Category Archives: Medical Aid

Information on Medical Aid schemes in South Africa

How a lack of competition in South Africa’s private health sector hurts consumers

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The investigation ran over five years and included over 43 million individual patient records, 11 million admissions, specifically commissioned studies, written submissions, public hearings and seminars. The investigation focused on hospitals, doctors, and funders. Funders include the medical schemes who purchase healthcare on behalf of members, and the administrators and managed care organisations that medical schemes contract with.

South Africa’s Competition Commission set up the inquiry in response to prices in the private healthcare sector which, it said, only a minority of South Africans could afford. The country has a two-tiered health system. About 71% of the population uses public sector, while the private sector serves around 27%.

Ideally competition should translate into lower costs and prices, better quality, and generally more value for money for consumers. In its final report, which was released recently, the inquiry found that competition wasn’t working as it should in private healthcare. The sector was characterised by high and rising costs, significant overuse, and no discernible improvements in health outcome.

Lack of competition

There were a number of factors that – alone or in combination – led to a lack of competition in the sector.

One factor is that three hospital groups dominated the facilities market: Netcare, Mediclinic and Life. They accounted for more than 80% of the hospital beds and 90% of all the admissions. These three hospital groups, both individually and collectively, were able to secure steady and significant profits year-on-year. A few firms owning the majority of the market is an indication that competition may not be working effectively.

Hospitals don’t attract patients, they compete for doctors who admit patients. Most doctors had contracts with the big three. Successful entry by new hospital owners is very difficult as they cannot attract doctors as easily.

Hospital groups are also able to build additional hospitals where they aren’t needed, resulting in an oversupply of beds and ultimately overuse of services.

In South Africa more people are admitted to ICU compared to eight other countries with comparable published data. The inquiry panel estimated that the country could save more than R2.7 billion – or 2% of its current private health care spend – if it halved the number of people admitted to ICUs and improved the care for patients in wards. Only the critically ill should be admitted to ICU. But the inquiry found that some of the patients who were in ICU could have been treated in wards.

There are no measures of quality of care in the public domain. This means that members of medical schemes and funders (who purchase healthcare on behalf of medical scheme members) weren’t able to judge if the care provided by doctors and specialists was effective.

The entire premise of effective competition is that purchasing healthcare services should be based on value – a combination of price and quality. This isn’t possible in South Africa.

There’s no way to assess if the care provided was improving health outcome. This is particularly problematic as the inquiry found significant over-servicing by doctors which cannot be explained by their patients’ level of illness. Doctors use a fee-for-service billing model. This means they bill patients for each service they perform during a consultation. In this system, the more you do the more you earn. This is called a perverse incentive and without knowing the impact of health outcomes neither doctors nor patients know if the extra tests or interventions are worth the cost. They also don’t know if it is improving health outcomes.

The inquiry also found doctors and specialists worked as individuals -– not as a team. There is growing evidence and acceptance internationally that team-based care is better and more cost effective.

Medical schemes compete for younger and healthier individuals. To do this, schemes have created numerous benefit packages. But these packages aren’t comparable. Medical schemes have done this in response to the absence of a mechanism for equalising risk between medical schemes. Medical scheme members do not know what they are paying for. Neither are they able to judge the quality of care.

Recommendations

The recommendations are aimed at creating greater competition, transparency, and accountability on how medical scheme member’s money is spent. They also aim to increase competition on the supply side (hospitals, doctors, and specialists) and on the demand side where funders represent the consumer.

Recommendations include a supply side regulator, whose job will be to:

  • assist provinces in issuing licenses for hospitals;
  • assist with a process and a platform for price setting for doctors;
  • conduct or contract out research looking at cost-effective healthcare interventions, including technology; and
  • facilitate access to reliable information on quality of health and health outcomes measurement.

To increase competition on the funder’s side, and to improve transparency for the consumer, the recommendations include that all medical schemes offer one comparable insurance package. In addition, government should introduce a mechanism to equalise risk between medical schemes so that they compete on the merits – not on risk or age selection.

What next

The recommendations have implications for the South African governments plan to introduce a National Health Insurance in a bid to level out the playing field between the public and private health care sectors. The plan is that the National Health Insurance will operate as a funding mechanism to move South Africa closer to universal health coverage.

Implementing the recommendations set out in the inquiry report is an essential step towards creating an environment where the purchaser – the National Health Insurance fund – will purchase from a private healthcare market that is competitive with lower costs and prices, and more value for money for consumers.

