Quality health cover that meets your needs doesn’t need to be complicated or too expensive. We offer you great cover, easy claims, and above all we tell it like it is – Affinity Health

To find out more, give us a call today!

One of our qualified and friendly agents will be happy to assist you.

Call Center:

0861 11 00 33

Fax:

086 607 9419


General Enquiries:

info@affinityhealth.co.za
The Official National Department of Health COVID-19 Support Service: 060 012 3456 (WhatsApp)

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Day-to-Day Health Plan

‘Out-of-hospital’ medical cover and benefits

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A Day-to-Day health plan for the management and treatment of common daily illnesses, injury and essential medical requirements.

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The Affinity Health Day-to-Day plan has been designed to help you cover the everyday costs of staying healthy such as going to the doctor or dentist, obtaining prescribed acute medication or receiving a pair of reading glasses. You also receive service from any Medical Society Centre for primary healthcare and medical treatment.

Basic radiology and pathology are also covered when recommended by your Medical Practitioner*.

Our Day-to-Day Plan starts from R649pm

An Affinity Health Day-to-Day plan can provide you with:

Unlimited Doctor visits, subject to primary healthcare referrals.

Radiology and Pathology are unlimited when recommended by your network GP*.

Post-hospital private home nursing to the value of R10,000.00 per year.

Acute medication, Basic Dentistry and Optometry.

Access to our nationwide network of medical professionals.

* Medication, Radiology and Pathology subject to Affinity Health’s formulary.

See benefit details below

1 Telehealth Consulting

Unlimited, telephonic consultations with an Affinity Health primary healthcare consultant. Includes medication subject to the Affinity Health Formulary.

No waiting period
Medication is subject to a 1 Month waiting period

1 Primary Healthcare Referrals

Unlimited GP consultations when referred by a designated Primary Healthcare Professional.

1 Month waiting period

1 Doctor Consultations

You have unlimited, managed doctor consultations under this benefit with a Network GP, subject to Affinity Health’s Formulary. Your doctor will provide healthcare services and dispense or prescribe medication according to Affinity Health’s formulary.

Out-of-network visits

Unlimited, subject to the Affinity Health Formulary. Member must pay the GP and claim back up to R250 per consultation.

1 Month waiting period

1 In-Room GP Procedures

Unlimited cover for minor procedures that can be performed in GP Rooms, subject to the formulary per procedure. Pre-authorisation is required.

1 Month waiting period

1 Primary Healthcare Consultations

Unlimited, managed visits to a Medical Practitioner at a Medical Society Centre. Includes acute medication and treatment prescribed and dispensed by a Primary Healthcare Professional.

1 Month waiting period

1 Primary Healthcare Screening

One primary healthcare screening visit per member per annum conducted by a primary healthcare professional at a conveniently located Medical Society Centre.

No waiting period

12 Casualty Room Treatment

Casualty Room treatment for accident or illness up to R3 000 per policy per year. Must be pre-authorised.

Immediate Casualty Room Treatment

1 Casualty room treatment event as a result of an accident activated as you apply, up to R1 000 per policy.

1 Month waiting period

12 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

12 Maternity Scans

Two growth sonars referred by your network GP, subject to the Affinity Health Formulary.

3 Month waiting period

12 Month pre-existing waiting period

12 Maternity Management Programme

Support for expectant mothers through the provision of medical advice and monitoring pregnancy through to birth and up to six weeks
post-delivery.

3 Month waiting period

12 Month pre-existing waiting period

3 Specialist Visit

Up to R1 200 per single member policy or R3 000 per family policy per year as referred by a GP. Subject to Pre-authorisation.

3 Month waiting period

4 Acute Medication

Unlimited, prescribed acute medication is covered if linked to the GP consultation and dispensed by the GP or obtained on script from a pharmacy linked to the Affinity Health formulary.

1 Month waiting period

5 Dentistry

1 full mouth assessment or 1 scale and polish, infection control, 2 intraoral radiographs, 3 extractions and 3 fillings per member per year.

3 Month waiting period

6 Optometry

One eye test and one set of standard frames and lenses per member per 24 months. This benefit is only available through a Spec-Savers outlet.

12 Month waiting period

7 Radiology

Unlimited, when referred by a Medical Practitioner according to a list of approved codes from the radiology formulary. Includes only black and white X-rays .

1 Month waiting period

8 Pathology

Unlimited when referred by a Medical Practitioner according to a list of approved codes from the pathology formulary.

1 Month waiting period

Pre-Existing Conditions are subject to a 12 month waiting period from Commencement Date.

Pre-authorisation is required for all benefits.

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Optional Benefits

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Chronic Essential Medication Benefit

Cover available for over 24 different chronic conditions.

Linked to the doctor consultation and obtained on script from a pharmacy linked to the Affinity Health formulary.

3 Month waiting period.

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HIV Chronic Medication Management Programme

The HIV/AIDS programme caters to the medical and lifestyle needs of members living with HIV/AIDS and provides them with suitable treatment and tools to live a healthy life.

3 Month waiting period.

Members are required to register as a Chronic Member for this Benefit.

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Diabetes Management Programme

The Diabetes Management Programme assist members in the management of their diabetes condition and provides them with tools to improve their overall health.

3 Month waiting period.

Members are required to register as a Chronic Member for this Benefit.

Remember, you can view the additional booster costs on our policy rates page.

VIEW POLICY RATES

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.