Health Cover from Affinity Health

    May 21, 2018

    Affinity Health offers affordable health insurance products to help protect you from unexpected medical expenses. In this article, we will have a look at health cover from Affinity Health. Affinity offers the following plans:

    Day-to-Day Plan

    Health Cover From Affinity HealthThis plan aims to help cover the costs of day-to-day medical expenses (such as doctor or dentist visits, acute medication or acquiring glasses). Also, policyholders can visit Medical Society clinics for primary healthcare treatment. So maximum entry age is 54 years (17 years for Affinity Junior and 70 years for Affinity Senior).

    Features of this plan include the following:

    • Cover starts at R468 per month
    • Also, unlimited doctor visits with a network GP and partial cover for non-network GP (1 month waiting period after joining)
    • Unlimited visits to Medical Society centre (1 month waiting period)
    • Casualty room treatment for accident or illness after hours (subject to pre-authorisation and up to prescribed limits; 1 month waiting period)
    • Specialist visits as referred by network GP (subject to pre-authorisation and plan specifics; 3 month waiting period)
    • Unlimited prescribed acute medication from GP or Affinity Health-linked pharmacy (1 month waiting period)
    • Basic dentistry covered per year (3 month waiting period)
    • Eye test and spectacles per member every 24 months (12 month waiting period)
    • Unlimited radiology and pathology when referred by network GP (subject to approved codes; 1 month waiting period)
    • Also, funeral cover for the death of a member (subject to certain criteria and excluded on junior policies; 3 month waiting period)

     

    The Day-to-Day Plan also includes the following optional boosters for chronic cover:

    • Chronic Essential
      • Cover for 23 chronic conditions
      • 6 month waiting period after joining

     

    • Chronic Booster
      • Cover for four specific illnesses: depression, diabetes, bipolar disorder & menopause
      • Includes 2 GP consults and blood tests
      • 1 month waiting period after joining
      • Excluded from the Senior plan

     

     

    Hospital Plan – Health Cover from Affinity Health

    This plan aims to help cover the costs of hospitalisation due to illness, accident or a medical emergency. The plan covers treatment for specific conditions as well as casualty room procedures and maternity cover, with access to private hospitals. Maximum entry age is 54 years (17 years for Affinity Junior and 70 years for Affinity Senior).

    Features of this plan include the following:

    • Cover starts at R615 per month
    • Accident benefit up to R175000 per member or R275000 per family (lower benefits for the Senior plan; no waiting period)
    • Permanent disability cover of R250000 for policyholder or spouse (Junior & Senior plan excluded, no waiting period)
    • Casualty room treatment for accident or illness after hours (subject to pre-authorisation and up to prescribed limits; 1 month waiting period)
    • 24/7 ambulance, inter-hospital transfer or medical advice (pre-authorisation required; no waiting period)
    • Also, hospitalisation for daily illness with maximum amounts for Day 1 – 5 and a set amount up to a maximum of 21 days per illness (3 month waiting period; 24 month waiting period for pre-existing conditions)
    • Set amounts for treatment of specific conditions (12 month waiting period, 24 months for hysterectomy)
    • Dread disease cover of R9000 per day from diagnosis up to R200000 (6 month waiting period, excluded on Senior plan)
    • Also, funeral cover for the death of a member (subject to certain criteria and excluded on Senior and Junior plans; 3 month waiting period)

     

    The Hospital Plan also includes the following optional boosters:

    • Accident Booster
      • Additional cover from R250000 to R1050000 (excluded from the Senior Plan)

     

    • Intensive Care Unit Booster
      • R12,500 ICU cover per day for 5 days (excluded from the Senior plan)

     

     

    Combined Plan – Health Cover from Affinity Health

    This plan offers a combination of the benefits on both the Day-to-Day and Hospital Plans. It offers increased benefits on both funeral benefits and casualty room treatment as well as a discounted premium.

    So this plan starts at R948 per month.

    All info was correct at time of publishing