Expert Advice from Bonitas Medical Fund
Bonitas – innovation, life stages and quality care

Hospital pre-authorisation vs quotes – what you need to know

Due to the different waves of Covid-19 and the emerging variants, a number of elective surgeries were postponed to help minimise the take up of hospital beds and to avoid unnecessary exposure to the virus.  However, surgeries are now getting back on track, – even if it’s only a window during which the backlog of elective surgeries can be tackled. It is the perfect time to talk about the issue of pre-authorisation and quotes and why you should know the difference.  Lee Callakoppen, Principal Officer of Bonitas Medical Aid, says pre-authorisation, ahead of any medical procedure or hospital admission, is always required. He also stresses the importance of asking for a quote to submit to your medical aid. This will ensure you know exactly what is covered and whether you should plan for any out-of-pocket expenses. Does pre-authorisation mean payment, in full, is guaranteed? Not necessarily.  Let’s take you through the process and T&Cs.  What is 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.  When do I need to pre-authorise? You must apply for a Pre-Authorisation Reference number (PAR) as soon as a visit or admission to a hospital is planned. This applies for a CT scan, MRI scan or radio-isotope study. Do this as early as possible in case you are required to submit additional documentation or a motivation from your healthcare provider.  You also need pre-authorisation for: Renal clinic admissions for dialysis Procedures in doctor’s rooms or day clinics, instead of hospital Physical rehabilitation care in rehabilitation facilities Drug and alcohol rehabilitation care in specific facilities Hospice admissions Oxygen therapy at home All specialised radiology What information is needed? Name and surname of the person having the procedure Membership number and dependent code The date of admission or procedure The diagnosis All proposed surgical procedures, diagnostic procedures or specialised radiology codes available (ICD-10, CPT, NRPL codes) The name of the facility where the procedure will take place The names and practice numbers of the healthcare professionals (doctor, surgeon, specialist etc)  Once your pre-authorisation has been approved you will receive a confirmation letter. Read this carefully and check that the information is correct. If you are any queries speak to your doctor or your medical scheme.  What about emergency admissions? In the event of emergency treatment or admission to hospital, you – or a family member or the hospital – must contact your medial aid on the first working day after the incident to obtain authorisation.  Did you know? Your doctor or the facility you are being admitted to, can do the authorisation on your behalf. Despite this, it remains your responsibility to ensure that the authorisation is completed and correct.  What happens if you don’t pre-authorise?   You will either be liable for a co-payment, or your procedure will not be covered. Does pre-authorising ensure payment of the procedure? No, unfortunately not.  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. This means you are responsible for any shortfall in the form of a co-payment.  Co-payments differ from one medical scheme to another and are often higher than anticipated, mostly due to medical practitioners and hospitals charging higher than the medical aid rate. ‘We mitigate this as much as possible,’ says Callakoppen, ‘by negotiating with hospitals and service providers who are on our network, to place a ceiling on the costs of the procedures.’ For this reason, it is best to find a healthcare provider on your scheme’s network Quotes vs pre-authorisation for procedures Callakoppen advises private medical aid members to not only obtain pre-authorisation but to also ask for a detailed quote from the hospital and medical practitioner prior to being admitted to hospital.  ‘This gives you an opportunity to negotiate and eliminates any additional ‘surprise’ payments required after the procedure. ‘The most important thing’, says Callakoppen, ‘is to find out, prior to being admitted, what your medical aid will pay and what payment you might be responsible for. The last thing you want to deal with is a surprise large co-payment and the stress related to that when you are recovering from a procedure.’ 

September 30, 2021
Bonitas – innovation, life stages and quality care

What should I do if I have symptoms of COVID-19 and I am pregnant?

