Day-to-Day Hospital Plan · 2019. 3. 5. · 0861 11 00 33 Essential medical cover such as doctor...
Transcript of Day-to-Day Hospital Plan · 2019. 3. 5. · 0861 11 00 33 Essential medical cover such as doctor...
0861 11 00 33
Essential medical cover such as doctor consultations, medication, dentistry, radiology and more.
Day-to-Day Hospital PlanOut-of-hospital health cover Private Hospitalisation cover
Hospitalisation in the event of a medical emergency such as an accident or severe illness. Includes maternity cover.
Maximum entry age is 54 for Both Day-to-Day and Hospital Plans.
Unlimited, managed GP visits, Pre- and Postnatal Care including two growth sonars referred by your Affinity Health Provider, subject to Affinity Health’s Maximum Expenditure Formulary.
1 Monthwaiting period
DoctorConsultations
Specialist Visit
Casualty RoomTreatment
Acute Medication
Radiology
Pathology
Out-of-NetworkVisit
Dentistry
Optometry
Family Funeral
PolicyholderSpouse and Children over the age of 14Children over the age of 6Children birth to 6 years of ageStillborn from 28 weeks
R12 500R12 500R6 000R3 000R1 500
1 Specialist visit per single member policy per year up to R800 or R1 600 per family policy per year as referred by a Network GP only. Subject to pre-authorisation
Casualty Room treatment for accident or illness up to R2 500 per policy per annum. Must be pre-authorised and only available after hours.
Linked to the doctor consultation dispensed by the Network Provider or obtained on script from a pharmacy linked to the Affinity Health Medicine Formulary.
Unlimited Basic Radiology as referred by a Network GP, subject to Affinity Health's Maximum Expenditure Formulary. Basic black and white x-rays only.
Unlimited Basic Pathology as referred by a Network GP, subject to Affinity Health's Maximum Expenditure Formulary.
Unlimited, subject to Affinity Health’s Maximum Expenditure Formulary. Member pays GP and claims back.
1 full mouth assessment or 1 scale and polish, infection control, 2 intraoral radiographs, 3 extractions and 3 amalgam fillings per member per year.
One eye test and one set of standard frames and lenses per member per 24 months.
3 Monthwaiting period
1 Month waiting period
1 Monthwaiting period
1 Monthwaiting period
1 Monthwaiting period
1 Monthwaiting period
3 Monthwaiting period
12 Monthwaiting period
3 Monthwaiting period
Each benefit has its own applicable waiting period from Commencement Date.
Accidents are covered from Commencement Date for the Hospital Plan.
Family Funeral
Daily IllnessHospitalisation
Specific StatedConditions
Accident Cover
AccidentalPermanentDisability
Casualty RoomTreatment
24-HourEmergency
Dread Disease
PolicyholderSpouse and Children over the age of 14Children over the age of 6Children birth to 6 years of ageStillborn from 28 weeks
R25 000R10 000R5 000R2 500R1 250
3 Monthwaiting period
3 Month waiting period
24 Month waiting period for pre-existing
Appendix Removal Kidney Stones - Theater Ectopic Pregnancy Hernia RepairGall Bladder Removal MiscarriageMaternity NaturalMaternity C-SectionHysterectomy
12 Monthwaiting period
24 Monthwaiting period forHysterectomy
R30 000R30 000R20 000R17 500R40 000R10 000R20 000R30 000R40 000
Up to R175 000 per single member per event or R275 000 per family per event.
No waitingperiod
R250 000 applicable to Policyholder or Spouse only.
No waitingperiod
Casualty Room treatment for illness only up to R2 500 per policy per annum. Must be pre-authorised and only available after hours.If a combined plan is taken, the benefit increases to R4 000 per annum.
1 Month waiting period
24/7 emergency medical advice, ambulance services, inter-hospital transfers. Hospital pre-authorisation & arranging for guarantee of payment to the treating facility in the event of an accident.
No waitingperiod
thereafter R1 500 per day up to a maximum of 21 days per member, per illness event.
R9 000 is payable per day upon diagnosis up to R200 000 according to severity, covering Heart Attack, Coronary Heart Disease, Stroke, Cancer, Kidney Failure and Major Organ Transplant.
