Hospital Plan
Private hospitalisation cover
Our hospital plan provides you with a wide range of benefits in the event of hospitalisation as a result of an accident, illness or medical emergency.
Accidents happen when you least expect them and even the healthiest amongst us can fall victim to disease and illness.
As one of the fastest growing providers of Hospital Plans and Health Cover in South Africa, Affinity Health offers you an affordable Hospital Plan that gives you access to a wide range of features and benefits when you need it most.
The great thing about an Affinity Health Hospital Plan is that you get a much wider choice of hospitals and doctors than if you were a public patient.
A brief overview of some of the
benefits on our Hospital Plan:
When it comes to medical expenses there are two types of costs associated with hospitalisation – hospital stay costs and medical costs.
Hospital Stay
Hospital stay costs are for general daily expenses like your bed, your meals and theatre. These costs accrue with each passing day during your stay in hospital.
Medical
Medical costs are charges from specialists like surgeons, radiologists and anaesthetists.
Having Hospital Cover from Affinity Health means that these costs will be covered.
PLEASE NOTE:
Pre-Authorisation must be obtained in all instances including emergencies prior to admission. Pre-authorisation can be obtained by contacting Affinity Health via telephone on 0861 11 00 33, via WhatsApp on 071 314 5862 or by sending a “please call me” to 071 314 5862. Upfront payments are available to all treating hospitals.
See benefit details below
Accident Benefit
Up to R275,000 per single member per event. R325,000 per family per event.
Immediate Accident Benefit* (Between the Application Date and the Commencement Date)
Up to R100,000 per single member policy. R150,000 per family policy.
*Subject to 1 admission per policy.
Senior Only
Up to R110,000 per single member policy. R150,000 per family policy.
Immediate Accident Benefit* (Between the Application Date and the Commencement Date)
Up to R70,000 per single member policy. R85,000 per family policy.
*Subject to 1 admission per policy.
No waiting period
Motor Vehicle Accident Benefit
This benefit offers assistance with claiming from the Road Accident Fund. Affinity Health has a network of attorneys that will assess the accident at no cost to the member and will facilitate any reimbursement from the Road Accident Fund on behalf of the member.
No waiting period
Sub-Acute Hospitalisation
Up to R20 000 per member per year for treatment in a Sub-Acute facility. Pre-authorisation is required.
3 Month waiting period
Day Clinic Procedures
Access to an affiliated Day Clinic for procedures up to R25,000 per member per year. Pre-authorisation required.
3 Month waiting period
Major Trauma
Trauma Cover for conditions relating to paraplegia, quadriplegia, severe burns, internal and external head injuries, polytrauma and loss of limb. Up to a maximum of R1 100 000. Subject to Pre-authorisation and benefit sub-limits.
No waiting period
Casualty Room Treatment
Casualty Room treatment for illness. Subject to pre-authorisation.
- Up to R2,500 (Senior: R3,250) per year.
- Up to R4,500 (Senior: R4,750) per year if combined plan is taken.
1 Month waiting period
Trauma Support Services
Telephonic trauma support and counselling by professional and dedicated staff member for any of the following events: sexual assault,
crime, trauma-related gender-based violence, death, attempted suicide and domestic violence.
No waiting period
24Hr Emergency
24/7 Emergency medical advice, ambulance services and inter-hospital transfers, hospital pre-authorisation required to arrange authorisation to the treating facility.
No waiting period
Workers Compensation Benefit
The benefit offers cover for occupational related injuries or diseases. Affinity Health also offers third party recovery services, such as advice and administrative assistance, keeping the member updated on the progress of the claim.
No waiting period
Pre-authorisation required.
Daily Illness Hospitalisation
- 1st Day Up to R22,000 / R27,000*
- 2nd Day Up to R22,000 / R27,000*
- 3rd Day Up to R22,000 / R27,000*
- 4th Day Up to R11,000 / R14,000*
- 5th Day Up to R11,000 / 14,000*
Thereafter up to R3,500 per day up to a maximum of 21 days per member, per illness event.
* Additional cover applicable when admitted to ICU and combined with the ICU Booster.
3 Month waiting period
Maternity
- Maternity Natural
- Maternity C-Section
- Up to R25,000
- Up to R35,000
12 Month waiting period
Serious Illness Hospital Benefit
Up to R300 000 per policy is payable according to severity. Includes Heart Attacks and Heart Block Up to R300 000 and Strokes, Cancer and Aneurysm Up to R150 000.
3 Month waiting period
Excluded on Affinity Senior
Diagnostic Procedures
Up to R20 000 per policy per year subject to member co-payment and benefit limits. Pre-Authorisiation required.
3 Month waiting period
Optional Benefits
Accident Booster
Single and family options available.
Starting at an additional R129pm for up to R350,000 cover, up to a maximum of R1,150,000 cover, dependent on the option chosen.
Excluded on Affinity Senior
No Waiting Period
Intensive Care Unit (ICU)
Up to R27,000 cover per day in ICU or up to R24 000 per day in High care for the first 3 days and R12,500 for day 4 and day 5. This is dependent on the admission dates.
Additional R129pm for single member.
Additional R259pm for family.
Excluded on Affinity Senior
3 Month Waiting Period
Remember, you can view the additional booster costs on our policy rates page.
Persons joining Affinity Health over the age of 54 will be subject to increased premiums.
Persons joining Affinity Health Junior over the age of 18 will be subject to increased premiums.