Day-to-Day Health Plan
‘Out-of-hospital’ medical cover and benefits
A Day-to-Day health plan for the management and treatment of common daily illnesses, injury and essential medical requirements.
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 healthcare and medical treatment.
Basic radiology and pathology are also covered when recommended by your Medical Practitioner*.
An Affinity Health Day-to-Day plan can provide you with:
* Medication, Radiology and Pathology subject to Affinity Health’s formulary.
See benefit details below
24/7 Telephonic Medical Consulting Hotline
Unlimited telephonic consultations with a Nurse, Doctor or Mental Health Professional. Includes Acute Medication recommended by the Nurse or Doctor subject to the Affinity Formulary.
Consultations – No Waiting Period
Medication – 1 Month Waiting Period
In-Person Nurse Consultations
Unlimited, managed visits at a Medical Society Centre. Includes all medication dispensed by the nurse practitioner subject to the Affinity Formulary.
1 Month Waiting Period
Virtual GP Consultations
Unlimited telephonic consultations with a virtual GP within the Affinity Provider Network, when referred by a designated nurse practitioner.
Consultations – No Waiting Period
Medication – 1 Month Waiting Period
GP Consultations
Unlimited, managed General Practitioner consultations within the Affinity Provider Network when referred by a designated nurse practitioner.
Pre-authorisation is required
1 Month Waiting Period
Out-of-Network GP Consultations
Covered up to R300 per consultation. Member will be reimbursed up to the maximum amount per consultation.
1 Month Waiting Period
Specialist Consultations
Specialist visits covered up to R2 000 per single member policy per year or up to R4 000 per family policy per year. Member must provide a referral letter from a Doctor.
1 Month Waiting Period
In-Room GP Procedures
Unlimited cover for minor procedures that can be performed in a Network GP’s rooms, subject to the Affinity Formulary.
1 Month Waiting Period
Healthcare Screening
One healthcare screening visit per member per year conducted by a Nurse Practitioner at a Medical Society Centre.
No Waiting Period
Acute Medication
Unlimited and linked to the Doctor consultation, medication dispensed by the Network Provider or obtained on script from a pharmacy subject to the Affinity Formulary.
1 Month Waiting Period
Over-the-Counter Medication
Over-the-Counter Medication up to R500 per member policy per year or R1 000 per family policy per year, pre-authorised through the 24/7 Telephonic Medical Consulting Hotline.
1 Month Waiting Period
Radiology
Unlimited basic Radiology according to the Affinity Formulary if referred by a Network Doctor.
1 Month Waiting Period
Pathology
Unlimited basic Pathology according to the Affinity Formulary if referred by a Network Doctor.
1 Month Waiting Period
Dentistry
Dentistry events at a Network dentist including, 1 full mouth assessment and 1 scale and polish every 6 months, infection control, 2 intraoral radiographs, 3 extractions and 3 fillings per member per year.
3 Month Waiting Period
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
Maternity Support
Support for Members, throughout pregnancy and up to six weeks post-delivery. Includes the provision of medical advice and monitoring. An additional specialist visit for members registered for the maternity management programme up to the maximum benefit limit of R1 000. Cover for the birth is only available on Hospital or Combined Options.
3 Month Waiting Period
12 Month Waiting Period for pre-existing conditions
Maternity Scans & Blood Tests
Two growth sonars and relevant blood tests as referred by a GP within the Affinity Provider Network, subject to the Affinity Formulary.
3 Month Waiting Period
12 Month Waiting Period for pre-existing conditions
Trauma Support Services
Telephonic trauma support counselling and mental health wellness support by qualified and dedicated professionals for traumatic events such as sexual assault, crime, gender-based violence, death, attempted suicide, and domestic violence.
No waiting period
Immediate Emergency Casualty Room Treatment
One Emergency Casualty Room treatment event up to R1 000 per policy, as a result of an emergency accident only, between Application date and Commencement Date.
No waiting period
Emergency Casualty Room Treatment
Emergency Casualty Room treatment for medical conditions and accidental injuries up to R3 500 per policy per year.
1 Month waiting period
Emergency Medical Response
24/7 Emergency medical advice, ambulance services and hospital pre-authorisation.
No waiting period
Optional Benefits
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.
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 healthier life. Medication will be covered according to Formulary, up to R500 per Member per month.
3 Month waiting period.
12 Month Waiting Period for pre-existing conditions.
Members are required to register as a Chronic Member for this Benefit.
Diabetes Management Programme
The Diabetes Management Programme assists members in the management of their diabetes condition and provides them with tools to improve their overall Health.
3 Month waiting period.
12 Month Waiting Period for pre-existing conditions.
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.
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.