transmission, not only in South Africa but globally. In order to minimise your risks and to stay healthy and safe these holidays we all need to do our bit and stick to the protocols.’

December 18, 2020

Birth injuries

You only want the best for your baby, but sometimes harm comes to them unintentionally. During the birthing process, your baby can experience harm or physical injury; this is known as a birth injury. Birth injuries are not uncommon, sometimes they are temporary and other times they may affect your baby for a lifetime. But what exactly are birth injuries? And what causes them? What are the chances of my baby getting injured during birth? Birth injuries range from harmless to serve, either quickly healing or causing disability throughout life. Although significant injury or death during the birth process isn’t as likely, birth injuries are not uncommon – according to the Birth Injury Guide, about 29 in 1000 babies suffer a birth injury of some kind. Why would my baby become injured during the birth process? There are several reasons why a baby can experience physical trauma during the birthing process. When you near the end of your pregnancy your baby moves into position for delivery, sometimes babies will move into an abnormal position, such as a breech (feet first), and this can cause them injury when they are born. Other reasons why baby’s may become injured during birth is being abnormally large, the mother’s pelvis is too small, or a long and difficult labour, where the mother’s contractions aren’t strong enough to push her baby out. What happens if my baby has a birth injury? Generally, birth injuries affect the babies head neck and shoulders, as babies are generally born head first. There are a variety of injures that your baby could stain from birth trauma, such as bruising of the scalp, broken bones or brain damage. Sometimes these injuries are temporary and other times they can last a lifetime. Your doctors and midwives will assess the damage to your baby and help you and your baby accordingly. Sometimes babies will sustain trauma during birth, and the injury won’t be noticeable until they have started school or being missing developmental milestones, as they struggle to mentally keep up with their peers or grow at what is considered a normal rate. Sadly most birth injuries aren’t preventable, but even so, moms whose babies experience birth injuries often feel guilty and angry, as if they are too blame. Although feeling this way is understandable, this is not the case and if you are feeling this way after your baby has experienced a birth injury it is best to speak to a health professional and reply on your partner, friends and family for support.

November 26, 2020

Are day hospitals the new trend?

Globally, day surgery hospitals have changed the experience of patients by offering an alternative to acute/conventional hospital surgery. Hospital costs the highest expense In South Africa, the concept of day hospitals is also gaining popularity – particularly as a result of high hospital costs. Lee Callakoppen, Principal Officer of Bonitas Medical Fund, says, ‘Using our hospital dashboard for the full 2019 year, direct hospital costs were 43% of the total scheme expenditure. These excluded doctor and allied services while a patient was in-hospital. The increase in the use of day hospitals Internationally there is a trend in increased day surgery for multiple reasons including: Improved anaesthesia (with quicker recovery period) Improved pain control (anaesthetic blocks and improved medication) Instrumentation and procedures (keyhole surgery). Cost saving initiatives Private medical aids are struggling to keep up with rising healthcare costs, which usually outpace inflation by 3+%. They are continually looking for ways of reducing costs and keeping premium increases as low as possible without prejudicing the quality of healthcare or financial stability of the fund. ‘We negotiate special rates through our hospital networks and Designated Service Providers (DSPs) and encouraging members to use our Managed Care initiatives. Encouraging members to use day hospitals is another way in which we can save on costs. That said, the strategy amongst acute hospitals is to reduce the tariffs for day surgery to the level of day clinics to prevent a market shift away from their facilities. For the Scheme and members this is a win-win as it still translates to cost savings. Examples of price differences ‘There remains a difference in costs between day and acute hospitals,’ says Callakoppen. The table below represents savings across some of the most prevalent surgeries. Procedure Difference in Case-Mix Adjusted Hospital Cost per Event (Acute Hospital Base) Corneal, Scleral And Conjunctival rocedures -6.3% Eyelid Procedures -28.1% Circumcision -13.9% Tonsillectomy And/Or Adenoidectomy (Child) -13.0% Tonsillectomy And/Or Adenoidectomy (Adult) -11.7% Myringotomy (grommets) -15.5% Colonoscopy -15.4% Other advantages of day hospitals Patient satisfaction No overnight stay – patients are admitted, operated on and discharged on the same day Child-friendly wards and facilities – day hospitals are the ideal alternative for children requiring same day surgery as the trauma of overnight stays are eliminated Lower risk of infection – due to the fact that patients return home on the same day, the risks of cross infection are reduced, which results in a shorter recovery Mortality and major morbidity is extremely low (<1%)* Improved surgery scheduling – decrease in waiting lists Why is take up not higher? Day hospitals clearly have marked advantages but the reason take-up is not that high, is there are some perceived disadvantages of using them. One which is the geographical access – specifically in areas like the Eastern Cape. There is concern around procedure complications and the need for a patient to have advanced care. But legislation is strict around day hospitals and they have to be located within five kilometres of an acute hospital for exactly this reason.’ The issue of doctor access is another factor inhibiting the rapid increase in use. Many doctors have their consulting rooms close to an acute hospital and are unwilling to travel further. Equipment may be limited in day hospitals but the increasing list of procedures which can be performed in day hospitals speaks to this challenge being overcome. This is probably why the percentage of day cases, split between acute hospitals and day hospitals, is still biased toward acute hospitals. Currently the split of day cases being done in acute hospitals is 74% and 26% in day hospitals. This implies that 74% of all procedures which could be performed in a day hospital are currently performed in acute facilities. Safety is foremost Not all patients can go to day hospitals. Callakoppen says, “It should be noted that this percentage will be lower as some patients would have anaesthetic and comorbidity risks and from a safety perspective may rather have the procedure performed in an acute hospital where overnight facilities are available. Additionally, not all day clinics are adequately equipped to do some procedures and, as such, the true percentage will be lower.’ Day hospital options for 2021 Bonitas currently has 68 day hospitals on the BonCap network and 30 day clinics on the Select options. According to Callakoppen, ‘This will be enhanced in 2021 when we implement a day surgery network across all options. A comprehensive list of procedures that should be done as day procedures has been collated for our members. If any of these procedures need to be done then members must use a facility on the day surgery network, or alternatively pay a co-payment. While the day surgery network will be comprised mainly of day clinics, it should be noted that certain acute (conventional) hospitals will need to be included on the network where there are areas of access constraint to them.” Will day hospital use be enforced? The Day Hospital Association of South Africa has proposed that medical aid enforce day hospital use in the future but also caution that there are some cases which cannot be carried out in day hospitals. He says, “The Scheme is in agreement with the concept. Although we do promote the use of day hospitals, we must bear in mind that there are some procedures for which this is not suitable. High risk patients who require more intensive post-surgery care would require acute/conventional hospitals. But the benefits of day hospitals should definitely be considered by all patients when undergoing a procedure.”

