Understanding Combined Medical Insurance for Everyday Needs and Emergencies

Combined medical insurance is created to address both routine healthcare and larger in-hospital events. For South African families, professionals, and retirees, this format allows for a single monthly premium that covers treatment like GP visits and prescription medicine as well as hospital admissions. This approach gives peace of mind by simplifying care and minimising out-of-pocket surprises should sudden medical events occur. Affinity Health was established in 2011 and focuses on making private health cover both affordable and accessible to South Africans of all ages.

Who Benefits Most From Combining Day-to-Day and Hospital Cover?

• Families seeking consistent access to GPs, dentistry, basic optometry, and hospital care for accidents or serious illness
• Young adults starting their careers who want balanced protection within a predictable monthly spend
• Older adults or retirees needing ongoing primary care in addition to cover for major medical incidents

Affinity Health’s combined plans have become popular because they offer practical solutions without unnecessary extras. To learn about pricing and specific benefits for different ages, see the current premium guide.

How Combined Medical Insurance Works

• Day-to-day benefits include GP consultations, acute medication, certain dental procedures, and basic optometry
• Hospital cover activates for planned admissions, emergencies, surgical procedures, and selected chronic care in private hospitals
• Telephonic healthcare consultations, wellness support, and emergency medical response are accessible, supporting convenience and fast intervention

Key Features at a Glance

To review plan options and provider access, explore the Combined Plan overview.

Who Can Access Combined Cover?

• Individuals 18-54 years can select the Standard combined plan for themselves or dependents
• Children 0-17 can receive cover via Junior options
• Members aged 55+ may consider Senior combined cover for later years

How to Select the Best Combined Plan for Your Needs

Choosing a suitable policy involves weighing expected day-to-day routines against possible hospitalisation needs. Consider the following step-by-step approach:

1. List your average monthly health expenses, including GP visits, medication, and any regular therapies
2. Factor in any chronic conditions or upcoming planned procedures
3. Compare benefit tables and premium levels using available resources
4. Check network coverage and make sure your preferred clinics and hospitals participate by visiting the provider finder tool and hospital network lookup

Plan Examples and Premiums (2024)

Combined plans are designed to protect members from large, unexpected costs and to promote wellbeing with routine primary care. Families benefit from single policies that manage both routine children’s appointments and major hospital events, while professionals have peace of mind during career years.

Advantages Compared to Single-Option Medical Cover

• Simplifies household healthcare management with fewer policies and statements
• Reduces gaps where certain real expenses could otherwise remain uncovered
• Promotes healthier habits through easier GP access and preventive care

The Affinity Health homepage provides detailed information about all plan types, including unique needs for children and retirees.

Points to Consider Before Applying

• Each plan has benefit limits for both day-to-day and hospital services
• Certain pre-existing conditions may involve waiting periods
• Excess options are available on some plans to manage monthly premiums

Sources

• Affinity Health - Combined Plan Overview
• Affinity Health - Premiums and Plan Details
• South African National Department of Health
• Statistics South Africa - Healthcare Spend Data
• Affinity Health - Find a Provider Tool