Given today’s current global COVID-19 pandemic, worrying about the potentially harmful viruses’ effect on your pregnancy and baby is a valid concern. You’re probably wondering the best ways to avoid the virus when pregnant, and what to do if you think you may have caught it. How can I protect myself and my baby from catching the corona virus? Protecting yourself from COVID-19 while pregnant, is similar to that of anyone else avoiding the virus. Minimise contact with others through social distancing, frequently wash and sanitise your hands, and avoid touching your nose, eyes and mouth. Don’t be tempted to skip important prenatal visits in lieu of avoiding the virus – chat to your doctor about the best way forward with regard to this. Although slightly disappointing, cancelling events such as baby showers is a good idea, as the risk of exposure and infection becomes bigger with larger groups. Being pregnant, it’s a good idea to be extra precautious where possible. However, the RCOG (Royal College of Obstetricians and Gynaecologists) states that pregnancy doesn’t increase your risk of becoming unwell from coronavirus, and the majority only develop mild to moderate symptoms. What should I do if I think I have COVID-19 while pregnant? If you think you may have COVID-19 or have tested positive for corona the first thing you should do is contact your doctor. However, it’s best to avoid travelling to the doctors office as you may come into contact with someone positive for COVID-19 in these spaces. As the virus is new, this means that the studies that have been conducted are limited. Because of this it’s essential to follow social distancing guidelines to try and protect yourself, however, if you do contract the virus there is no immediate need for stress, as pregnancy doesn’t increase your risk.

September 23, 2021
Bonitas – innovation, life stages and quality care

Redefining healthcare in 2022

As South Africa moves to Covid-19 adjusted Level 2 and vaccination numbers increase, access to quality healthcare remains a priority.  Today, Bonitas Medical Fund announced its 2022 product line up offering. This includes the use of reserves to keep contribution increases lower, a Benefit Booster to stretch day-to-day benefits, a revised international travel benefit with payment for Covid tests and a contribution towards quarantine costs. There is also a renewed focus on preventative care, virtual consultations and plans that enable more South Africans to have access to affordable, quality healthcare.  Lee Callakoppen, Principal Officer of Bonitas said, ‘The Scheme performed well in a volatile market, attributable to proactive risk management and prudent board decisions. A positive offshoot of the pandemic was an increased appreciation of medical aid cover that resulted in better-than-expected member retention and a 2.3% membership growth since January.’ Top line changes ’We have taken a strategic decision to utilise approximately R600m of reserves to ensure that 82% of members receive a below CPI contribution increase for the 2022 benefit year. The innovative Benefit Booster equates to an increase in day-to-day benefits for members ranging from 16% to 32%, depending on the members’ plan. We believe it is the largest increase in benefits ever seen in the medical aid industry.’  The average weighted contribution increase across all plans is 4.8% with the BonStart premium decreasing by 7.9%, which can be attributed to the low cost versus benefits ratio and the younger membership profile on the plan. The decrease in contribution is an industry first – as was the decision to offer BonFit Select at a 0% increase in 2020. New offerings include an additional virtual plan, BonStart Plus, a renewed focus on Managed Care with an oncology management programme as well as an enhanced member app, powered by AMP, which includes a personalised wellness programme to encourage healthier behaviour. Plans There will be a total of 15 plans for the year ahead comprising traditional, savings, hospital, edge (virtual), network and income-based plans, each carefully crafted with a specific mix of benefits to appeal to various target markets. Increases range from