November 17, 2020

Sunburn in babies, how to prevent and treat it

Living in sunny South Africa, worrying about your baby being exposed to the sun’s rays is a valid concern. Too much unprotected time in the sun can be harmful to your baby, leading to painful sunburn and, even skin cancer later in life. Here’s how to prevent and treat sunburn if your little one has spent too long outside. How to treat sunburn Babies and toddlers are more sensitive to the sun as they have less developed skin than adults. Prevention is better than cure when it comes to sunburn, however, if your baby has spent too much time in the sun, the reddy, painful burn will only show up a view hours later. Those who have darker complexions tend to be less sun sensitive, however, everyone has some risk of sunburn. Redness, swelling of the skin (warmth) and pain are all symptoms of sunburn. If the sunburn has caused fever, chills, blisters and headaches its best to consult your local health practitioner. You can treat mild sunburn with a cooling bath, moisturiser or aloe gel – all of which will help cool irritated and inflamed skin. Giving your baby extra fluid in the days following the burn should prevent dehydration. It is recommended that you keep your baby out of the sun until the burn has healed.x Tips for preventing sunburn Sun is strongest between 10am and 4pm so limit your little one’s sun exposure during this time. When your baby is spending time outdoors in the sun, be sure that they are wearing a hat and sunblock with an SPF of higher than 30, if your baby is older than 6 months (if they are younger you will need to find alternative protection for them). Try to find sunblock that is formulated for kids (as this will work best for sensitive skin) and do a patch test on their skin before using it. If your child doesn’t like the feel of sunscreen (or is younger than 6 months), sun protective clothing is the better option.

October 21, 2020

Ten tips for choosing the right medical aid

The medical aid landscape can be tricky to navigate so it’s best to compare all the available options and schemes to find a medical aid that works for your budget and your family’s health. Bonitas Medical Fund helps guide you through choosing the best plan. Analyse your healthcare needs No two people or families are alike, medical needs differ so do a quick personal healthcare needs’ analysis to determine what cover you need. If you have dependants, factor in their healthcare needs too. Factors to consider include: How often you visit your family visit a doctor or specialist Over-the-counter medication or chronic medication required Chronic conditions like high blood pressure or diabetes Specific conditions like cancer, HIV or renal failure Dentristy Optometry This will help you decide on whether you need a comprehensive medical aid or a hospital plan. Read the small print Benefits vary from plan to plan, so establish what is and isn’t covered and look at whether the option offers additional risk benefits which can save on day-to-date expenses. Such as free wellness screenings (blood pressure, cholesterol, blood sugar and BMI measurements) through to mammograms, pap smears and prostate screening. In some cases this extends to maternity programmes, dental check-ups, flu vaccinations and more. Managed Care options Managed Care programmes help members manage severe chronic conditions such as cancer, diabetes and HIV/AIDS. What about savings? Medical savings are a fixed amount a medical scheme gives you at the beginning of the year. There are ways to maximise your savings but first you need to know what you annual allocation is. The day-to-day detail Look at what the scheme suggests as a way to make your benefits last, bearing in mind the following: Some plans require you to use a specific GP, hospital network and have a list of Designated Service Providers (DSPs). These keep costs down because the scheme will have negotiated special rates with these services providers. Check the network in your area before making a final decision. Must you be referred to a specialist by your GP? Does your medical aid offer additional GP consultations, which they will pay for, after you have exhausted your day-to-day benefits? Virtual Care and technology Technology and virtual care is being embraced by medical schemes and members. Check what is offered on the plan you’re considering and whether it you want access to your benefits 24/7. Age impacts your decision As parents of young children, ensure the option you select provides sufficient child illness benefits If slightly older, select a plan that covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation Ensure the affordability Consider all the costs involved before you make your final decision, such as: Monthly contributions: The rule of thumb is that contributions should not exceed 10% of your monthly income. A medical aid co-payment is a fee that the member is liable for when making use of certain medical services. These co-payments usually apply to specialist or elective medical procedures and will differ from one medical aid scheme to another. Waiting period and exclusions The Medical Schemes Act and the specific scheme’s rules determine this. Bonitas recommends that you enquire with the relevant scheme about their exclusion list and waiting periods. Brokers Using a broker doesn’t cost you anything. An independent broker will help you work your way through the different options and help choose the medical aid plan best suited to your and your family’s needs. For more information on the product offerings from Bonitas go to www.bonitas.co.za

