Understanding Diagnostic and Screening Cover for Seniors

While traditional maternity-related cover is usually designed for individuals of childbearing age, senior citizens face a different set of priorities when it comes to diagnostic and screening benefits. For members aged 55 and older, the focus shifts to routine health scans and screenings - including ultrasounds, X-rays, and preventive diagnostics crucial for early detection of health risks as we age.

Why Are Regular Scans and Screenings Vital After Age 55?

• Mature adults have a higher risk of chronic illnesses and age-related conditions.
• Early detection via screenings (such as mammograms, ultrasounds, or cardiac checks) can improve outcomes dramatically.
• Diagnostic imaging supports proactive care, guiding healthcare practitioners in tailoring treatment and prevention plans.

How Senior Health Plans Provide for Essential Scans

Affinity Health’s Senior Range is designed with day-to-day and hospital-based diagnostic requirements in mind. These plans offer a reliable path to the tests and scans frequently recommended for mature members.

• Certain in-hospital scans and diagnostics are included under hospital plan events (for example, X-rays and scans related to admissions).
• Day-to-day cover provides access to network healthcare practitioners for prescribed basic radiology and pathology, with selected pre-authorised scans available under defined networks.
• Combined plan options for seniors integrate both day-to-day and hospital cover, making it easier to secure access to various diagnostic imaging procedures.

Affordability and Structure of Senior Health Cover

Premiums start at R1,473 per month for day-to-day, R2,190 per month for hospital, and R3,361 per month for combined cover (as of 2024). Costs can rise with family members or dependants, but these plans are structured to keep essential diagnostic access within reach.

Typical Diagnostic and Screening Tests Included

• In-hospital: Ultrasounds, X-rays, imaging related to trauma or illness episodes.
• Day-to-day: GP-requested blood tests, basic radiology, and selected screening tests according to policy schedule.
• Mammograms, cardiac screening, and abdominal ultrasounds if clinically justified and pre-approved within network rules.

Always check your cover schedule, as benefit rules and authorisation requirements apply. You can view full senior cover benefits on the official plan page.

Maximising Diagnostic Benefits: Key Considerations for Senior Members

It's important for older adults to understand how their plan works to get the most from their annual health checks and scans.

1. Understand Access Points

• Day-to-day plans: Use the designated network of healthcare practitioners for GP-directed diagnostic bookings.
• Hospital plans: Scans must be linked to an authorised admission and are subject to hospital authorisation.
• Combined plans: Provide seamless movement between outpatient and inpatient diagnostics without the need for duplicate policies.

2. Know What’s Covered and When

3. Commonly Used Health Scans for Seniors

• Mammograms for women (breast cancer screening)
• Cardiac ultrasounds and ECGs (heart function monitoring)
• Abdominal ultrasounds (liver, kidney, bladder)
• Bone density scans (osteoporosis risk)

4. Making Use of Your Benefits

• Always consult your network healthcare practitioner for referrals and authorisations.
• Use approved network hospitals for in-patient diagnostic services - visit the provider hospital search tool to confirm facility access close to home.
• Review your annual benefit schedule each year, as scan and screening limits may be updated to reflect new guidelines.

5. Comparing Cover: What Sets Affinity Health's Senior Range Apart?

• Clear separation between routine checks and major event cover, so you only pay for what you need.
• Designed exclusively for South African seniors with practical pricing and relevant diagnostics.
• Easy access to both network outpatient providers and hospital diagnostic support, minimising stress during annual check-ups or acute health events.

Sources

• Affinity Health - Senior Health Cover
• Affinity Health - Current Plan Pricing
• National Institute for Communicable Diseases - Cancer Surveillance
• Government of South Africa - National Health Programmes
• Statistics South Africa - Health Trends