Health is wealth: Bonitas Medical Fund puts price freeze on 2023 first-quarter contributions
The scheme offers a range of Managed Care programmes to help members understand and manage their conditions comfortably
Image: Supplied
If the last few years are anything to go by, looking after our health and adopting a healthy lifestyle should be top of mind. We've also learnt the importance of choosing the right healthcare partners, which include medical aid.
Prevention is better than cure so working effectively with your medical aid scheme is crucial for you to live your best life.
As medical schemes announce their contribution increases and plans for the year ahead, we take a look at one of the leading medical schemes in SA, Bonitas Medical Fund — which is celebrating its 40th anniversary — to see what they have to offer.
Lee Callakoppen, principal officer, says the average increase for the year ahead would have been 5.9% — still well below the current inflation rate of 7.6%.
“However, the good news is that we’ve put a price freeze on contributions for the first quarter of 2023, to offer members some respite. This means an increase of 4.4% over the 12 months. We have also shared what members can expect to pay from April 1 2023, so that they can make informed decisions,” says Callakoppen.
“By applying low contribution increases since December 2020, Bonitas has effectively passed R1.4bn in savings back to members.”
The scheme has also seen growth during these tough economic times, having signed up 190,000 new members. “What is encouraging is the average age of new members is about 15 years younger than the current membership. This means we are succeeding in attracting a younger, healthier profile, which is coveted across the industry,” says Callakoppen.
“The future of healthcare is around primary and preventive care. There is a rise in non-communicable or lifestyle diseases, such as diabetes, high blood pressure and cancer, 80% of which are caused by lifestyle risk factors. This is why Bonitas offers a range of Managed Care programmes — to help members understand and manage their conditions.”
These programmes include:
Cancer care
The Bonitas Cancer Care Programme includes screening for early detection, treatment and palliative care. For 2023, the benefits have been restructured to be unlimited for prescribed minimum benefit cancers, on all options.
Diabetes
Bonitas has an effective disease management programme and better outcomes than the industry standard for diabetic members. In 2023, the scheme will introduce an annual benefit of R51,000 per family for an insulin pump or continuous glucose monitor for type 1 diabetics for members under the age of 18.
Mental health
Bonitas has introduced an innovative digital solution, called Panda, to support members in managing their mental wellness. The free app offers everything from audio sessions with peers and mental health experts to one-on-one virtual consultations with professionals.
Benefit Booster
Launched last year, the Benefit Booster has unlocked R446m in additional benefits for members to extend their day-to-day benefits. For 2023, the benefit limits have been adjusted in line with utilisation, with enhancements seen on several plans.
Designated service provider
Bonitas implements networks to negotiate the most favourable tariffs for members so they can avoid out-of-pocket expenses and get more value. This includes a GP network of over 4,000, an extensive pharmacy network through Scriptpharm, a dental network through DENIS, and an optical network through PPN. In 2023, 85% of members will be within a 30km radius of a network hospital.
Hospital-at-home
The hospital-at-home service brings all the essential elements of in-hospital care to a patient’s home, without moving away from evidence-based clinical protocols and state-of-the-art 24hr vital sign monitoring. Next year this will include: a programme for readmissions, screening and disease prevention, alternatives to step-down facilities and kidney dialysis at home.
Savings
Bonitas has amended the rules to allow members to use their savings as they deem fit for the new year. Savings have also increased by up to 9.4% — depending on the plan selected.
Exclusive offers and discounts
With the current economic challenges facing the country, everyone is constantly looking for added value and ways to save money every month. Bonitas has partnered with top providers in the industry for exclusive offers across a range of categories including: lifestyle, wellness, gap cover, short-term insurance, life insurance and credit solutions.
Image: Supplied
“Health is the new wealth,” says Callakoppen. “Your health is important, as are your finances — don’t take either for granted. When it comes to healthcare cover, invest time to research and understand what you need. Then find the right medical scheme to walk the healthcare path with you.”
Top tips on choosing a medical aid
With 17 open medical schemes in SA, it’s important you choose a scheme that gives you the healthcare cover you need, and is within your budget.
1. Analyse your healthcare needs
No two people or families are alike — which means medical needs differ. Do a quick personal healthcare needs analysis to determine the cover you need, which could include: frequent doctor visits, chronic or specific conditions, dentistry and medicine required. If you have dependents, factor in their healthcare needs too.
2. Read the small print
Take the time to read the information sent to you. Benefits vary from plan to plan, so establish what is and isn’t covered. Ask about supplementary benefits — these could include preventive care benefits, ranging from basic screenings (blood pressure, cholesterol, blood sugar and body mass index measurements) through to mammograms, pap smears and prostate testing. In some cases, this extends to maternity programmes, dental check-ups, flu vaccinations and more.
3. Managed Care options
Look out for Managed Care programmes: they help members manage severe chronic conditions such as cancer, diabetes and HIV/Aids.
4. 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 your annual allocation is.
5. How age can affect your decision
If you have young children, ensure the medical aid option you select provides sufficient child illness benefits. For young couples looking to start a family: does the option provide sufficient maternity benefits? If you are slightly older, then ensure you select an option that covers chronic conditions and provides sufficient in-hospital cover in the event of hospitalisation.
6. Ensure affordability
Consider all the costs involved before you make your final decision, including monthly contributions (which should not exceed 10% of your monthly income), the cost of co-payments, and the additional value you will get from the scheme.
7. Waiting periods and exclusions
The Medical Schemes Act and the specific scheme’s rules determine this. Check with the relevant scheme about their exclusion list and waiting periods.
8. Brokers
An independent broker will help you work your way through the different options and help you decide on a medical aid plan best suited to you and your family’s needs. And, it won’t cost you a thing.
This article was paid for by Bonitas.