October 21, 2020

Bonitas takes the edge off contribution increases

Financially solid, younger new members, two new plans, virtual healthcare and a renewed focus on Managed Care for chronic diseases are just a few of the insights from the Bonitas 2021 product launch. But it is the annual contribution increases which are highly anticipated and the moment of truth for all medical schemes. Lee Callakoppen, Principal Officer of Bonitas Medical Fund announced an unprecedented 0% increase on its BonFit Select plan and a weighted increase of 4.6% across all plans. The highest increase is 7.1%. ‘Members on our growth options, which contribute to 91% of business, will only experience an increase on 3.9%. I think, looking at the pricing and the benefit richness we offer in comparison to the market, the changes for 2021 will be well received.’ He says, ‘The guidelines received from the Council for Medical Schemes (CMS), clearly highlighted that medical schemes should limit contribution increases as far as possible. We crunched numbers and worked tirelessly to find the sweet-spot between sustainability and ensuring affordability. Not an easy task, especially in a weakened economy. We took a responsible stance, with a long-term view, to ensure that our members wouldn’t have to pay the price of a low increase for 2021 in the coming years. One of our core considerations was finding ways to ensure members could get access to full healthcare cover and avoid out-of-pocket expenses and co-payments.’ Pricing and technology Seven of our current options are priced between R1 500 and R3 000 which is where the medical scheme market is experiencing growth currently. Member behaviour has changed significantly and demand is for innovation, accessibility and technology. This has the benefit of attracting, a younger, target audience and driving sustainability. We can’t talk about 2020 without mentioning Covid-19. Key trends that emerged from a medical schemes perspective were: Changes to benefit structures and PMBs Lower than anticipated investment income as markets slumped Changes in claiming patterns in terms of seasonality and volume, due to the lockdown measures that came into effect And a Consumer Price Index that was lower than previous years which is expected to be at around 3.9% in 2021 In an industry like ours, it’s challenging to be different – to innovate, disrupt…to be better. But not impossible. The Fund needed to make short-term decisions with the long-term view and sustainability in mind. One of the highlights over the past few years, has been the introduction of four Efficiency Discounted Options (EDOs). Plans whereby members use network healthcare providers and pay around 15% less for the same benefits. The EDOs cover over 74 000 lives and the principal members who join are around 10 years younger than the average Bonitas member. 2021 – changes, contribution increases and enhancements Over the past five years, we have proactively driven innovative product design, actuarial modelling and constant engagement with various stakeholders. We believe we offer the ultimate split risk solution, with a comprehensive product range and diversified membership base. To stay at the forefront of innovation we have introduced: Edge – a new category driven by technology, intelligence and innovation, with two plans called BonStart and BonStart Plus. These are designed for economically active singles or couples, living in the larger metros. The plans include access to: A private hospital network and full cover for emergencies; PMB chronic medicine; excellent day-to-day benefits including unlimited GP consultations; layers of virtual care, dental and optical benefits; preventative care; wellness screenings; contraceptives and more. The cost: R1 452 and R1 731 respectively for the principal member. Managed Care One of the leading trends worldwide is the rise in non-communicable diseases, such as diabetes, high blood pressure and oncology. In fact, during this global pandemic, the impact lifestyle diseases and comorbidities had on Covid-19 patients was put in the spotlight. 20% of our members have multiple comorbidities which means, even without the pandemic, we need a stronger focus on preventing and managing lifestyle behaviours. Poor diet, smoking and lack of exercise are the three lifestyle factors that contribute to over 80% of chronic conditions. Managed Care continues to be a focus to empower members to take charge of their health and support them along the way. Home-based care During Covid-19, home-based care received renewed interest and focus. This dovetails with our strategy to move more care to the home and out of hospital. As an example, post-surgery or mild pneumonia, treatment can be effectively provided at home through the assistance of nurses. Not only is home-based care a cost effective delivery of care but it also promotes healing. Studies show that patients recover faster in their comfort of their own home. Day hospitals We believe the use of day hospitals and clinics should be encouraged, where possible. Some procedures such as cataract surgery, circumcisions and scopes are better suited to be performed in day hospitals or clinics versus larger hospitals. There is minimum disruption to members, speedier recovery times, less risk of infection and day hospital are also a more cost effective alternative. Technology One of the key learnings has been adapting to a new way of working – with virtual technology at the forefront. The WhatsApp channel we introduced has the most room for potential. This platform is convenient for members and allows them to manage their medical aid through live chats. Virtual Care There was a positive response to the launch of the new Bonitas Member Mobile App and free virtual care for all South Africans. This provided access to GP consultations for a range of conditions, including Covid-19, as well as free delivery for chronic medicine. At the heart of the model is the GP. This aligns to our care coordination initiatives, ensuring members receive the right level of care and support in managing their conditions. It allows access to a virtual nurse, advice in an emergency, auxiliary and home- based care, ensuring members have comprehensive support for any condition, in any circumstance, through our virtual based model. We’re pleased to announce that this model is unique and