The National Health Insurance bill talks about strategic purchasing or value based purchasing which refers to using the capacity in the private sector to relieve the public sector. This aligns with the health market inquiry recommendations.

But it needs an independent supply side regulator to enable competitive price setting and coding mechanisms. Codes form the basis on which prices are determined – which is necessary for the National Health Insurance fund to reimburse providers. Value based purchasing also requires implementation of performance and outcomes reporting and monitoring.

This article is republished from The Conversation under a Creative Commons license. Read the original article.The Conversation

Medical Aid – Making the right choice

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Private and public healthcare has been in the news lately and will continue to be a topic of discussion due to the Department of Health’s proposed National Health Insurance (NHI) Bill, the Health Market Inquiry (HMI) report as well as the current socio-economic landscape.

Traditionally, this is the time of year when 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 your 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 you are on, whether it meets your health needs and compare it to the various options available.”

Medical aid plans can be confusing which is why it’s important to compare the various options and benefits 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, 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 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 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 Designated Service Providers (DSPs). This helps to keep costs down 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 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 a 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.”

Medical schemes performance underwhelming

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As the economy bites and more consumers are downgrading their medical scheme cover to lower benefit options to cut costs, they are not realigning their ‘consumption-based’ expectations and are struggling to decipher the complexity of benefit options and scheme rules.

The South African Customer Satisfaction Index (SA-csi) for Medical Schemes (2019) provides insights into the overall level of satisfaction of customers of medical scheme providers – Bonitas, Discovery, Gems, Medihelp and Momentum. Gems is the only closed medical scheme included in the survey. Consulta, which conducted the survey, polled 1,707 medical scheme members across five of the leading schemes by membership numbers.

Overall, customers indicated that they do not believe that the premiums paid match the quality of cover and experience on offer. Across the board, the industry is struggling to meet the needs of customers in terms of benefit design that meets the needs of customers in a simple and transparent manner. No outright leader was identified in this year’s index, with Bonitas and Discovery obtaining a joint leadership position, Medihelp coming in on par with the industry average (72.9) while Momentum is just below par and Gems lagging in last place.

Customer satisfaction – overall index

Bonitas (75.1) and Discovery (74.8) lead the industry, Medihelp (73.5) come in on par with the industry average score of (72.9), while Momentum scores just below and Gems with the lowest score at 68.3. Overall customer satisfaction for the industry has increased to 72.9 compared with 71.6 in 2018.

Bonitas and Discovery were the only two schemes to show an improvement on 2018 scores, with Bonitas showing a big improvement of 4.9 index points in 2019, followed by Discovery with 1.7 index points.

Gems (-0.5), Medihelp (-1.6) and Momentum (-1.3) showed a decline on overall customer satisfaction compared with 2018 scores.

While Discovery, Gmes, Medihelp and Momentum have stayed relatively stagnant on overall customer satisfaction scores for the last two years, Bonitas has made a significant improvement in 2019, suggesting that recent strategic reviews of its benefit options and member focus are starting to pay dividends.

Customer expectations and perceived quality

Across all brands, customer expectations are not being met consistently. South African customers have very high expectations of their medical scheme providers (industry average of 80.6) given the fact that it’s an expensive buy and communication around benefits is often not done clearly.

Bonitas and Medihelp are the only two brands that showed a positive gap – albeit marginal – where perceived quality meets customer expectations.

Perceived value

Perceived value is a measure of the quality, relative to the price paid. The perception of value for money is a very strong predictor of future usage and company growth.

In terms of the value index, Medihelp (71.6) takes the lead, Bonitas (70.9), Discovery (70.6) and Momentum (71.4) are all on par with the industry (69.6). Gems is below par at 66.1. Bonitas and Discovery are the only two schemes that saw a marginal increase in perceived value score compared with 2018.

However, when perceived value is overlaid with the price-quality alignment, customers of all brands feel that the premiums charged do not match the quality of the cover and experience on offer. In this regard, Discovery has the biggest gap (-6.2) in perceived value and price-quality alignment, followed by Bonitas (-5.8), Medihelp (-4.9), Momentum (-3.9) and Gems (-2.3).

Complaints incidence and resolution

Of the complaint incidence across the industry, customers complained most about fees and charges (22%), claims issues (19%), terms of cover or scheme rules (13%), feedback (9%) and waiting time (7%).

Discovery and Medihelp have the most complaints about fees and charges, both at 28% and above industry average (22%).

