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 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:

Unlimited, managed virtual or in-person GP Visits, subject to a telephonic consultation referral.

Radiology and Pathology are unlimited when recommended by your Network GP*

Post-hospital private home nursing to the value of R11,500.00 per single member policy 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 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

1 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

1 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

1 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

1 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

1 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

1 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

1 Healthcare Screening

One healthcare screening visit per member per year conducted by a Nurse Practitioner at a Medical Society Centre.

No Waiting Period

1 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

1 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

1 Radiology

Unlimited basic Radiology according to the Affinity Formulary if referred by a Network Doctor.

1 Month Waiting Period

1 Pathology

Unlimited basic Pathology according to the Affinity Formulary if referred by a Network Doctor.

1 Month Waiting Period

1 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

1 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

1 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

1 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

12 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

12 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

3 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

4 Emergency Medical Response

24/7 Emergency medical advice, ambulance services and hospital pre-authorisation.

No 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 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.

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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.

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.

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