Affinity Health Day-to-Day Medical Aid Plan

 

Overall, the Affinity Health Day-to-Day Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and post-hospital private home nursing to up to 3 Family Members. The Affinity Health Day-to-Day Medical Aid Plan starts from R809 ZAR.

 

👤 Main Member Contribution	R809
👥 Adult Dependent Contribution	R739
🍼 Child Dependent Contribution	R389
🔁 Gap Cover	None
📉 Annual Limit	Unlimited
💶 Prescribed Minimum Benefits	✅ Yes
😷 Screening and Prevention	✅ Yes
💙 Medical Savings Account	None
🏥 Hospital Cover	✅ Yes
🤓 Optometry Benefit	✅ Yes

 

 

 

Affinity Health Day-to-Day Plan – 7 Key Point Quick Overview

 

1. ✅ Affinity Health Day-to-Day Plan Overview
2. ✅ Affinity Health Day-to-Day Plan Contributions
3. ✅ Affinity Health Day-to-Day Plan Benefits and Cover Comprehensive Breakdown
4. ✅ Affinity Health Day-to-Day Plan Exclusions and Waiting Periods
5. ✅ Affinity Health Day-to-Day Plan vs Similar Plans from Other Medical Schemes
6. ✅ Our Verdict on the Affinity Health Day-to-Day Plan
7. ✅ Affinity Health Day-to-Day Plan Frequently Asked Questions

 

 

Affinity Health Day-to-Day Plan Overview

 

The Affinity Health Day-to-Day medical aid plan is one of 3, starting from R809, and includes unlimited doctor visits, radiology and pathology, post-hospital private home nursing, and more.  Gap Cover is available on the Affinity Health Day-to-Day Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Affinity Health has a trust rating of 9.9.

 

Affinity Health has the following three options to choose from:

 

• 💙 Affinity Health Hospital Insurance Plan
• 💙 Affinity Health Day-to-Day Medical Aid Plan
• 💙 Affinity Health Combined Medical Insurance Plan

 

 

 

Affinity Health Day-to-Day Plan Contributions

 

🔎 Category	👤 Policyholder	👥 Spouse	💙 Adult Dependent	🍼 Child Dependent
🥇 Typical	R809	R739	R739	R389
🥈 Junior	n/a	n/a	n/a	R759 first child Additional children – R389 each
🥉 Senior	R1,219	R1,109	R1,109	R389

 

Discover the 5 Best Gap Cover Options for Under R200

 

 

Affinity Health Day-to-Day Plan Benefits and Cover Comprehensive Breakdown

 

Day-to-Day Plan Main Benefits

 

🟥 Registered Nurse Consultations and Referrals	Nurse Practitioner referrals for unlimited GP visits.
🟧 24/7 Telephonic Medical Consulting	Unlimited nurse, doctor, or mental health professional phone consultations. Includes Formulary-approved Nurse, Doctor, or Mental Health Professional-recommended acute medication.
🟨 Registered Nurse Consultations	Unlimited, managed Medical Society Centre visits. Includes Registered Nurse-dispensed Affinity Health Formulary medications.
🟩 Doctor Consultations	Unlimited, managed Affinity Health Provider Network GP consultations.
🟦 Out-of-Network GP visits	Unlimited, per Affinity Health Formulary. Member pays GP and claims up to R250 per consultation.
🟪 Specialist Visits	Limited to one Affinity Network Doctor-referred specialist visit per member per year (subject to pre-authorization). Limited to R1,700 per single policy or R3,500 per family policy per year.
🟥 In-room GP procedures	Unlimited cover for minor GP-room procedures with sub-limits.
🟧 Healthcare Screening	Limited to one annual nurse practitioner health screening per member at a Medical Society Centre.
🟨 Acute Medicine	Unlimited and linked to the GP consultation, Network Provider, or pharmacy-dispensed Affinity Health Formulary medication.
🟩 Over-the-Counter (OTC) Medication	Over-the-counter medication up to R500 per member policy or R1,000 per family policy per year, subject to Nurse practitioner pre-authorization.
🟦 Radiology	Unlimited basic Radiology from Affinity Health’s Formulary for Network GP referrals.
🟪 Pathology	Subject to the Affinity Health Formulary, unlimited basic pathology from Network GPs.
🟥 Dentistry	Limited one full mouth assessment and scale and polish every six months. Includes infection control, 2 intraoral radiographs, 3 extractions, and 3 fillings per member annually.
🟧 Optometry	Limited to one eye exam and standard frames and lenses per member every 24 months. Only Spec-Savers stores offer this benefit.
🟨 Maternity Management Program	Includes pregnancy and six weeks of postpartum support for Members. Includes medical advice and monitoring. Includes an additional specialist visit for maternity management program members up to the R1,000 benefit limit.
🟩 Maternity Scans and Pathology	Your network GP may order two growth sonars and relevant blood tests under the Affinity Health Formulary.
🟦 Post-hospital Private Home Nursing	Private nurse assistance is covered up to R11,000 per single member policy or R13,000 per family policy per year.

 

Day-to-Day Plan  Optional Benefits

 

🟣 HIV Chronic Medication Management Program	The HIV/AIDS program treats and equips HIV-positive members to live healthier lives. Benefits require chronic condition registration.
🔵 Diabetes Management Program	Members can manage their diabetes and improve their health with the Diabetes Management Programme. Benefits require chronic condition registration.
🟢 Chronic Medication Benefit	Affinity Chronic Medication Formulary covers 24 Chronic Conditions. Limited to R109 per member per chronic condition. Benefits require chronic condition registration.