Medihelp has the highest incidence of claims-related complaints at 26% and well above industry par of 19%.

In terms of complaints incidence and handling the industry average of complaints incidence is 15.9/100 and complaint handling is 48.6/100.

Discovery has the lowest complaint incidence at 13.2/100 and complaint handling of 51/100. Bonitas’ complaint incidence is at 14.3/100 and complaint handling of 51.5/100. While Medihelp has a complaint incidence slightly higher than industry par at 15.8/100, its complaint handling score is well above industry par at 55.7.

Momentum and GEMS perform below average in this category.

Customer loyalty

Bonitas has the most loyal customers at 69.4%, above industry par of 64.0%, and has also seen a big improvement of 7.5% in loyalty score compared with 2018 (61.9%).

Discovery, Medihelp and Momentum all saw a decline in customer loyalty scores.

Net promoter score

This measures the likelihood of a person recommending a brand.

Bonitas has the highest net promoter score (NPS) at 21.6%, which is well above the industry average (9.5%). Customers are active promoters of the brand to others, with 45% of customers recommending the brand. It also has the lowest number of detractors at 24%.

Compared with 2018, Bonitas has seen a radical increase in NPS score when it came in at a low of 2.6%, suggesting that its focus on benefit simplification and customer satisfaction and complaints handling have had a marked impact on how customers perceive the brand, and their willingness to endorse it to others.

Discovery follows with an NPS of 14.5% which is on industry par and marginally up on its 2018 score of 12.2%. 41% of Discovery customers actively promote the brand, and 27% are detractors.

The balance of scores see a big drop-off on NPS performance well below industry par – Medihelp (10.9%), Momentum (8.4%) and Gems (-6.7%).
Gems has a high percentage of detractors at 43%, well above its promoters at 36%.

Treating Customers Fairly (TCF)

The degree to which customers feel they are being treated fairly by their medical scheme is highest with Medihelp (78.2) and Bonitas (78.9) – both above the industry score of 76.2.

Discovery follows with a score of 77.1 which is in line with the industry.

Gems (73.6) and Momentum (72.9) are lower than the rest of the industry.

Overall score

The make-up of the overall TCF score looks at seven key aspects including:

  • Fair treatment of customers
  • products and services that address customer needs
  • Transparent and easy to understand information
  • Advice that is suitable for the customer’s circumstances
  • Products and services deliver as expected
  • It is easy for customers to claim, change provides, complain or consider other providers
  • Customers are treated with respect and there is an open relationship

Annual private healthcare increases have been well above, if not double inflation, for more than two decades now which has steadily eroded the benefits that consumers can afford, with many forking out as much as 20% of their monthly income for medical aid. In response, consumers have opted to downgrade to more affordable benefit options.

HMI recommendations will contribute to universal coverage

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Once implemented, the majority of recommendations in the Competition Commission’s Health Market Inquiry (HMI) will provide a conducive environment for attaining universal health coverage.

“These recommendations introduce mechanisms for progressive and positive changes to occur in the private healthcare market, such as moving towards alternative reimbursement systems and away from the traditional fee for service system, which has led to perverse incentives,” Lerato Mosiah, CEO of Health Funders Association (HFA), says.

The recommendation for maximum tariffs for Prescribed Minimum Benefits (PMBs) is positive. However, Mosiah believes that in order to achieve this, funders and providers should come together to work on an industry wide single set of billing codes before the Supply Side Regulator for Healthcare is established, as suggested by the HMI. Clarifying the definitions of PMBs will also assist with this.

The HFA agrees with the recommendation for an industry-level role for health technology assessment and believes that this will assist the entire industry to make funding decisions based on the quality and efficacy of new technology entering the market, such as biological medicines and new equipment. This competency will also improve the health system’s capacity to assist patients with rare diseases.

“Most other health systems in the world rely on a central entity for health technology assessment in order to provide guidance in benefit design and funding decisions. In South Africa, each medical scheme has been left to do this work on their own for their own members. This is not only a duplication of work but also a waste of funds”, she said.

The association welcomes the proposed mechanisms to introduce greater transparency for members of medical schemes, such as a standardised benefit option and comparable top-up cover, as these will empower members to make more informed decisions about their healthcare.

The HMI also emphasises the importance of a well-functioning medical schemes market in healthcare provision. The recommendation for the creation of a risk adjustment mechanism may contribute in this regard and would close some of the gaps in the incomplete private healthcare sector regulatory regime.