September 23, 2020

Elective surgeries – the disruption, the trends and back to business unusual

On 9 September, South Africa recorded 1990 new cases of the pandemic in 24 hours. The country has now slipped to the eighth worst affected nation in the world in terms of the number of Covid-19 infections. In spite of this elective surgery has been given the green light and its back to business – albeit with strict protocols in place to safeguard staff as well as patients. Almost five months ago elective surgeries came to a standstill. This was reflected in claiming patterns in the private healthcare sector during lockdown – a disruption of the norm globally. In South Africa, elective surgery in both the private and public healthcare space and specialists’ visits are just two of the areas which have been affected by Covid-19. The link between the two is clear: Fewer specialists’ visits mean fewer referrals for surgery. So what exactly is elective surgery? The term can be ambiguous. 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. Some of these surgeries are necessary to prolong life, for example an angioplasty or, as in most cases, improve the quality of life. In brief, elective surgery is ‘A planned, non-emergency surgical procedure.’ Elective surgeries dropped by over half According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, ‘there has been a 60% reduction in hospital authorisation requests compared to 2019. A study release in March predicted that an estimated 28.4 million elective surgeries worldwide, would be cancelled during the 12 weeks of peak disruption due to the global pandemic. This has been a similar experience to other industry role players and is predominantly due to a combination of member fears related to Covid-19, lockdown and provider caution.’ Surgeries delayed not cancelled The postponement of surgeries was done to prevent patients taking up hospital beds and to avoid unnecessarily exposure to the virus – a strategy that worked well to flatten the curve. Surgeries were delayed based on provider discretion and subsequent patient engagement. Callakoppen says, ‘Providers are best placed to make these clinical decisions in the interests of their patients. If the procedures were emergencies or urgently required to enable member quality of life, those would have proceeded.’ The public sector too experienced backlogs in terms of elective surgeries. Examples are procedures including but not limited to, cataracts, orthopaedic surgeries, scopes, caesarean sections, tonsillectomies and adenoidectomies. BHF cautioned funders In July, The Board of Healthcare Funders (BHF) and its members in the healthcare funding space requested members of medical schemes to proceed with caution in scheduling elective surgical procedures. Dr Rajesh Patel, Head of Benefit and Risk at the BHF, said, ‘While the relaxation of the lockdown restrictions is good news for people, the country and the economy at large, we are still in the eye of the storm.’ The way forward? ‘As we move toward Level one, elective surgeries are almost back to normal,’ says Callakoppen. ‘It’s time to address the backlog of surgeries not considered emergency during lockdown. These include slow-growing cancers, orthopaedic and spine surgeries, airway surgeries, surgeries for non-cancerous tumours as well heart surgeries. We caution against a rush of elective surgeries though. Any surgery has an impact on the immune system which means the patient has a greater risk of contracting Covid-19 and developing complications from it. ‘It must further be noted that in some instances surgery is often recommended by specialists as one of the key courses of action. But we have noted that managed care protocols, in many instances, improve clinical outcomes with lower risk to the patient. One such example of this is spinal surgery, which is often unsuccessful. From a Bonitas perspective, we have noted that in the back and neck programme which enforces functional rehabilitation has been far more effective for our members. In addition, the risk to the member is significantly lower.’ Bonitas recommends the following is taken into account: That elective surgeries should only be resumed in instances where not having the procedure will severely impact the members’ health and quality of life That the current state of a patient’s healthcare is assessed – individuals with chronic conditions such as diabetes, asthma HIV/AIDS and hypertension, are at high-risk of developing Covid-19 complications The patient’s age is taken into consideration (older individuals are identified as one of the most vulnerable groups) The impact of waiting on the patient’s healthcare outcomes (for example, is it essential that the surgery takes place now or can it safely be deferred for a few months) Alternative care protocols – in some cases surgery, which should be a last resort, is prescribed without considering other treatment protocols such as rehabilitation. The most common examples of this include back and spine procedures, elective c-sections as well hip and knee replacements The use of day hospitals and clinics, where possible, to limit the possible chance of infection We may have flattened the curve but we are by no means out of the woods. Current Covid-19 cases in South Africa prove that. What is happening in hospitals? ‘Surgeries are being resumed responsibly with due collaboration and consideration exercised between the surgeon, the patient and hospital staff,’ says Callakoppen. Where there are capacity constraints, surgeries will be classified in terms of priority at the various hospitals. Pre-operative screening will continue. Facilities will continue to utilise separate zones for Covid-19 positive patients, Persons Under Investigation (PUI) and those for whom the status is unknown at the point of admission. Surgeries will be carefully planned and scheduled. Specialist visits on the up ‘Consultations are starting to increase once again but providers in general are likely to remain prudent. However we urge people who have not had their necessary annual check-ups, particularly our high risk members, to consult with their doctors. There may be members who have put these consultations on hold and are now more comfortable to visit a specialist. But care coordination

September 11, 2020

Physical touch & newborns – why is this so important

The birth of your baby is a beautiful and special moment in both of your lives. You may be wondering about your newborn’s senses, while they are born with all necessary senses, some are less precise than others and develop as your baby grows. Physical touch is an important aspect of your child’s growth, coming from your womb, where they are tightly cocooned in your womb. Skin to skin contact offers benefits to both you and your baby, and touch is one of the senses that can help comfort your baby, making them feel more secure and helping strengthen the bond between the two of you. Why is touch important? Touch enables your baby to learn more about the world, bond with their mother and learn communication skills, as touch and body language will be the first way that you can ‘speak’ to one another. Breastfeeding is an important part of this, as your baby then spends time in her mother’s arms. The benefits of touch goes beyond the physical. Contact between mom and baby has been shown to lower cortisol levels, which in turn benefits the functioning of the immune system. Children that are deprived of touch can be more aggressive with other conduct disorder problems. What is swaddling? Coming from a tightly packed womb, you’ll find that your baby is comforted by touch and close cuddles. Swaddling your baby in a blanket is also another technique that you can use on young babies to help them feel more secure, as it stops them from upsetting themselves from their own startle reflex. It’s important that your newborn finds their new world a comfortable and soothing place. Swaddling is an old technique, and beyond helping your little one feel safe and secure, your baby is likely to sleep better and will be kept nice and cosy in their blanket. If you decide to swaddle your baby it’s best to do so from birth, as opposed to introducing it when they are older as this can increase the risk of Sudden Infant Death Syndrome. Using the proper techniques when swaddling is also important, as incorrect wrapping can lead to issues.

September 8, 2020

How does my diet affect my pregnancy?

A healthy diet is always important, but during pregnancy you are eating for both you and your baby so it’s critical that you remain healthy. Eating poorly during pregnancy can have a long term impact on your baby’s health growing up. So that being said, what foods should you be eating during pregnancy? If you eat healthily already you won’t need to go onto a special diet during pregnancy, but it’s important to get the right nutrients for you and your baby through a balanced diet. Don’t be alarmed if you find yourself hungrier than usual, but even if you are expecting twins you won’t need to eat for two. It is also important to note that weight gain during pregnancy is normal, so don’t be alarmed by this. Eating schedules differ between moms, however, it is generally recommended that you eat smaller amounts more frequently when pregnant, especially if you are struggling with morning sickness. What to eat when you’re expecting Fruit and veggies are your friend during pregnancy. Providing much needed vitamins and minerals, as well as fibre which helps with digestion and keeps you feeling fuller for longer. Protein is another important nutrient, and you should try to include it in your diet everyday as it helps your baby grow strong. Sources of protein include nuts, beans, pulses, eggs, lean meat and fish. However, raw, cured and uncooked meat are all risky to consume during pregnancy as they can cause toxoplasmosis. Another important source of energy is carbohydrates, specifically whole grains. They contain vitamin B, fibre and iron, which are all important for the baby’s growth and staying healthy. These include oatmeal, wholewheat pasta and bread, potatoes and maize. If you are suffering from morning sickness, these blander foods fill you and can be eaten little and often. Foods that are rich in calcium should also be eaten regularly. Dairy foods, such as milk, cheese and yogurt are all options containing calcium as well as protein and vitamin D. That being said, some cheeses (such as soft cheese like brie) should be avoided as they can contain harmful (although rare) listeria bacteria. What foods should be avoided during pregnancy There are certain foods that you should take care to avoid during pregnancy. As mentioned, rare meats and certain cheeses should be avoided. Liver and raw fish (i.e sushi) are also on the to-avoid list. Consuming too much caffeine can also affect the baby negatively. Coffee is the obvious drink to avoid, but be aware that soft drinks, green tea, certain energy drinks and chocolate all contain caffeine.

