2015 Health Insurance [ Not a Medical Aid ]
UNLIMITED DOCTOR VISITS
Medication, Basic Dentistry, Optometry and much more
option 1 day to day cover Unlimited GP managed visits, Pre and Post Natal Care including two growth sonars referred by your Affinity Health Provider, subject to Affinity Health’s Maximum Expenditure Formulary.
Specialist Visit
1 Specialist visit per member per year up to R600 or R1 200 per family as referred by the Network GP only. (Subject to preauthorisa on.)
Acute & Chronic Medication
Linked to the doctor consulta on dispensed by the Network Provider or obtained on script from a pharmacy linked to the Affinity Health Medicine Formulary.
Radiology
Unlimited Basic Radiology linked to the doctor visit as referred by the Network Provider from the Radiology Formulary. Basic black and white x-rays only.
Pathology
Unlimited Basic Pathology linked to the doctor visit as referred by the Network Provider from the Affinity Health Pathology Formulary.
Out-of-Area Visit
Unlimited, according to Affinity Health’s Maximum Expenditure Formulary. Member pays GP and claims back.
Dentistry
Full mouth assessment, infec on control, 2 intra oral radiographs, 1 scale and polish, extrac ons max 3 per year, amalgam fillings.
6 month waiting period for chronic
3 month waiting period
Optometry
12 month waiting period
Family Funeral Benefit 3 month waiting period Anity Junior Excluded
Waiting Period Maximum Age
Up to R150 000 per single member per event. R250 000 per family per event.
ICU Illness Benefit Booster Add the ICU Illness Booster Benefit Cover by paying an additional small fee per month.
24/7 emergency medical advice, ambulance services, interhospital transfers. Hospital pre-authorisa on & arranging for guarantee of payment to the trea ng facility of up to R150,000 in the event of an accident.
Accidental Permanent Disability
R250 000 principal member and spouse only.
(Anity Junior Excluded)
Daily Illness Hospital Benefit
24 month waiting period
Single
R335
R447
R671
R481
Single with 1 child
R486
R502
R867
R632
Single with 2 children
R637
R557
R1 063
R783
Single with 3 children
R788
R612
R1 259
R934
Single with 4 children
R939
R667
R1 455
R1 085
Couple
R586
R872
R1 309
R937
3 D
4 D
5 D
R4500
R4500
R3000
R3000
R30 000 R30 000 R20 000 R15 000 R35 000 R10 000 R15 000 R25 000 R40 000
R25 000 R10 000 R5 000 R2 500 R1 250
Principal Member Spouse and Children over the age 14 Children - over the age of 6 Children - birth to 6 years of age S llborn - from 28 weeks
3 months waiting period
Day-to-Day Senior
2ⁿ D
R7500
R9 000 is payable per day upon diagnosis up to R200 000 according to severity, covering Heart A ack, Coronary Heart Disease, Stroke, Brain Tumour, Cancer, Kidney Failure, Major Organ Transplant, Paraplegia and Blindness.
Dread Disease 6 months waiting period and 24 months for pre-exisiting
Maximum entry age is 54 (64 for senior plan, and 17 for Affinity Junior)
Combined
1st Day
Appendix Removal Kidney Stones - Theater Ectopic Pregnancy Hernia Gall Bladder Removal Miscarriage Maternity - Natural Maternity C-Sec on Hysterectomy
12 months waiting period
30 days a er incep on date of policy on Day-to-Day Benefits. (Unless otherwise stated.)
Hospital Only
Family R99p/m
24 Hour Emergency
Specific Stated Conditions Benefit
R10 000 R10 000 R5 000 R2 500 R1 250
Day-to-Day Only
Single R49p/m
therea er R1 500 per day up to max of 21 days per member, per illness event.
One eye test and one set of standard frames and lenses per beneficiary per 24 months. Principal Member Spouse and Children over the age of 14 Children - over the age of 6 Children - birth to 6 years of age S llborn - from 28 weeks
Accident Benefit
R500 excess No waiting period
Family Funeral Benefit
Package Options
R335 p/m
option 2 hospital cover
Doctor Consultations 3 month waiting period
from only
Anity Junior Excluded
Waiting Period
90 days from incep on date. (Unless otherwise stated)
Maximum Age
Maximum Entry age is 54 (17 for Affinity Junior)
Single Accident Benefit Booster
Benefit
Premium
Family Accident Benefit Booster
Premium
Benefit
Couple with 1 child
R737
R927
R1 505
R1 088
x1 Booster cover
R49
R250 000
x1 Booster cover
R99
R400 000
Couple with 2 children
R888
R982
R1 701
R1 239
x2 Booster cover
R98
R350 000
x2 Booster cover
R198
R550 000
Couple with 3 children
R1 039
R1 037
R1 897
R1 390
x3 Booster cover
R147
R450 000
x3 Booster cover
R297
R700 000
Couple with 4 children
R1 190
R1 092
R2 093
R1 541
x4 Booster cover
R196
R550 000
x4 Booster cover
R396
R850 000
x5 Booster cover
R245
R650 000
x5 Booster cover
R495
R1 000 000
x6 Booster cover
R294
R750 000
Increased Family Funeral Benefits
included in both day-to-day and hospital plan
(Affinity Junior Excluded)
(If both op ons are taken) Principal Member Adults & Children over 14 Children 6 to 14 Birth to 6 S llborn from 28 weeks
JUNIOR
R30 000 R15 000 R10 000 R5 000 R2 500 Day-to-Day Only
Hospital Only
Post Hospital Private Home Nursing for up to R10 000 as recommended by an Affinity Health Specialist. Combined
Affinity Junior 1 Child
R313
R425
R649
Affinity Junior 2 Children
R464
R531
R867
Affinity Junior 3 Children
R615
R637
R1 085
Affinity Junior 4 Children
R766
R743
R1 303
JUNIOR:
The insured applies to the child only, not the proposer (principal member)
x7 Booster cover
R343
R850 000
x8 Booster cover
R392
R950 000
x9 Booster cover
R441
R1 050 000
Contact us 0861 11 00 33
www.facebook.com/ affinityhealthcoza
086 607 9419
Agent:
Contact:
Code:
Email:
[Email] [Web]
info@anityhealth.co.za www.anityhealth.co.za
Affinity Health (Pty) Ltd and its Insurer, Constan a Insurance Company Ltd and Constan a Life and Health Assurance Company Ltd reserve the right to decline any applica on due to pre-exis ng condi ons. This policy shall be voidable in the event of mis-representa on, mis-descrip on by or on behalf of an insured person of any par cular material fact to this insurance. Affinity Health is a Juris c Representa ve of Authorised Financial Services Provider 37213.
Constantia Life and Health Assurance Company Ltd and Constantia Insurance Company Ltd.