minus -7.9% to 6.5%. Bonitas has opted to increase its options which are currently in a growth phase – BonSave, BonFit and BonEssential – by only 3.6%. Sustainability and affordability The Council for Medical Schemes (CMS) recommended increases in line with CPI of 4.2% with the caveat that financial stability and sustainability of schemes must remain a priority. We feel that the use of part of our reserves to cushion members against increasing costs is an appropriate strategy. Other recommendations by the CMS include: Driving innovation from a pricing point of view; exercising caution in terms of utilising reserves to help cushion increases and adopting innovative pricing models – a directive Bonitas took to heart. Boosting benefits The Benefit Booster is the most innovative change in the healthcare industry since the advent of the savings account. It stretches value and equates to an increase in day-to-day benefits ranging from 16% to 100%, depending on the plan. This covers all out-of-hospital claims including acute medicine, GP consultations and non-surgical procedures such as wart removal. Members simply need to complete a wellness assessment (which can be done online), to tap into the Benefit Booster. Claims will pay from this benefit first – helping to preserve savings and day-to-day benefits for members. Managed Care At the launch, Dr Morgan Mkhatshwa,Head of Operations said, ‘Lifestyle diseases have reached epidemic proportions in South Africa. 80% of these Non-Communicable Diseases (NCDs) are caused by lifestyle risk factors like smoking and obesity.  Managed Care is designed to help members with chronic conditions by using the best clinical and treatment protocols. This is achieved by analytics and continuous research, alignment to the latest technology, market trends and member needs and leveraging this data for enhanced treatment.   Oncology Cancer prevalence is increasing alarmingly. As a result, coordination of care is critical for oncology. Bonitas is introducing a new Oncology Management Programme that utilises a partnership between Medscheme Managed Healthcare and the South African Oncology Consortium (SAOC), to improve the coordination of care of oncology patients. Back and Neck Programme ‘Our back and neck programme has seen a 93% success rate. In 2022, we introduce the eDBC app.  This technology-driven channel offers digital coaching solutions and home-based care to help improve pain and mobility. It includes a self-assessment, baseline progress checks and outcomes’ evaluation.’ The GP is key ‘The Scheme believes that the GP is at the heart of the Managed Care model. Care coordination is essential in ensuring that members get the right level of care and support in managing their conditions. Our GP network has a broad national footprint and 98% of members are within a 10km radius of a network GP.’ Virtual Care BonStart, the inaugural Edge plan introduced in 2020, proved very successful – using virtual care as its base. For this reason, the Scheme is introducing an additional Edge plan, BonStart Plus for 2022, aimed at attracting a new profile of member through this diversified distribution channel and attractive pricing. Virtual care has proven a sound and reliable solution, locally and internationally, for improving access to quality healthcare and is now offered across all 15 Bonitas plans.   Digital Covid-19 spurred progression of digital enhancements with innovations such as a mobile app and WhatsApp channel being swiftly created. The Member Zone is being enhanced allowing members to manage their medical aid more effectively.  Amalgamations Callakoppen says, ‘Bonitas’ track record for amalgamations is excellent and we are currently awaiting approval from the Competition Commission to our proposed amalgamation with the Nedgroup Medical Aid Scheme. The amalgamation will fortify the size of Bonitas as well as decrease the average age and pensioner ratio while bolstering the reserves.’  Travel benefits  ‘We wanted to ensure that our members are covered should they need to travel and noted that testing and enforced quarantine could be expensive. The Scheme is therefore offering a Covid-19 PCR test pre-