6 Monthwaiting period
R468pm R221pm eachR418pmSingle Member Spouse Child - Max 6
Day-to-Day R615pm R110pm eachR554pmSingle Member Spouse Child - Max 6
Hospital
Affinity Health, a product of National Risk Managers (Pty) Ltd (FSP 47132), the Underwriting Managing Agency; Lion of Africa Life Assurance Company Ltd (FSP 15283), the Insurer and its Services Providers reserve the right to decline any application for cover. This policy shall be voidable in the event of misrepresentation, misdescription or non-disclosure of any particular material fact to this insurance by or on behalf of an insured person. Terms and conditions as contained in the policy document apply.
R948pm R295pm eachR862pmSingle Member Spouse Child - Max 6Combined
Benefits Include: Benefits Include:
st 1 Day R8 500nd2 Day R5 500
rd3 Day R5 000
th4 Day R4 250th
5 Day R4 250
Medical Society Clinic Consultations
Unlimited, managed visits to a Medical Practitioner at a Medical Society Centre. Includes Acute Medication prescribed and dispensed by the Medical Practitioner.
1 Monthwaiting period
Included in both Day-to-Day and Hospital plans
Post-Hospital Private Home Nursing for up to R10 000 as recommended by an Affinity Health Specialist.
2018
Maximum entry age is 54 for Both Day-to-Day and Hospital Plans.
Each benefit has its own applicable waiting period from Commencement Date.
Accidents are covered from Commencement Date for the Hospital Plan.
www.affinityhealth.co.zafacebook.com/affinityhealthcoza
[email protected]/affinityhRSA
linkedin.com/company/affinity-health-rsa
plus.google.com/+AffinityhealthCoZa
Affinity Health, a product of National Risk Managers (Pty) Ltd (FSP 47132), the Underwriting Managing Agency; Lion of Africa Life Assurance Company Ltd (FSP 15283), the Insurer and its Services Providers reserve the right to decline any application for cover. This policy shall be voidable in the event of misrepresentation, misdescription or non-disclosure of any particular material fact to this insurance by or on behalf of an insured person. Terms and conditions as contained in the policy document apply.
Chronic Medication Benefit
Optional Accident Booster
Linked to the doctor consultation. Dispensed by the Network Provider or obtained on script from a pharmacy linked to the Affinity Health Medicine Formulary. 6 Month waiting period
R65pm PER CHRONIC CONDITION
Cover available for over 23 different chronic conditions.
Optional ICU Add-On BenefitR12 500 cover per day for 5 days.Intensive Care Unit 3 Month waiting period
+
Diabetes
from R438pm
Depression
from R181pm
Bipolar
from R375pm
MenopauseHRT for women
from R246pm
Includes 2 GP consults and formulary blood tests.
Chronic Booster We offer additional cover for Chronic Medication for four specific chronic illnesses over and above the Chronic Essential Medication benefit on our Day-to-Day and Combined plan.
1 Month waiting period
Chronic Essential
Additional for single member. Additional for family.R73pm R146pm
Single Family
OPTION OPTIONPREMIUM PREMIUMCOVER COVER
Level 1 Level 2 Level 3 Level 4 Level 5 Level 6 Level 7 Level 8 Level 9
R76 R152R228R304R380R456R532R608R684
R250 000R350 000R450 000R550 000R650 000R750 000R850 000R950 000R1 050 000
R148
R296
R444
R592
R740
R400 000
R550 000
R700 000
R850 000
R1 000 000
Level 1
2 Level
3 Level
4
When taking the cover Combinedyour are Family Funeral Benefitsautomatically increased.
(Affinity Junior not included)
Principal MemberSpouse & Children over the age of 14Children aged 6 to 14Birth to 6Stillborn from 28 weeks
R30 000R15 000R10 000R5 000R2 500
Level
5 Level
Ages 0 to 17 years
Junior planBenefits as stated on our Day-to-Day, Hospital or Combined cover are available, unless otherwise stated. Standard waiting periods apply.
The insured applies to the child only
Senior planHealthcare benefits for clients over the age of 55. Choose from Day-to-Day, Hospital or Combined Cover.
Ages 55 to 70 years
R726pm R224pm eachR651pmSingle Member Spouse Child - Max 6
Day-to-Day
R672pm R110pm eachR616pmSingle Member Spouse Child - Max 6
Hospital
R1 109pm R295pm eachR986pmSingle Member Spouse Child - Max 6Combined
R443pm R221pm each
Single Child Child - Max 6Day-to-Day
R615pm R147pm each
Single Child Child - Max 6Hospital
R948pm R295pm eachSingle Child Child - Max 6Combined