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 primary healthcare and medical treatment.
Basic radiology and pathology are also covered when recommended by your GP*.
See benefit details below
Unlimited, telephonic consultations with an Affinity Health primary healthcare consultant. Includes medication subject to the Affinity Health Formulary.
Primary Healthcare Referrals
Unlimited GP consultations when referred by an Affinity Health primary healthcare consultant.
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.
Unlimited, subject to the Affinity Health Formulary. Member must pay the GP and claim back up to R250 per consultation.
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.
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.
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.
Two growth sonars referred by your network GP, subject to the Affinity Health Formulary.
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.
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 full mouth assessment or 1 scale and polish, infection control, 2 intraoral radiographs, 3 extractions and 3 ﬁllings per member per year.
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.
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 .
Unlimited when referred by a network GP according to a list of approved codes from the pathology formulary.
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.
Family Funeral Benefit
Funeral assistance cover as a result of death of a member:
- 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
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.
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.
- 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
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 17 will be subject to increased premiums.