September 22, 2021
Bonitas – innovation, life stages and quality care

Covid-19 Information for Moms-to-Be

Pregnant women do not appear to be more severely unwell if they develop Coronavirus than the general population. As this is a new virus, how it may affect you is not yet clear. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

September 16, 2021
Bonitas – innovation, life stages and quality care

Urban living’s impact on our wellness

South Africa is urbanising rapidly: 63% of South Africans are already living in urban areas.  Stats indicate this will rise to 71% by 2030 and by 2050, eight in 10 people will be living in urban areas. While it is unavoidable that people migrate to cities for work, it does have a negative effect on people’s health. The most significant effect is the increase in non-communicable or lifestyle diseases.  Dr Morgan Mkhatshwa,Head of Operations at Bonitas Medical Fund, says that the main problems associated with changes in lifestyle and behaviour, due to urbanisation, are: Increased alcohol and tobacco use Lack of exercise.  Cities are often over-populated, there are too few public spaces for physical activity and many residents have to use public or private transport because of long commutes to work, schools and amenities 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 Socio-economic factors There is an increasing recognition of the importance of social, economic and physical environments as determinants of health and well-being. Unfortunately, the poorest people living in under-serviced inner city areas or informal settlements are the most exposed to unhealthy urban environments. With urbanisation, the double burden of non-communicable diseases (NCDs) will increase if no effective health systems and policies are put in place to prevent, detect and treat communicable and non-communicable diseases. ‘Our analysis of lifestyle diseases indicate that hypertension is the most prevalent non-communicable disease, followed by high cholesterol and diabetes Type 2. Obesity, high cholesterol, diabetes Type 2 and hypertension are all symptoms of metabolic syndrome, caused by poor nutrition and a sedentary lifestyle. ‘The science around nutrition has long been problematic. Published results have varying conclusions but concur that highly processed and food with high sugar and “bad fat” content should be avoided. ‘Also, in the top seven conditions are susceptibility to blood clotting, asthma, underactive thyroid and depression,’ says Dr Mkhatshwa.  Asthma is a respiratory condition most often caused by pollution or other irritants in the environment and mental health conditions can also be a consequence of urban living. Oncology is also becoming more and more prevalent. The number of Bonitas members with cancer has more than doubled since 2016. Air pollution Motor vehicle, industry and domestic fuel use increases air pollution which is responsible for a range of lung and respiratory diseases, heart conditions and cancers. Chronic Obstructive Pulmonary Disease (COPD) and asthma are two of the most prevalent respiratory diseases.  ‘We have the expertise to respond to these risks and lifestyle diseases by providing comprehensive, integrated care, every step of the way,’ explains Dr Mkhatshwa. ‘And, through our Managed Care programme, we help equip our members to take responsibility for their health by providing information and education, encouraging wellness, paying for preventative care and providing cover for medical costs incurred.  However, more needs to be done and we advocate collaboration with public health authorities to educate and encourage South Africans to look after their health.’ Covid-19 and NCDs It is common knowledge that Covid-19 and non-communicable diseases such as hypertension and diabetes interact to create a perfect storm. The pandemic has made people more aware of having to take responsibility for their health and preventing or managing chronic disease optimally. ‘Co-morbidities have an impact on those who contract Covid-19 and there is possibly a synergistic issue with the coronavirus and these co-morbidities that exacerbates the prognosis and burden of disease.’  Managed Care ‘Achieving good patient health outcomes is the fundamental purpose of healthcare,’ says Dr Mkhatshwa. ‘Measuring, reporting and comparing outcomes is perhaps the most important step towards unlocking rapid outcome improvement and making better choices.   ‘Managed Care is a critical component and improves quality of care and we know that proactive intervention and working with members to prevent or control lifestyle diseases is the only way forward. Because when ‘I’ becomes ‘we,’ illness can become wellness.’ The GP is pivotal  We believe there needs to be coordination of care and that members should be encouraged to nominate a General Practitioner as the first port of call for all health care needs, who can refer to a specialist or auxiliary provider as the need arises. This eliminates inefficiencies caused by ‘doctor hopping.’ ‘To tackle the rising burden of disease, we need medical schemes to work together with public health authorities, particularly in the context of the challenges of urbanisation, lifestyle diseases and the Covid-19 pandemic.’

