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

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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 GP*.

Our Day-to-Day Plan starts from R579pm

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*.

Family funeral cover

Acute medication, Basic Dentistry and Optometry.

Access to our nationwide network of medical professionals.

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

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

See benefit details below

1 Telemedicine 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 an Affinity Health primary healthcare consultant.

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 sub-limits 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 the Medical Practitioner.

1 Month 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 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

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 network-registered GP 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 network GP according to a list of approved codes from the pathology formulary.

1 Month waiting period

8 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

9 Family Funeral Benefit

Funeral assistance cover as a result of death of a member:

  • Policyholder
  • Spouse and Children over the age of 14
  • Children over the age of 6
  • Children birth to 6 years of age
  • Stillborn from 28 weeks
  • R12,500
  • R12,500
  • R6,000
  • R3,000
  • R1,500

3 Month waiting period
Excluded on Affinity Junior

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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Day-to-Day Boosters

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Medication: Chronic Essential

Cover available for over 23 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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iER Booster

iER is South Africa’s leading, dedicated 24-hour emergency response and disaster management network. This service is linked directly to our own ‘free to use’ and graphically appealing mobile application with built in GPS location functionality.

Includes:

  • Access to over 8000 network providers.
  • Private Emergency Evacuation Services.
  • Hospital stabilisation deposit up to R40,000.
  • Emergency Casualty Room Stabilisation up to R6,000.
  • 24-Hour telephonic medical advice.
  • All benefits, except the telephonic medical advice, are applicable to life-threatening events only.

R39pm – Individual

R59pm – Family

No waiting period

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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 17 will be subject to increased premiums.