 

Day-to-Day Plan 24/7 Emergency Services

 

➡️ Trauma Support Services	Telephonic trauma support counseling and mental health wellness support for sexual assault, crime, gender-based violence, death, attempted suicide, and domestic violence by qualified and dedicated professionals.
↪️ Immediate Emergency Casualty Room Treatment	Limited to 1 ER Accident-related room treatment up to R1,000 per policy.
🔁 Casualty Room Treatment	Emergency Room treatment for medical conditions and accidents up to R3,500 per policy per year.

 

You might like: Medical Aid vs Medical Insurance

 

 

Affinity Health Day-to-Day Plan Exclusions and Waiting Periods

 

Day-to-Day Plan Exclusions

 

The Affinity Health Day-to-Day Plan will not cover any of the following:

 

• If a pre-existing condition causes injury within the first 12 months of cover.
• If an injury is due to suicide, intentional self-injury, or exposure to obvious risk (excluding attempts to save human life).
• If an injury is caused by alcohol, drugs, or narcotics (unless prescribed by a medical professional).
• If an injury is caused by exposure to atomic energy or nuclear reaction.
• If an injury occurs while traveling by air, participating in riots, civil commotion, or war, or during professional sports.
• If an injury results from mountaineering, rock climbing, skydiving, or similar activities unless agreed upon by the Assurer.
• If an injury is caused while committing intentional unlawful acts or driving a vehicle without proper authorization.
• If an injury results from a gradually operating condition known to the Assured Person.
• If an injury is due to congenital abnormalities, chronic diseases, or disorders.
• If an injury is related to regular medical treatments, contraceptive medication, or fertility-related therapies.
• If an injury results from elective cosmetic surgery, corrective optical or laser surgery, or treatment.
• If an injury results from male or female birth control, infertility, or assisted reproduction.
• If an injury is due to a pandemic or epidemic.
• If an unregistered healthcare professional provides the treatment.
• If a superbug or multi-drug-resistant illness causes an injury.
• If the Assured Person(s) is covered by a statutory body for a defined event, the policy will pay only the maximum benefit amount.
• If the Assured Person(s) does not follow a doctor’s medical advice or instructions.
• If fertility treatment leads to multiple births.

 

Day-to-Day Plan Waiting Periods

 

Affinity Health applies the following waiting periods to the Day-to-Day Plan:

 

• Benefits have a waiting period of 3 months from the Commencement Date unless mentioned otherwise.
• Pre-existing Conditions have a waiting period of 12 months from the Commencement Date.
• Each Benefit may have its specific Waiting Period according to the policy.

 

 

Affinity Health Day-to-Day Plan vs Similar Plans from Other Medical Schemes

 

🔎 Medical Aid Plan	🥇 Affinity Health  Day-to-Day	🥈 KeyCare Start Regional	🥉 Bonitas BonCap Plan
👤 Main Member Contribution	R809	R1,102	R1,430
👥 Adult Dependent Contribution	R739	R1,102	R1,430
🍼 Child Dependent Contribution	R389	R664	R673
📉 Annual Limit	Unlimited	Unlimited Hospital Cover	Unlimited

 

Read more about Bonitas Medical Aid Scheme

 

 

Our Verdict on the Affinity Health Day-to-Day Plan

 

The Day-to-Day Plan from Affinity Health is designed to offer affordable medical coverage for individuals and families. This plan provides unlimited GP consultations, basic dentistry, optometry, and medication. The plan also covers pathology and radiology services, a useful feature for those needing regular check-ups and screenings. One of the main advantages of this plan is that it provides access to a 24-hour emergency helpline. This feature particularly benefits those requiring medical assistance outside of regular working hours.

 

The plan also offers the convenience of telephonic consultations with medical professionals, which can save time and money. However, it is important to note that the Day-to-Day Plan has some drawbacks. The plan only covers basic dentistry and optometry, which may not be sufficient for individuals with more complex dental or eye care needs.  Additionally, the plan has limited benefits, which may not be suitable for those with more extensive medical requirements.

 

You might also like the following:

 

• Affinity Health Hospital Insurance Plan
• Affinity Health Combined Medical Insurance Plan
• Affinity Health Medical Aid

 

 

Affinity Health Day-to-Day Plan Frequently Asked Questions

 

What is Affinity Health Day-to-Day plan?

Affinity Health Day-to-Day plan is a health insurance plan that covers day-to-day medical expenses such as consultations, medication, and chronic medication.

 

Is Affinity Health Day-to-Day plan a medical aid?

No, the Affinity Health Day-to-Day plan is not a medical aid. It is a health insurance plan that covers day-to-day medical expenses.

 

What benefits are included in the Affinity Health Day-to-Day plan?

The benefits included in the Affinity Health Day-to-Day plan include consultations with doctors, chronic medication, dental benefits, and optical benefits.

 

Are there waiting periods for the Affinity Health Day-to-Day plan?

Yes, there are waiting periods for the Affinity Health Day-to-Day plan. The waiting periods are subject to a 3-month period from the commencement date unless stated otherwise, and pre-existing conditions are subject to a 12-month period from the commencement date.

 

Are pre-existing conditions covered under the Affinity Health Day-to-Day plan?

Yes, pre-existing conditions are covered under the Affinity Health Day-to-Day plan. However, they are subject to a 12-month waiting period from the commencement date.

 

Can I use any doctor or pharmacy with Affinity Health Day-to-Day plan?

No, you can only use doctors and pharmacies in Affinity Health’s network. You can find a list of network providers on Affinity Health’s website.

 

How do I claim benefits under the Affinity Health Day-to-Day plan?

Submit a claim form and the relevant supporting documents to claim benefits under the Affinity Health Day-to-Day plan. You can submit your claim online, by email, fax, or post.

 

How much does the Affinity Health Day-to-Day plan cost?

The Affinity Health Day-to-Day plan starts from R759 per month for the policyholder.