September 13, 2021
Bonitas – innovation, life stages and quality care

Performing in a pandemic: Bonitas announces healthy annual results

Bonitas Medical Fund reported its financial results for 2020, with significantly bolstered reserves of R6.1 billion. Luke Woodhouse, Chief Financial Officer of Bonitas says, ‘The Fund, which has 40 years’ experience in the medical aid industry, had 333 141 principal members and total beneficiaries of 710 157 as of 31 December 2020. This accounts for 14% of the open scheme market, representing 8.3% of total market share.’ Bonitas ended 2020 with an unprecedented surplus of R1.7 billion (2019: R186.1 million). The surplus is the largest ever reported by the Fund and is largely attributable to the suppressed utilisation of non-COVID related claims expenditure. ‘The surplus was also positively impacted by the effective implementation of our strategic pillars, proactive risk management and prudent Board decisions in a unique, but volatile year,’ says Woodhouse.  ’Bonitas’s medium-term objective is to sustain solvency levels above the statutory minimum of 25% and to make meaningful, strategic decisions about current reserves in the interests of our members. This while facing significant uncertainty, especially in terms of the cost and prolonged impact of COVID-19, non-COVID-19 utilisation and roll-out of vaccines.’ 2020 performance at a glance:  R3 billion gross healthcare result (2019: R1.3 billion) Reserves reaching R6.1 billion (2019: R4.3 billion) A net surplus of R1.7 billion (2019: R186.1 million) Solvency ratio of 32.7% (2019: 24.9%) R51.7 gross recoveries from Fraud, Waste and Abuse (2019: R41.2 million)   Strategic purchasing yielded hospital negotiation savings of R346 million (2019: R370.4 million).  This is lower than the previous year, in absolute terms, due to lower outflows as a result of COVID-19, including cancellation of elective procedures and a reduction in trauma and major medical related costs An investment income of R316.6 million (2019: R420.1 million) that exceeded CPI  Net claims decreased by 4.7% to R14.3 billion (2019: increased by 8.9% to R15.0 billion) Healthcare cost savings initiatives realised savings of R221m – the most significant of these were achieved through the Scriptpharm chronic medicine capitation model  83.0 claims loss ratio (%) (2019: 92.3)  The Investment Committee was particularly active given the volatility in equity markets and the market crash that occurred in March 2020. The active management and continued strategic asset allocation approach contributed to a turnaround in investment returns, growing the investment portfolio (excluding cash and cash equivalents) from R5.01 billion in December 2019 to R7.14 billion at the end of December 2020 – delivering an overall return of 4.16%. Although COVID-19 induced severe capacity constraints in the healthcare system, the hiatus in all other areas of healthcare decelerated a long-term trend towards overuse and medical cost inflation. This occurred against an economic backdrop of market volatility, record low interest rates, rising unemployment and declining incomes. The significant surplus capacity was systemic within the healthcare industry.  Investments and economic growth In addition to investment volatility, South Africa’s sovereign credit rating was downgraded to sub-investment grade status with a negative outlook by the Moody’s and Fitch ratings agencies. According to the IMF, South Africa’s real GDP contracted by 8% in 2020, but is expected to show 3% growth in 2021, before slowing again. Claims’ expenditure While some categories such as in-hospital admissions experienced a major decline, with a high number of elective surgeries cancelled, there was a marked increase in medicine claims and costs. Under servicing could, however, lead to higher downstream healthcare costs over the long term. The combination of these factors led to lower claims in an environment where Bonitas actively continued to manage costs, promote Managed Care and supervise investment performance. As opposed to other years the key cost drivers were COVID-19 related, including: Hospital admissions, investment in PPE, pathology test costs, home-based care, healthcare support to members in the workplace, medication and deferred elective surgeries.  Hospital negotiations This year we participated in the first collective negotiation process on hospital tariffs with five other medical schemes administered by Medscheme. This followed the finding by the HMI that collective negotiations would not contravene the Competition Act. The common tariff resulted in a 3.1% saving in 2021 terms and these savings could exceed R200 million in 2021. In addition, hospital costs and medical specialist costs reduced by 5.4% (2019: increased by 8.9%) and 5.3% (2019: increased by 10.0%) respectively on a per-member-per-month basis. Total claims per-member-per-month declined by 8.7% (2019: increased by 8.1%). Strategic purchasing  Cumulative savings since the start of the strategic partnership arrangement with hospital groups in 2017 was R1.247 billion.   Growth and retention To retain members under significant financial stress due to COVID-19, members received assistance in line with CMS regulations This had a negligible impact on performance but assisted in retention of members during the worst of the pandemic. COVID-19 also resulted in a marked increase in queries about joining a medical fund as people realised the need for quality healthcare. We experienced a cumulative net decline in membership of 5 610 members (1.7%) in 2020, which compares well against a significant contraction in GDP and increased unemployment. Despite the challenges experienced in 2020, Bonitas acquired 37 814 new members (2019: 50 680). Bonitas also kept increases as low as possible without jeopardising the sustainability of the Fund. There was a competitive weighted average contribution increase of 4.6% – 1.61% higher than CPI whereas, under normal circumstances, contribution increases are set at a minimum of CPI +3,5%. Day hospitals We identified day hospital use as a viable option to improve efficiency and reduce costs. There is minimal disruption to members, speedier recovery times, less risk of infection.   Home-based care  During COVID-19, home-based care received renewed interest and focus. Not only is it a cost saver but studies have shown that patients recover faster in their comfort of their own homes. Efficiency Discounted Options (EDOs)  The four EDOS introduced have been a success – the EDOs cover over 74 000 lives and the principal members who join are around 10 years younger than the average Bonitas member. Members on these plans use network healthcare providers and pay around 15% less for the same benefits.  Virtual

August 30, 2021
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Advice from the experts
Good Night Baby

WHEN NUTRITION CAN INFLUENCE SLEEP

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February 17, 2020
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CLAIMING PREGNANCY RELATED EXPENSES

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Bonitas – innovation, life stages and quality care

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Bonitas – innovation, life stages and quality care

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Benefits of Music Therapy for Children on the Spectrum

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How bullying can affect your child’s mental health

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Bonitas – innovation, life stages and quality care

Enhanced maternity benefits in 2020 from Bonitas

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October 17, 2019
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Head lice – they’re not inside they’re on top!