September 1, 2020

Stimulating your baby’s senses

The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Believe it or not your baby will learn a lot in their first year of life. One way you can help them learn is to provide stimulation for them in different forms. This can be done in a variety of ways such as stimulating their vision and hearing or through touch and movement. Remember to spend some time every day working to help your baby explore the world around them. Stimulating your baby’s visionThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Make eye contact with your baby during times when their eyes are open. Look them right in the eye. They recognize faces very early in life, especially yours! This helps them develop their memory. Use a mirror to let your baby stare at his or herself. They will enjoy looking at “another” baby and watching the movements it makes. Stick out your tongue for your baby or make funny faces. Starting at 2 days old newborns can begin to mimic simple facial movements as they begin to develop problem solving skills. Hold up two pictures for your baby to look at. They should be similar, but with some sort of difference between the two – maybe one has a house and the other doesn’t. Even young babies will look back and forth between the two to try and figure out the difference between them. This can help them develop letter recognition and reading skills later on. Stimulating your baby with laughing and singingThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Find ways to get your baby laughing. This can be through methods like gentle tickling, blowing on their arms and tummy, or making funny faces. As they get older you can joke around more too. Laughter is great for babies! Sing songs to your baby. Learn as many as you can or make up your own words to songs you already know. Play music to your baby. This can be Bach or Mozart or even the Beatles. Learning music rhythms may help them learn math skills later on. Talk away. In other words, have a silly, fun conversation with your baby. Chat away and pause at places where your baby would speak in the conversation. As your baby grows, they will learn to start chatting to fill in the spaces you leave. Be sure to make eye contact and smile a lot! Play peek-a-boo, it’s great for getting babies to giggle and laugh – it also teaches them that objects can disappear and then come back. Physical activities for your babyThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Turn yourself into a playground by lying on the floor and letting your baby crawl all over you. This will help boost their problem-solving skills and coordination. Teach them to move to music. You can teach them to do the twist, twist and shout or even twirl like a ballerina. This helps them develop skills like balance and coordination as well as a sense of rhythm. Create an obstacle course by laying toys, boxes or sofa cushions on the floor and then show your baby how to crawl over and around or under the items. This helps with problem-solving, strength and coordination. Play pick-up by allowing them to drop toys or pieces of wadded up paper off their highchair into a bucket or other safe container. This helps them learn and explore the laws of gravity. Newborn hearingThe following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion. Newborns can hear immediately upon birth and are able to distinguish their mother’s voice above all else. If your baby does not seem to react to your voice or does not startle with a loud noise, be sure to tell your paediatrician.

August 17, 2020

Cancelling your medical aid should be a last resort

When your income is threatened, reduced or, in the worst-case scenario has dried up, deciding where to spend and where to save becomes critical. In circumstances such as retrenchment, or periods of reduced employment, it may be tempting to consider quick-fix solutions and take a break from your medical aid but, during a global pandemic, you may want to think twice. ‘South Africans are faced with many challenges during this tough time and we are aware of the financial implications the lockdown has placed on everyone,’ says Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘The pandemic has put a spotlight on the need for quality healthcare, which means a decision to cancel your medical aid is not recommended and should not be taken lightly.’ Let’s consider the costs involved if you are not on medical aid, become infected with the Coronavirus and are admitted to a private hospital. Cost realities The cost for a patient spending two weeks in a general ward for the treatment of COVID-19 is around R99 201. But if that patient is transferred to ICU for a period of two weeks, the cost rises to about R392 340. These costs include specialists, pathology, radiology and allied services. The alternative: Public healthcare. However, the exponential spike in the number of COVID-19 cases has meant that hospitals are overcrowded, resulting in a shortage of staff, equipment and ventilators. ‘Our advice is to consider your specific medical needs, as well as your budget, when deciding how to proceed, particularly if you have chronic conditions or are at greater risk. Buying down is definitely a key consideration, or look at network options which offer marked savings. The Bonitas Select Plans, for example, are priced 15% cheaper than non-network options. In addition, we strongly advise that you consider benefit richness against your contributions.’ Key questions to ask yourself include: Does my medical aid offer additional benefits that are paid from risk rather than savings or day-to-day benefits? Does my medical aid offer alternatives like virtual GP consultations, chronic medicine delivery and online antenatal classes to deal with the concerns posed by the lockdown? Another big factor to consider when it comes to COVID-19 medical care is comorbidities, or the coexistence of two or more diseases or disorders. ’The Minister of Health, Dr Zweli Mkhize, warned early on in the pandemic that South Africa has a significant burden of non-communicable diseases, or chronic conditions, with diabetes and hypertension topping the list,’ says Callakoppen. Projections are highly uncertain at this time but our actuarial team has estimated around 30%, or 215 851, members of the Bonitas population are at risk of contracting COVID-19, based on comorbidities. The conservative financial impact to the Scheme could potentially exceed R450m, in addition to annual claims costs, which amounts to R15bn. Although there is a high level of uncertainty around the level of care required, we project that COVID-19 cases will be managed as follows: 20% requiring hospitalisation 5% requiring treatment in ICU What will the consequences be on members if they cancel their policies? ‘Unfortunately, members who resign from the Fund are unable to access healthcare benefits. There are strict rules and regulations governing the medical aid industry, in place to protect both members and the financial sustainability of medical schemes.’ Cancelling your membership This should be your last resort. If you do cancel, try to rejoin or join a new scheme within three months otherwise the new scheme can impose: A three months’ general waiting period A 12 months’ exclusion from cover for any existing medical condition Late joiner penalties on all people over 35 years of age. Before you make any important decisions, it might be worth considering what options are available to you, what your priorities are and where you cannot afford to fall short. It is also advisable to speak to your medical aid provider to find out what they can offer you. Joining a medical aid now Callakoppen says they have a seen a marked increase in queries about joining the Fund. Waiting periods apply as normal with a 12 month’s exclusion cause. However, Prescribed Minimum Benefits (PMBs) are covered immediately, this includes COVID-19. ‘Medical aids have needed to adapt during the pandemic, offering added value to members including education, advice, virtual care, etc. COVID-19 has meant we have to be more innovative and re-evaluate the way we consult with members. The need for social distancing has accelerated access to virtual care to protect health practitioners as well as patients. As a Fund, we continue to explore new ways to ensure our member have access to quality healthcare at all times.’ Added value is essential, particularly during this tough economic time and we’ve introduced a range of elements to support members on a clinical, emotional and financial basis. These include: Introducing free 24/7 virtual care with GPs to all South Africans through the Bonitas app. We have had over 33 000 downloads of the app over the past six weeks Through our partner, Pharmacy Direct, we offer home delivery of chronic medication and, during COVID-19, six month prescriptions are being delivered. Around 187 995 members are enrolled on the chronic medicine programme, of these over 55% use the home delivery service Setting up a dedicated Rapid Response Unit in our managed care team to address COVID-19 concerns and support members who are Persons Under Investigation, test positive or are in recovery Creating a COVID-19 hub on our website so that members have access to accurate information on the Coronavirus and the steps they can take to protect themselves and their loved ones Creating a corporate return to work programme to support employer groups with daily screenings, occupational health and safety, etc Creating isiXhosa, isiZulu, isiSetswana and Afrikaans videos to help educate on steps to take to curb the spread of COVID-19 Launching new self-service channels through the Bonitas app and WhatsApp that allow members to access statements and tax certificates, submit and view claims and access electronic membership cards. There is also a

