What Are Out-of-Hospital Benefits?

Out-of-hospital benefits, often called day-to-day benefits, provide cover for common medical expenses that do not require hospital admission. These may include consultations with general practitioners, acute and chronic medicines, basic pathology, radiology, optometry, and dentistry. Affinity Health offers dedicated Day-to-Day Plans to make routine care affordable and predictable for individuals, families, and seniors across South Africa.

Key Out-of-Hospital Benefits Typically Included

• Consultations with general practitioners (GPs)
• Prescribed acute and some chronic medications
• Basic blood tests and radiology (as part of GP visits)
• Basic dentistry (examinations, fillings, extractions)
• Eye tests and frames through partnered providers
• Telephonic consultations for health advice

Who Benefits Most from Out-of-Hospital Cover?

These benefits are valuable for young adults, families raising children, corporate professionals, and retirees seeking to manage their health proactively. By addressing common healthcare needs outside the hospital, day-to-day benefits support:

• Families requiring frequent GP visits for children
• Young professionals prioritising preventive care
• Older adults managing chronic conditions
• Anyone seeking predictable monthly medical expenses

Why Preventive Care Matters

South Africa faces rising rates of lifestyle-related conditions such as hypertension, diabetes, and obesity. Early intervention is key, and day-to-day cover makes preventive check-ups more accessible, helping with earlier diagnosis and better long-term outcomes. For a comprehensive view on affordable plan pricing, visit Affinity Health’s Pricing Page.

Typical Benefits Breakdown

For specific details, limits and annual maximums, consult the Affinity Health Day-to-Day cover page.

Plan Options: Day-to-Day Cover for All Ages

Affinity Health’s Day-to-Day plans are tailored for different life stages:

• Junior plans- for children (0-17 years), offering essential GP, dental, and acute medicine cover.
• Standard Range- for adults (18-54), suitable for individuals or families starting out or growing.
• Senior plans- for those aged 55+, including benefits suitable for chronic condition management.

All plans include access to Affinity Health's extensive national network of healthcare professionals, supporting fast access to care. Monthly premiums are designed to stay affordable even as your needs evolve. For example, monthly day-to-day cover for adults starts from around R709 and from R489 for children; retirees’ day-to-day rates start at R1099 (as per the official rates).

Best Practices: Maximising Your Benefits

• Visit network GPs to avoid extra co-payments.
• Use preventive check-ups for children and the elderly.
• Keep track of annual benefit limits and pre-authorisation where required.
• Leverage telephonic consultations for quick advice and mental health support.

Integrating With Hospital and Combined Plans

Day-to-day cover can work alongside hospital or combined plans for those seeking broader protection. A combined health plan covers both everyday needs and extensive in-hospital events. You may wish to compare options at Affinity Health’s Combined Plan overview to see how you can achieve full peace of mind.

How to Get Started

1. Assess the healthcare needs of each family member by age and health status.
2. Review the benefit schedule and network guides for your preferred plan.
3. Speak to an authorised representative to confirm eligibility and application details.

Sources

• Affinity Health - Day-to-Day Cover
• Affinity Health - Policy Rates
• Department of Health South Africa - Preventive health
• Statistics South Africa - National Health Profile
• Affinity Health - Senior Cover