Limited contribution increases for 2023
• Bonitas balances keeping prices low while maintaining fund stability, writes Lynette Dicey
THE SCHEME HAS DESIGNATED SERVICE PROVIDER NETWORKS TO NEGOTIATE THE MOST FAVOURABLE TARIFFS FOR ITS MEMBERS
Bonitas Medical Fund has announced that its average increase for the year ahead would have been 5.9% well below the current inflation rate of 7.6%.
However, a price freeze on contributions for the first quarter of 2023 effectively means an increase of 4.4% over the 12 months.
Lee Callakoppen, principal officer of Bonitas, says the scheme’s price increase is a balancing act between keeping increases as low as possible while maintaining the fund’s stability. “By applying low contribution increases since December 2020, Bonitas has effectively passed on R1.4bn in savings to members.”
The scheme, which celebrates its 40th birthday this year and is one of the leading medical schemes in SA, is financially stable with more than R7.4bn in reserves.
YOUNGER MEMBERSHIP
Callakoppen says that more than 190,000 new members have been signed up in the past 36 months. Encouragingly, the average age of these new members is about 15 years younger than the current membership. “This is proof that the scheme is attracting a younger, healthier profile which is something that is coveted across the industry,” he says.
There is no question that the future of healthcare is around primary and preventative care, particularly given the rise in noncommunicable or lifestyle diseases such as diabetes, high blood pressure and cancer, 80% of which are caused by lifestyle risk factors.
To help members understand and manage their conditions, Bonitas offers a range of Managed Care programmes. In 2021, Bonitas announced a partnership with the South African Oncology Consortium to enhance its cancer programme including screening for early detection, treatment and palliative care. For 2023, it has restructured benefits to be unlimited for PMB cancers, on all options.
Data from the South African Health Quality Assessment shows Bonitas has an effective disease management programme and better outcomes than the industry standard for diabetic members. In 2023, the scheme introduces an annual benefit of R51,000 per family for an insulin pump or continuous glucose monitor for type 1 diabetics under 18 years.
In October, Bonitas introduced an innovative digital solution, 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.
The scheme is encouraging its members to complete an online mental health questionnaire to assess their mental health status.
Launched last year, the Benefit Booster is aimed at supporting the scheme’s preventative care strategy. It unlocked R446m in additional benefits for members to extend their day-to-day benefits. For 2023, Bonitas has adjusted the benefit limits in line with utilisation with enhancements seen on several plans.
Callakoppen explains that the scheme has designated service provider networks to negotiate the most favourable tariffs for its members so they can avoid out-of-pocket expenses and get more value.
This includes a GP network of more than 4,400 practices; a pharmacy network with about 2,500 practices to dispense chronic, acute and over-thecounter medicine through Scriptpharm; DENIS, a dental network which provides access to about 3,000 practices; and an optical network of more than 2,300 practices, through PPN.
“Our medicines formulary is aligned to the WHO’s Essential Medicines List (EDL) to promote affordability and accessibility to clinically approved medicines, in support of medicine adherence,” he says.
Bonitas’ 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-ofthe-art 24-hour vital sign monitoring. In 2023 this service will be expanded to include a programme for re-admissions, screening and disease prevention, alternative to stepdown facilities and kidney dialysis at home.
INCREASED SAVINGS
For the year ahead, the scheme has amended its rules to allow members to use their savings as they deem fit and increased savings by up to 9.4%, depending on the plan selected.
“With the current economic challenges facing the country, we know everyone is constantly looking for added value and ways to save money every month. Which is why, for 2023, we’ve partnered with top providers for exclusive offers across a range of categories including lifestyle, wellness, gap cover, short-term insurance, life insurance and credit solutions,” says Callakoppen.
“As South Africans face increased challenges around inflation, fuel and electricity hikes we remain committed to providing quality healthcare at affordable prices, while ensuring the sustainability of the scheme,” he says.