If you are considering joining Affinity Health, one of the first questions you might have is: May I still see my family’s doctor? The answer is yes. Affinity Health gives you flexibility — you can visit doctors within the Affinity Health network, and there will be no out-of-pocket costs for the visit, or see a doctor who is not  part of the network of doctors and receive a reimbursement towards the consultation. It all depends on whether the doctor is part of the Affinity Health network of providers.

There are two main types of healthcare cover: medical aid, which generally covers most costs but comes with higher monthly premiums, and health insurance, like Affinity Health, which provides affordable, structured benefits with fixed payouts for specific events.

How Affinity Health’s GP Network Works

Affinity Health has an extensive network of contracted providers, known as Designated Service Providers (DSPs). This network includes doctors, specialists, dentists, pharmacies, and other healthcare professionals nationwide. When you visit a Network GP, Affinity Health pays the consultation in line with your plan benefits. Network doctors charge the Affinity Health rate, so you will not  face out-of-pocket costs unless you ask for services that are not covered by your plan.

Finding one is simple — just use the Affinity Health Find a Provider tool to search for a GP, dentist, or pharmacy near you.

Seeing an Out-of-Network Doctor

You may consult a doctor outside the Affinity Health network. However, you will be responsible for the upfront payment of the consultation fee, which you can then claim back from Affinity Health;  provided you have received pre-authorisation and submit the correct documents. This means you can keep your current doctor, while still enjoying the benefits of Affinity Health cover.

That said, using a Network GP will always give you more value, since you will not risk shortfalls if your doctor charges above the set reimbursement.

Affordable Day-to-Day Medical Cover

Affinity Health’s Day-to-Day Plan helps you cover common healthcare costs. Key benefits include:

• Unlimited, managed doctor visits.
• Virtual doctor and nurse consultations, with acute medication included, subject to the Affinity Formulary.
• Specialist visits (GP referral required).
• Basic dentistry and optometry every 24 months.
• Radiology, pathology, and in-room doctor procedures are covered.
• Over-the-counter medication.
• Maternity support and annual health screenings.

Combined Plans for Extra Peace of Mind

If you want both everyday medical cover and hospital protection, Affinity Health’s Combined Plan is the ideal choice. It includes all the Day-to-Day benefits plus hospital cover for accidents, illness, maternity, and certain serious conditions. You will also have access to private hospitals in emergencies, within your plan benefits.

Why the GP Network Matters

Choosing an Affinity Health Network GP makes life easier. You don’t pay upfront, claims are handled directly, and you avoid shortfalls since doctors charge the agreed Affinity Health rate. Network GPs also streamline referrals to specialists and tests because they are familiar with the benefit rules.

If you see a doctor outside the Affinity Health network, you can still claim back (with pre-authorisation), but you’ll need to pay first and then be reimbursed up to the set limit.

The Bottom Line

Yes, you can make use of out-of-network doctors; however, you will save more and avoid extra costs by using doctors in the Affinity Health network. With its wide list of providers, you will have plenty of options wherever you are.

Affinity Health’s affordable Day-to-Day and Combined Plans make private healthcare predictable and accessible, without the high cost of medical aid. More than just cover, Affinity Health is a healthcare partner you can rely on — offering 24/7 telehealth consultations, unlimited managed GP visits, and access to a nationwide network of providers.