“The recommendations will bring about more cohesive and efficient private and public healthcare sectors that will improve the quality of care experienced by patients,” concludes Mosiah.

NHI written submissions deadline extended

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The deadline for written submissions on the National Health Insurance (NHI) Bill has been extended to end of November.

The original closing date for written submissions was 11 October, but given the magnitude of the NHI, the Portfolio Committee on Health received numerous requests from stakeholders for an extension to mid-November.

“We have been considering the requests from relevant stakeholders who play an important role in the delivery of healthcare in the country. We have actually agreed to extend the closing date for written submissions to 29 November 2019,” Dr Sibongiseni Dhlomo, chairperson of the committee, said.

The new closing date for the written submissions doesn’t affect the start of the public hearings, which are scheduled to start on 25 October 2019 in Mpumalanga.

Written submissions must be directed to Vuyokazi Majalamba and be addressed to the Portfolio Committee on Health 3rd floor, 90 Plein Street, Cape Town 8000 or e-mailed to vmajalamba@parliament.gov.za, or faxed to 086 6943279 by no later than 29 November 2019.

In addition to the written comments, people should indicate their interest in making a verbal presentation.

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HMI report: Private sector characterised by high costs and no competition

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The Competition Commission’s long-awaited Health Market Inquiry (HMI) has found that the private healthcare sector is “highly concentrated”, “characterised by high and rising costs of healthcare and medical scheme cover, and significant over-utilisation without stakeholders being able to demonstrate associated improvements in health outcomes”.

The panel found there are three hospital groups dominating the market – Netcare, Mediclinic and Life Healthcare, which has potential to “distort and prevent” competition. More competition, it said, would translate to lower cost and prices and more “value for money” for consumers.

However, Mediclinic has challenged this assertion, saying it (and the other two groups) had submitted data analyses and research studies indicating that the conclusions are “incorrect and outdated”.

“It is important to note that the market context has moved on since 2014; the end date for the majority of data used. Current data must be used to find current best solutions for the unique South African healthcare market, especially as South Africa prepares itself for the introduction of the NHI,” said Koert Pretorius, CEO of Mediclinic Southern Africa.

The report recommends that a number of oversight bodies be set up to rectify regulatory failings related to private healthcare.

Supply Side Regulator for Healthcare (SSRH)

The National Health Act of 2003 makes provision for appropriate geographical distribution of facilities based on population need. However, when the National Department of Health’s tried to implement this measure, 11 years later, it failed because it didn’t have the necessary regulatory framework necessary for implementation.

The report therefore recommends that the SSRH be set up to regulate health facilities and practitioners. Its duties will include capacity building and issuing facility licences that follow national guidelines developed by a technical team.

It will also set up a negotiating forum for practitioners to set a maximum price for prescribed minimum benefits or PMBs. Additionally, practitioners will also set reference prices for non-PMBs.

Outcomes Monitoring and Reporting Organisation (OMRO)

This body will be set up as a platform for providers, patients and all other healthcare stakeholders to provide “patient-centred” and “scientifically robust” information on healthcare outcomes.

As hospitals, doctors and patients cooperate in generating information on healthcare outcomes, it will provide practitioners and hospitals with relevant information and ways to improve clinical quality.

It will also help provide patients and funders with relevant information on health outcomes for decision-making purposes.

Health Professions Council of South Africa (HPCSA)

Changes in the ethical rules of the HPCSA would promote innovation in models of care, the report said.

This includes mandatory ethical training at both undergraduate and postgraduate level so future healthcare professionals are aware of cost implications of their decisions.

“The existing HPCSA ethical rules prohibit joint initiatives to develop new efficient and cost-effective care delivery models,” Mediclinic said.

Medical schemes

“The principal officers and trustees of schemes could be more active in ensuring that beneficiary interests are protected… there is a need to strengthen the role played by the boards of trustees and principal officers to ensure the member is always put first,” the report read.

In addition, it proposes a single, comprehensive standardised base benefit option will be introduced and offered by all schemes.

This is “to increase comparability between schemes and to increase competition in the funders market,” the report read. This will enable consumers to compare products, reward funders able to innovate and offer lower prices or at a higher quality.

Mediclinic supports bilateral tariff negotiations between facilities and funders. “Quality outcomes information has been an ongoing issue as flagged by Mediclinic’s participative submissions in the HMI process… This will provide patients, healthcare professionals and funders with greater transparency on clinical performance information,” the group said.