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October 1, 2019
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The Surprising Benefits of Non-Alcoholic Malt Beverages for Moms

With World Breastfeeding Week recently celebrated and the focus placed on the importance of breastfeeding to improve the health of babies, it is an ideal time to consider the risks of alcohol for pregnant and/or breastfeeding mothers – and the delicious alternative beverage options that are now available in the market. Today, one of the major risks to a pregnant or breastfeeding woman is alcohol consumption. While many women do limit their intake during pregnancy and breastfeeding, they may not be doing enough. The health risks associated with consuming alcohol during pregnancy, breastfeeding and even conception mean that there are now an increasing variety of alcohol-free beverages for moms and moms-to-be in order to have safer (and healthier) choices. In fact, it turns out that 0.0% non-alcoholic malt beverages can even boost breastmilk supply by stimulating prolactin levels. It also has some other surprising – and quite remarkable – health benefits… Without going into the technical details, the barley malt contains lactogenic beta-glucan. This not only makes it highly nutritious, but when enjoyed 90 minutes prior to breastfeeding, can see an increase in the mom’s milk production. This makes sense, considering that barley is a starchy food that contains complex carbohydrates. The soluble fibre (essentially slowing glucose absorption) contained in the barley can lower cholesterol and even reduce the risk of heart disease. Malt drinks are well known to be both wholesome and highly nutritious, while providing some protein, sugar, essential minerals and levels of vitamins A and B vitamins. It also provides the all-important folic acid that is beneficial during both pregnancy and breastfeeding. The Risks of Alcohol During Pregnancy Here’s how it works, in a nutshell. Alcohol in the mother’s blood passes to the baby through the umbilical cord. This can result in miscarriages, stillbirth, or a range of disabilities that are classified under the term foetal alcohol spectrum disorder (FASD). Sadly, South Africa has the highest prevalence of these disorders than anywhere else in the world with 111.1 instances per 1 000 children (the global average is 7.7). The Consumption of Alcohol During Breastfeeding & Alternative Options Conventional wisdom used to state that drinking a beer before nursing could help with the milk ejection reflex. However, more recent studies have shown that infants who are fed milk by mothers who have consumed alcohol tend to take in less milk than those who did not.  Startlingly, consuming alcohol while breastfeeding can lead to a multitude of ill effects: disturbed sleep cycles, extreme drowsiness, weakness, decreased growth in the infant, the possibility of decreased milk-ejection reflex and milk quality in the mother, not to mention the impairment of a mother’s natural reflexes that are needed in taking proper care of her child! On the other hand, consuming a non-alcoholic beverage or two means that you get all the benefits without any of the disadvantages – whether pregnant or breastfeeding. Moreover, modern 0.0% non-alcoholic beverage now has the same taste, while being devoid of the negative health side-effects associated with alcohol. Additional benefits include the hangover-free lifestyle and reduced calorie consumption. A win for South African mothers, and mothers all around the world! To celebrate women as everyday heroes, Bavaria threw a surprise baby shower for Itumeleng Nyathi, a Zimbabwean woman who left her country to pursue a brighter future in South Africa. In doing so, she had to walk away from her family and existing support systems. While in South Africa, Itumeleng met her husband Larry and they are now expecting their first child together, a baby girl arriving in September. Itumeleng received a bumper supply of gifts at the event, courtesy of Bavaria and a Johannesburg Mom’s Group – who banded together to provide her with a stroller, car seat, cot, feeding chair, baby bath, bouncer, booster seat, and more. An extra special surprise awaited Itumeleng as she was reunited with her mother, whom she hadn’t seen in several years.  This heart-warming story has been turned into a special, shareable video: Please click here to watch By Oliver Wills, Marketing Manager at Bavaria