August 13, 2020

Collaboration addresses the challenges of COVID-19

‘Collaboration between all the stakeholders is the cornerstone of tackling the coronavirus pandemic,’ this according to Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘This includes engaging both the public and private healthcare sector to find a way forward to address the challenges faced by South Africans. Negotiations, strategising and robust discussion with The Council for Medical Schemes(CMS), The Board of Healthcare Funders (BHF), hospital groups, healthcare practitioners and strategic healthcare service providers will enable us to find the best possible solution during this pandemic.’ Callakoppen highlights some of the key challenges facing consumers and the way forward. COVID-19 testing Challenge: Costs and availability of Coronavirus tests Solution: Negotiation and co-ordination to manage tests and a payment plan put in place Our administrator and business partners are collaborating with the National Institute for Communicable Diseases (NICD), the Department of Health (DoH), pathology laboratories and the Radiology Society of South Africa to try to monitor and manage the availability and cost of tests. In addition, we are collaborating on the provision and delivery of medicines and co-ordination of treatment available in order to ensure sustained, quality healthcare is available to all members. Bonitas covers COVID-19 as a Prescribed Minimum Benefit (PMB), paying for up to three PCR tests from risk – regardless of the result. ‘One of the problems has been a shortage of tests in South Africa and we have urged our members to follow the guidelines from the Government and the World Health Organization, only testing when absolutely necessary, such as when they have come into contact with a known COVID-19 positive case, are showing symptoms and have received a referral from a healthcare practitioner for a test,’ Callakoppen says. This step aims to ensure that tests are reserved for those who really need them. These measures also go a long way in helping to curb misuse of tests and mistaking the symptoms of other respiratory illnesses for COVID-19. ‘We note that as the number of COVID-19 positive cases increase, there is a significant increase in the number of tests conducted. However, again we strongly urge the public to only test when absolutely necessary or when advised by their Healthcare practitioner to do so, as a shortage of tests could have a much more far-reaching impact on the spread of the disease.’ Addressing affordability Challenge: Helping cash-strapped members continue paying their medical aid premiums Solution: Proactive application to CMS for concessions and looking for ways to add value to our members and South Africans ‘The economy and livelihoods of many South Africans have been adversely impacted by the pandemic. We definitely sympathise with this and, as the cost of living continues to increase it was very clear to us that affordability of medical aid, as well as daily living expenses, would become a concern. We began engaging with the CMS prior to the issuing of the CMS Circular 28 of 2020 containing COVID-19 Medical Schemes Industry Guidelines to try and offer our members some respite from the harsh economic impact. However, as medical schemes we are highly regulated in terms of our operations. As such there is a lack of parity between the level of relief we would have liked to offer our members to the level of relief that was approved.’ CMS issued an additional industry circular in April 2020, outlining how medical schemes can apply for exemptions to the Medical Schemes Act to launch lifelines to members, such as contribution holidays or accessing their medical savings accounts to cover premiums. The R160bn medical scheme market covers about 8.9-million members, most of whom are subsidised by their employers. Callakoppen says, ‘The CMS regulates the industry and has been very specific in terms of what medical aids may and may not do. Schemes are required to request exemptions from the Medical Schemes Act to relax certain credit management policies through the CMS. ‘We approached the CMS in April with requests for concessions and have implemented those they approved. At present, our concessions include allowing contributions to be funded from savings. In addition, we have special concessions in place for members who belong to employer groups.’ Despite the regulatory environment, Bonitas has been agile in its approach. ‘We used the challenges of the current landscape to become more innovative in terms of what we can do, within our environment, to assist our members and South Africans at large with some relief. We therefore introduced free virtual GP consultations to all South Africans through the Bonitas Member App so that they would continue to have access to healthcare during this time. We continue to keep the issue, of how members are impacted due to the economic challenges, top of mind and this informs your strategies to respond and address the challenges consumers are experiencing. Hospital beds Challenge: Shortage of high care and ICU beds Solution: Negotiations to have access to facilities outside of network hospitals and standardised tariffs Together with Medscheme, our administrator, we have implemented tariff enhancements to ensure that sub-acute and day hospitals can accommodate admissions where provincial licence exemptions have been granted, when the time comes. There are about 25 800 adult acute beds in the private sector and about 3 700 day hospital and sub-acute hospital beds that stable patients could be sent to. In addition, there are 3 600 dedicated paediatric beds nationally. ‘As a Fund we have negotiated with hospital groups to ensure that members do not have to go to a network hospital during this time when private hospitals may experience capacity constraints. Our key mandate is to act in the best interests of our members at all times and as such we strive to ensure that they have access.’ Virtual Care 24/7 for everyone Challenge: How to maintain your health during the Government’s call to stay at home and social distancing Solution: Virtual Care Early in April, Bonitas launched its Virtual Care, offering it to all South Africans, at no cost, during the COVID-19 crisis. These virtual medical consultations, with GPs and

