By implementing this strategy, a saving of more than R100 million in 2017 and around R500 million over the next three years in present value terms is projected. This will directly influence future contribution increases and ensure that Bonitas can continue to meet the needs of its members.
Why was the co-payment implemented? Hospital admissions account for half of Bonitas’ annual claims costs, around R6 billion a year. In 2016, we negotiated with the three largest hospital groups in South Africa, with a view to create a network of designated service providers to ensure the lowest possible increases for our members and to keep costs down.
This then assists in ensuring quality and affordable healthcare for our members. However, we were unable to strike a favourable deal across all of Life Healthcare’ s facilities. For this reason, a 30 % co-payment was introduced at 14 Life Healthcare Hospitals on BonComprehensive, BonClassic, BonComplete, BonSave, Standard, Primary, Hospital Plus, Hospital Standard and BonEssential.
What hospitals does the 30 % co-payment apply to?
The co-payment will apply to voluntary admissions for members on BonComprehensive, BonClassic, BonComplete, BonSave, Standard, Primary, Hospital Plus, Hospital Standard and BonEssential, at the following hospitals:
• Rosepark Hospital
• Bedford Gardens Private Hospital
• Brenthurst Clinic
• Carstenhof Clinic
• Flora Clinic
• Genesis Clinic( Saxonwold)
• Wilgeheuwel Private Hospital
• Eugene Marais Hospital
• Faerie Glen Hospital
• Life Groenkloof Hospital
• Wilgers Hospital
• Hilton Life Private Hospital
• Kingsbury Hospital
• Vincent Pallotti Hospital
What about emergency admissions? In the case of emergencies, members may be admitted to one of the demarcated hospitals. We will cover the initial treatment, but will request that the member be moved to a network hospital once they are stable. This will ensure that a member will not be liable for the co-payment, should Life opt not to waive it.
If Life Healthcare has waived the co-payment, why is Bonitas still applying it? The co-payment will remain as part of the Bonitas Rules, until a formalised agreement is reached with Life Healthcare. As a result, we urge you to use discretion when using the 14 hospitals listed above, voluntarily. The onus is on all members to ensure that the co-payment has been waived before being admitted to one of the above-mentioned hospitals.
How will I know if a co-payment is applicable to a hospital that I have chosen to use? You will be advised of this when you pre-authorise your hospital admission.
I am on Standard Select / BonFit / BonCap, has my co-payment for use of a non-network hospital been waived? No, this does not apply to Standard Select, BonFit and BonCap, which make use of specific hospital networks. The co-payments which apply to use on non-network hospitals on these options will continue to apply as per the Bonitas Rules.
What if Life Healthcare decides to enforce the co-payment? It is a member’ s responsibility to ensure that the co-payment has been waived before being admitted to one of the hospitals listed above.
Will the list of hospitals change? While the list of hospitals may be amended, we will not be adding to it. Members and financial advisors will be notified should any changes occur. Please refer to the Bonitas website www. bonitas. co. za or call us on 0860 002 108 for the most updated list of hospitals.
B-Living Issue 2, 2017 Page 14