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Membership growth and a weighted increase below double digits for Bonitas

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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.

Lee Callakoppen, Principal Officer of Bonitas Medical Fund, announced that the increases for 2020 range from just 6.2% with an average increase on risk contributions of 9.4% and a weighted increase of 9.9%. ‘Taking into account the impact of the current socio-economic landscape on consumers, our focus is to add value while balancing costs.’

“Last year, we realigned our product offering based around member needs,” explained Callakoppen. “Through a product gap analysis we identified where our offering could be improved and addressed this. Bonitas attracted around 40 000 principal members during the first eight months of 2019, mainly due to the introduction of two new plans. PrimarySelect was the biggest growth area attracting 6 000 new members in the first month – but 42% of the business growth this year was drawn from the Primary, Primary Select, BonSave and BonFit plans.”

2018 reflections

In July, the Fund reported its financial results for 2018, announcing bolstered reserves from R4.0 billion in 2017 to R4.13 billion, despite difficult economic conditions. “This is satisfying, especially given the stagnant economy and other negative fiscal influences. Our strategic initiatives resulted in a positive impact with the Fund attaining a 25.2% solvency rate and achieving a surplus of R164.8 million.”

The year ahead

For 2020, the Fund has introduced new benefits, changed the name of BonFit to BonFit Select and kept increases as low as possible. “South Africans are under immense financial pressure. This combined with the concerns around the NHI Bill definitely impacts members,” says Callakoppen. “We’d like to assure everyone it is business as usual at Bonitas and quality, affordable healthcare for our members, remain a priority.”

Delivering healthy returns

Over the years, emphasis has been on our Managed Care initiatives, helping members to take control of their health to enjoy a better quality lifestyle. The successes:

  • Chronic medication: Around 187,000 members are enrolled on the chronic medicine programme, 79% of these are adhering to their chronic medicine regimens.
  • Diabetes: 60,000 are registered as chronic diabetic beneficiaries with 77.6% adherent to chronic medicine.
  • Mental health: There are around 28,000 unique registered beneficiaries with mental illness. 1,700 members have enrolled on the mental health programme and adherence to chronic medicine is 91.4%.
  • The DBC back and neck programme: Continues to enjoy a 91% success rate, with 3,200 members completing the programme with improved movement and functional rehabilitation. Of the members who completed the programme, only 5% required surgery.

Enhanced Wellness Extender

One of the Fund’s key initiatives for 2020 is an enhanced Wellness Extender benefit to include, amongst others, blood tests and x-rays available on all options, except BonCap without impacting on day-to-day benefits or savings. The Wellness Extender can be used across a range of services from GP consultations to physiotherapy and blood tests. The good news is this will be paid from the Wellness Extender first so members can stretch their benefits further.

Because completing a wellness screening is a prerequisite to accessing the extender benefit, we are rolling out screenings to Dischem and Clicks clinics and the greater public, through family days and activations. This will also allow the Fund to identify high-risk beneficiaries early and put them on the path to wellness.

More value for members

“In looking at our members’ needs, it became clear that they require additional out-of-hospital benefits for daily medical and day-to-day expenses such as acute medicine, blood tests and x-rays,” Callakoppen said. On some plans day-to-day benefits have been increased while on others the savings portion has been increased – the benefit increases range from 16-20%. On other options, the dental benefit has been restructured and in some GP visits have been increased.

Talking babies

Bonitas covers the birth costs of around 9,000 babies every year, 20% of these involve some kind of complication. For this reason the Fund firmly believes they need to offer pregnant women additional support and education. Next year the maternity benefit will allow one of the post-natal consultations to be used for a consultation with a lactation specialist. Moms will also be able to access vouchers for up to 70% off baby products and further discounts a Baby City from the voucher platform.

Bonitas is also in the process of establishing a comprehensive baby programme which will offer pregnant moms a range of benefits and care.

We hear you

The hearing aid cycle has been adjusted in line with international protocols, which show that the average lifespan of a hearing aid is approximately eight years. Hearing aids will now be available on five-year cycle from the date of last claim on BonComprehensive, BonClassic, BonComplete, Standard and Standard Select.

Run/Walk for Life and Eat for Life

The top four conditions suffered by our high-risk members are hypertension, diabetes, high cholesterol and heart disease. These conditions can be significantly improved by exercising regularly and eating a healthier diet. To this end, we have partnered with Run/Walk for Life which is offering Bonitas members a 70% discount. Members can join Run/Walk for Life and Eat for Life for R135 a month. As an added bonus, if a pregnant Bonitas mom joins the programme, her partner can join too at no cost.