August 7, 2020

C-section questions, answered

One of the biggest decisions you’ll make about your baby’s birth is whether to have a vaginal birth or a Caesarean section, also known as a c-section. Neither method is objectively better than the other, some moms need to have c-sections for physical or health reasons, or decide that they would rather opt for a c-section for personal reasons. Focusing on the c-section, we’ll let you know what you can expect when having one and what the average recovery time is. When making this decision you should consult with your health practitioner, but it won’t hurt to know more about what is happening to your body during the process so that you can make the most informed decision for you and your baby. So what exactly is a c-section? C-section is the surgical delivery of a baby. During the process you doctors will cut into your abdomen and your uterus and lift your baby out of this. As you are having a major surgery, you’ll typically have an epidural. This way you’re numb, but still awake so you can experience the magic of your baby’s birth. Both c-sections and vaginal births have their pros and cons. You’re likely to take longer to recover from a c-section birth and you’ll probably feel pain in the incision area for a few weeks. As it’s a surgery, there’s a risk of damage to surround organs, infection and excessive bleeding. Make sure to consult with professionals about what works best for you and your baby before making a choice. When is a c-section necessary? Some moms elect to have c-sections before the time, whilst others may need to have an emergency c-section due to complications that arise during birth. If you are expecting twins, have high blood pressure, diabetes or have an infectious disease, such as HIV or genital herpes you’ll schedule your c-section ahead of time. Unplanned c-sections are necessary if your labour doesn’t start or stalls, if you become too exhausted or your baby goes into distress, if the umbilical cord slips into the birth canal before the baby (as there is a risk of the baby’s air supply being cut off) or if your uterus ruptures. How long will I take to recover from a c-section? Don’t expect too much of yourself after having a c-section, you’ll typically spend around 3 to 4 days in hospital and take about 4 to 6 weeks recovery time at home before you start feeling normal again. Some moms experience muscle or incision pain for a few months following the c -section.

August 3, 2020

Virtual medical consultations now available 24/7

Staying healthy remains a priority for South Africans especially during the COVID-19 lockdown. However it can be a challenge to seek medical help when the Government is asking us to stay home, wear masks, wash our hands frequently and practice social distancing. The solution lies in virtual care.

June 15, 2020

Vaccine against Streptococcus Pneumoniae

The World Health Organization (WHO) stresses that although pneumonia vaccines are not effective against COVID -19, vaccinations against respiratory illnesses are highly recommended to protect your health and lowering the risk of becoming infected with any respiratory disease during this time. WHO also states that globally more children, under the age of 5, die from pneumonia than malaria, AIDS and TB combined. In SA, flu and pneumonia rank second – after intestinal infectious disease – as the leading cause of children under 5, which doesn’t make sense when vaccines are available in both the private and public healthcare sector for children and adults. Bonitas Medical Fund recommends having a flu vaccine, it is the first line of defence when it comes to protecting yourself. For those who are at risk of pneumonia, a second vaccination against Streptococcus pneumouniae is also recommended. What is pneumonia? Pneumonia is inflammation of the lungs caused by an infection. Many organisms can cause lower respiratory tract infections or pneumonia. Mixed infections with multiple viral and/or bacterial infections are common. Streptococcus pneumoniae is a bacterium known to be a common cause of bacterial pneumonia in South Africa. Pneumococcal infection may cause mild disease such as a middle ear infection or more complicated infections like pneumonia or an infection of the blood called bacteraemia. In South Africa, individuals at risk of more severe or invasive pneumococcal disease include the elderly, HIV-infected individuals and individuals with chronic medical conditions (e.g. chronic lung disease). Severe disease may require hospitalisation for treatment and may result in death. These streptococcal bacteria can spread from the nose, throat and ears of infected individuals. Pneumococcal vaccine Two pneumococcal vaccines are registered for use in adults (over 18 years of age) in South Africa: The 23-valent polysaccharide vaccine (PPV23) and the 13-valent pneumococcal conjugate vaccine (PCV13). PCV13 is also included in the South African Extended Programme of Immunisation (EPI) for childhood vaccines and is given to infants at 6 weeks, 14 weeks and 9 months. These vaccines aim to provide immunity against the types of Streptococcus pneumoniae that are most commonly associated with severe disease. According to local clinical guidelines from the South African Thoracic Society and Federation of Infectious Diseases Societies of Southern Africa, since the introduction of the PCV13 into the EPI there has been a reduction in the number of cases of pneumococcal pneumonia caused by these types of Streptococcus pneumoniae in South Africa. Who should have the vaccination? Infants routinely receive pneumococcal conjugate vaccines (PCV13) as part of the EPI for childhood disease*. The pneumococcal polysaccharide vaccine (PPSV23) is recommended for individuals who are at risk of developing severe disease*: individuals 65 years or older anyone with chronic medical conditions affecting the lung, heart or kidneys HIV-infected individuals Those with a compromised immune system due to other medical conditions (e.g. individuals with cancer) Pneumococcal vaccination during the COVID-19 pandemic The pneumococcal vaccination is not active against the novel coronavirus and will not protect you from becoming infected; it will offer protection against Streptococcus pneumoniae. However, the National Institute of Communicable Disease (NICD) states the following, ‘any intervention to lower the risk of becoming infected with any respiratory disease at this time may be of benefit. Lowering the risk of acquiring a respiratory infection, will allow for less visits to clinics and less hospital admissions, thus decreasing the burden on the health infrastructure at this time and lowering ones’ exposure to acquiring COVID-19 in the hospitals/clinics.’ Although pneumococcal vaccination does not protect against COVID-19 mild or severe disease or COVID-19 pneumonia, it could play a role in preventing secondary pneumococcal pneumonia infections in those with underlying conditions and the elderly. When to get vaccinated? If you think you may be within one of the groups at risk of severe pneumococcal disease, contact your pharmacy to check whether stock of the vaccine is available and schedule an appointment to be vaccinated. Most medical aid plans offer a free flu vaccine annually to members as well as a once off –pneumococcal vaccine for those over the age of 65. As part of the preventative care benefit this is taken from risk cover so it doesn’t deplete members’ savings. Bonitas says that despite the evidence of the efficacy of both the flu and the pneumonia vaccinations, there is not enough uptake. To address this and encourage more members to get vaccinated the Scheme runs email and SMS vaccine drives targeted at the elderly, high risk/emerging risk members as well as children. It reports that this has shown an improvement in people taking the necessarily precautions, but the Fund still believes there is a long way to go.