September 27, 2019
Bonitas – innovation, life stages and quality care

Medical Aid – making the right choice

Private and public healthcare has been in the news lately and will continue to be a topic of discussion around the Department of Health’s proposed National Health Insurance (NHI) Bill as well as the current socioeconomic landscape.  Traditionally in September, private medical aids present their products, plans and pricing for 2020 to existing members, or potential members, so that they can make informed choices. ‘It is imperative that the decision you make regarding you and your family’s health and wellness is balanced against affordability,’ explains Lee Callakoppen, Principal Officer of Bonitas Medical Fund. ‘For existing medical aid members, it’s the time to analyse the plan they are on, whether it meets their health needs and compare it to the various options available.  If you’re joining a scheme for the first time, you need to consider your specific healthcare needs and spend time investigating which plan will be best suited to deliver on this.’ However, medical aid plans can be confusing which is why it’s important to compare the various options and schemes to ensure you find a medical aid that works for you and your family’s health and that is within your budget. For people who have a broker, that should be the first point of call to help you can make an informed decision. Here are some steps to help simplify the decision.  Analyse your healthcare needs Completing a quick personal healthcare needs’ analysis will help you determine what level of cover you need. If you have dependants, you need to factor in their healthcare needs too.  Consider how much you and your family spent on medical expenses over the past year as a guide and then ask the following: How often did your family visit a doctor Do you require medicine often Did you or the family need to visit a specialist Are any of you in need extra cover for cancer, HIV, renal failure or any other specific conditions How much did you spend on dentistry, optometry and over-the-counter medicine Then consider which of the expenses were once-off and won’t come up again soon (like childbirth) and which are likely to come up again and again (such as flu) as well as chronic conditions like high blood pressure and diabetes.  Check how much cover you require If you find you hardly claimed (if you are on a medical aid) or have very a few medical expenses, then you will need a lower level of cover. However, if you have a large number of medical expenses, you will require one of the more comprehensive plans.   Once you’ve established this you can decide whether you require a full medical aid or a hospital plan.  Are you happy to use a network Some plans require you to use a specific GP, hospital network and have a list of preferred providers. This helps to keep costs as low as possible because the Scheme will have negotiated special rates with these services providers. Check whether there is a wide enough network in your area to cover your specific needs. Check your budget Once you have an idea of what you might need for the year ahead in terms of healthcare, then it’s time to look at your budget. Decide what you can afford and remember that the rule of thumb is that contributions should not exceed 10% of your monthly income.  Read the small print  Make sure you read all the details including the benefits. These vary from plan to plan so establish what is covered and look at whether it offers additional risk benefits which can potentially save on the day-to-date expenses. These could include anything from free wellness screenings (blood pressure, cholesterol, blood sugar and BMI measurements) through to maternity benefits, flu vaccinations, mammograms, pap smears and HIV tests. All of these are costly if you have to pay for them yourself. What about savings Medical savings are a fixed amount medical scheme gives you at the beginning of the year.  You can use your savings for daily out-of-hospital medical expenses, such as GP and specialist consultations and over the counter medicine. There are ways to maximise your savings but first you need to know what you annual allocation is.  Age can influence the decision If you have young children, ensure that the medical aid option you select provides sufficient child illness benefits. For young couples looking to start a family, ensure the option provides sufficient cover for maternity benefits. However, if you aging then you need an option that covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation. Some additional advice Remember to be honest on your application form, disclose all information about you and your dependents’ health. Membership can be suspended or cancelled if you fail to do so Any waiting period or exclusions? Schemes may impose certain waiting periods for new members joining or for a pre-existing medical condition. This is based on the guidelines of the Medical Schemes Act and the specific scheme’s rules. Finally, get expert advice ‘Your health and that of your family is important so it is vital that you are comfortable with the choice you make and are confident your healthcare needs will be taken care of,’ says Callakoppen. ‘My advice is to make sure you are informed. Read the information and fine print and compare what the different plans are offering before you commit. If you are still unsure, phone the scheme and ask questions or check with your broker or financial advisor.’

September 24, 2019
Bonitas – innovation, life stages and quality care

Addiction – a dangerous trend gripping the nation

It is estimated that around 10 million – or 20% – of South Africans are abusing substances. This is according to the South African Society of Psychiatrists. Whether it is alcohol, codeine, dagga, heroin or other drugs it’s a very worrying statistic that costs the private and public healthcare industry millions annually in rehabilitation and recovery.

September 20, 2019
Parenting Hub

HAPPY FAMILY ORGANICS – CHANGING LIVES AND THE WORLD, ONE MEAL AT A TIME

Happy Family Organics, makers of ready-to-eat, nutritious and delicious organic meals, is not only changing the way babies and children are nourished in South Africa and around the world, but they are also changing the lives of young orphans in Tanzania through their Happy Family Children’s Village (HFCV).

September 9, 2019
Bonitas – innovation, life stages and quality care

Medical aid non-disclosures: What you need to know

Be honest and disclose all information. Don’t forget to read the questionnaire carefully and regardless of whether you think it’s important or not, or whether the medical condition was years previously, include it in your application

August 28, 2019
Paarl Dietitians

How Sugar can Damage our DNA

While we may be familiar with the dangers of a poor diet, in particular eating too much sugar, the actual effects of this may be far more frightening than previously imagined. Certainly, science supports the idea that excess sugar consumption leads to weight gain, increasing our chances of becoming obese as well as developing diabetes and heart disease. But now, new data shows that sugar can harm us in a place we didn’t expect, by actually attacking our DNA. Majority of the world’s population will average around 13-14% of calories a day from pure added sugar. It would seem we’re destined to harm our DNA.

August 15, 2019
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