Corporate wellness

There has been a distinct shift towards making employee wellness a serious focus to address work-life balance and maintain employee health. Our approach is to manage the health of the employees proactively by providing access to range of services from Health Risk Assessment, TB screening, optometry, prostate and breast screening, all delivered on site to avoid disrupting the work environment.

Improved value-adds:

We know South Africans are looking for added value and ways to save money every month. Attracting a younger, target market is vital to sustainability and they demand additional benefits over and above healthcare. This is why we introduced our value-added product model for 2019.

For the year ahead these include:

Improved access to free discount vouchers, with over 300 retail discounts available to members every month on groceries, travel, fashion and more. Discount partners include: Takealot, Planet Fitness, Checkers, PnP, Spar, Edgars, Dis-Chem, Baby City, Unilever and Tiger Brands.

MedGap has increased its limit to R165,000, introduced a trauma benefit for children under 5 and a R2,000 payout on confirmation of pregnancy, while offering Bonitas members a 26% discount. A special millennial gap product has also been released.

Sanlam Indie offers members a wide range of life, funeral, disability cover products and an exclusive benefit in the form of free investments up to 100% of monthly contributions, with Bonitas members receiving an additional 10%. In 2020, new Bonitas members will get R150,000 free life cover for three months.

And finally, MiWay is offering a 5% discount on household and motor insurance, a free tracking device and emergency transport benefit to Bonitas members.

“There are a number of issues facing South Africans,” says Callakoppen. “From healthcare inflation and the general high cost of living, to concerns regarding an increased prevalence of lifestyle diseases and mental health issues. However we have solid plans in place to help reduce the burden on our members with a renewed focus on prevention.

“We have a huge responsibility to find more affordable ways of providing quality healthcare We are pleased that our strategy is providing us with solid financial stability, to continue our innovation in terms of our offering going forward,” concluded Callakoppen.

Summary of key changes for the year:

  • Average on risk contributions is 9.4% with an average increase of 9.9%.
  • The name of BonFit has been changed to BonFit Select to highlight the rich network of providers. The option has also had an increase in medical aid savings to 16%. Members can also access two GP consultations when savings are depleted.
  • Savings on BonSave have increased to 20%.
  • Hearing aid cycle restructured to five years.
  • Dental benefit, paid for from risk, on BonSave and BonFit has been restructured to cover consultations and oral hygiene.
  • A 15% increase in day-to-day benefits on Primary and Primary Select. In addition, auxiliary benefits for PMBs will be unlimited in-hospital.
  • Enhanced specialised radiology benefits on BonEssential and BonEssential Select for in and out-of-hospital use.
  • Extended and broadened income bands for BonCap.
  • Enhanced maternity programme.
  • Improved Wellness Extender.
  • A 70% discount for members who join Run/Walk for Life and Eat for Life.
  • An enhanced multi-insurer platform with exclusive deals and offers for Bonitas members including gap cover and short-term insurance.
  • The establishment of the Bonitas Pharmacy network to enhance value for money.

For more information on the range of medical plans available from Bonitas, or to compare options, go to www.bonitas.co.za.

Have your say on the NHI bill

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The Portfolio Committee on Health has called on interested individuals and relevant stakeholders to submit written comments as well as indicate interest in making an oral submission on the National Health Insurance Bill [B11 – 2019].

“The objective of the Bill is to achieve universal access to quality health care services in South Africa in accordance with section 27 of the Constitution, to establish a National Health Insurance Fund and to set out its powers, functions and governance structures, and to provide a framework for the strategic purchasing of health care services by the Fund on behalf of users,” the committee said in a statement.

The Bill further aims to create mechanisms for equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of the population, to preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users and to provide for matters connected herewith.

Written submissions must be directed to Vuyokazi Majalamba and be addressed to the Portfolio Committee on Health 3rd floor, 90 Plein Street, Cape Town 8000, e-mailed to

az.vog.tnemailrap@abmalajamv

or faxed to 086 6943279 by no later than 11 October 2019.

In addition to the written comments, individuals must indicate their interest in making a verbal presentation.

Copies of the Bill can be obtained from Vuyokazi Majalamba (021) 403 3770, cell 083 709 8522 or at www.parliament.gov.za.