June 8, 2020

Coronavirus – should you still have a flu vaccine?

The flu season is officially underway and, while Coronavirus is bringing the world to a standstill, it is important to remember that flu can be deadly too. Which is why it is important to have a flu vaccine.

June 3, 2020

Making sense of the numbers – cases, co-morbidities and costs

As the number of COVID-19 infections creeps closer to 20 000, both public and private healthcare is going to be under constant pressure. The World Health Organization (WHO) says its COVID-19 data to date suggests that 80% of infections are mild or asymptomatic, 15% are severe infections, requiring oxygen and 5% are critical infections, requiring ventilation.

May 26, 2020

Supporting you through your pregnancy

Bonitas Medical Fund believes that as an expecting mom your pregnancy should be a unique and joyful experience. Through targeted support during each trimester, pregnancy education and specific related engagements – via telephone and digital channels – we aim to help you achieve this. With the new Maternity Programme we hope to improve the health of moms-to-be and, as a result, reduce possible complications.

May 19, 2020

Back pain during pregnancy and how to deal with it

Back pain is a common occurrence during pregnancy and can be frustrating to deal with. Unfortunately, if you have any pre-existing back problems you are more likely to struggle with back pain during your pregnancy. If you are suffering from back pain during your pregnancy and are wondering what you can do to help reduce it; we explain what causes it and how you can find some relief. What causes back pain during pregnancy If you are experiencing back pain during your pregnancy you are probably wondering what is the root cause of it. Generally there are two types of back pain that expecting moms deal with. Pelvic pain, which is felt in the pelvic tailbone area, and lumbar pain which is similar to any lower back pain felt when not pregnant. There are a few culprits of back pain during pregnancy. Hormones, stress, weight changes and posture are all causes of sore and uncomfortable back. During your pregnancy, your hormones change. One of them, known as relaxin, softens the joints in the pelvic region. This can directly impact on your back’s ligaments, causing you back pain. Stress can also cause your back to ache, whether you are pregnant or not. If you are worried about your job, family or pregnancy, you can find that this added anxiety can contribute to back pain. This is due to the fact that anxiety can cause muscle tension, which can then translate into back pain. Changes in weight as your baby grows and shifts in your centre of gravity can also be a cause of a sore back. If you’re already struggling with poor posture or back ache, then back pain during your pregnancy becomes far more likely. What can help relieve my back pain? Completely alleviating your back pain may not be possible, but there are things you can try that could help ease and manage your pain. Avoiding lifting heavy objects, opting for flat, supportive shoes and getting plenty of rest are all things you can try to improve your back ache. Exercises that help strengthen your glutes and abs can also help relieve back pain. Prenatal yoga and water aerobic classes are examples of gentle exercises which can help strengthen your body. However, if you are feeling cramps, experiencing vaginal bleeding, feeling feverish, numbness or sporadic pain you should consider consulting with your doctor, as these are all more than just normal pregnancy back pain symptoms.

May 18, 2020

Lifestyle diseases and Coronavirus

As the number of Covid-19 infections moves over 10 000, the health minister Zweli Mkhize has expressed concern about the huge risk group of South Africans suffering from high blood pressure, diabetes and obesity. In other words Comorbidities.

May 12, 2020

Free virtual medical consultations for all South Africans

Bonitas Medical Fund announced that it has extended its free virtual medical consultations to all South Africans. This facility includes medical advice about COVID-19, other medical problems, the writing of prescription, where necessary and free delivery of chronic medication.

April 9, 2020

Don’t dread the dentist

Most of us are scared of the dentist which means dental care can easily be overlooked but, taking good care of your teeth will not only leave you with a brilliant smile, it will also keep your mouth healthy. By following a good at-home care regime and regular dental visits, you can decrease the likelihood of health problems in the future.

December 5, 2019

When you have a pain in the neck or back

Back pain is a common problem – 80% of us will experience an episode at some point in our lives. It is associated with many factors that vary from person to person but can be caused by an injury, a disc or joint problem, an irritated nerve root or poor posture. The pain might be acute or chronic but living with either can be debilitating.

November 7, 2019

Enhanced maternity benefits in 2020 from Bonitas

Around 9 000 babies are born to Bonitas Medical Fund members annually and while most of these little members are welcomed into the world without any hitches, about 20% of pregnant moms experience complications during childbirth. Many experience challenges of some kind during their pregnancy, or immediately after the birth of their child. For this reason, the Fund is making maternity education and support a focus for 2020. The aim is to offer pregnant members all the support and guidance they need to improve their health and that of their baby. It is about making the pre- and post- birth period as stress-free and healthy as possible.

October 17, 2019

Membership growth and a weighted increase below double digits for Bonitas

A growth in membership, an increased emphasis on Managed Care, a range of enhancements for members and added value, are just some of the highlights from the Bonitas 2020 Product Launch.

October 3, 2019

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