Scheme reviews
Affinity Health: how it differs from a registered medical aid
By Naledi Mokoena · 6 min read · Updated 24 June 2026
- Product type
- Health insurance (not a registered medical scheme)
- Plan types
- Day-to-day and hospital-event insurance benefits
- Known for
- Affordable entry-level health cover
- PMBs
- Not covered the way a medical scheme must cover them
- Regulator
- Insurance regulation, not the CMS scheme framework
- How to join
- affinityhealth.co.za
Affinity Health is a health insurance product in South Africa, not a registered medical scheme, and that is the single most important thing to understand before you buy, since it changes how your cover works in practice. Health insurance pays stated amounts for defined events, while a medical scheme must cover Prescribed Minimum Benefits and answers to the Council for Medical Schemes.
Affinity markets affordable day-to-day and hospital-event cover that can suit people who cannot afford a full medical scheme. The trade-off is that it does not work like medical aid: cover is capped at stated amounts and PMBs do not apply in the same way.
Use it with eyes open. For full private hospital cover and PMBs, you need a registered medical scheme, not health insurance.
Health insurance vs medical aid - the key difference
A registered medical scheme must cover the Prescribed Minimum Benefits and is regulated by the Council for Medical Schemes. Health insurance like Affinity pays defined benefit amounts for specific events and is regulated as insurance. That means a hospital stay may pay a stated amount per day rather than the full private hospital bill. For a large claim, the gap between the stated benefit and the actual cost falls on you.
| Feature | Affinity Health (insurance) | Registered medical aid |
|---|---|---|
| Entry contribution (indicative) | low, often from a few hundred rand | from ~R1,000 |
| Hospital cover | stated amount per day or event | actual cost at scheme rate |
| Day-to-day | stated benefit amounts | savings or plan benefits |
| PMBs | not covered the scheme way | must be covered |
| Regulator | insurance ombud | Council for Medical Schemes |
Indicative only - confirm the current benefit amounts before you buy.
Who Affinity Health suits
Affinity-style health insurance can suit people who genuinely cannot afford a medical scheme and want some cover for GP visits, basic dentistry and a hospital cash benefit. It is better than nothing for day-to-day primary care. It is not a substitute for medical aid if you face a serious illness, surgery or a long hospital stay, because the stated benefits can be far below the real cost.
What to check before you buy
- Confirm in writing that it is health insurance, not a medical scheme.
- Read the stated benefit amounts and daily hospital limits.
- Check waiting periods and exclusions, including pre-existing conditions.
- Understand that PMBs do not apply the way they do on a medical scheme.
- Compare against the cheapest income-based or network medical scheme plan you might qualify for.
Your rights and where to complain
Because health insurance is not a medical scheme, complaints do not go to the Council for Medical Schemes. Insurance products fall under the insurance ombud and the relevant financial sector regulator. If you specifically want medical scheme protection and PMBs, choose a registered scheme, where the CMS at medicalschemes.co.za handles complaints.
Frequently asked questions
Is Affinity Health a medical aid?
No. Affinity Health is a health insurance product, not a registered medical scheme. It pays stated benefit amounts for defined events rather than covering the full bill and PMBs the way medical aid must. This is a crucial difference.
What is the difference between Affinity Health and medical aid?
Medical aid is a registered scheme that must cover PMBs and is regulated by the CMS. Affinity is insurance that pays defined amounts and is regulated as insurance. For a big hospital bill, insurance can leave a large gap.
Does Affinity Health cover private hospital fully?
Not the way medical aid does. Health insurance typically pays a stated amount per day or per event, which can be far below an actual private hospital bill. For full private hospital cover you need a registered medical scheme.
Who should consider Affinity Health?
It can suit people who cannot afford a medical scheme and want basic day-to-day and hospital cash cover. It is better than no cover for primary care, but it is not a substitute for medical aid for serious illness or surgery.
Does Affinity Health cover PMBs?
Not in the way a medical scheme must. Prescribed Minimum Benefits are a medical scheme obligation. Health insurance products are not bound by PMBs in the same way, so do not assume PMB conditions are fully covered.
Where do I complain about Affinity Health?
Because it is insurance, not a medical scheme, complaints go to the insurance ombud and financial sector regulator rather than the Council for Medical Schemes. Check the product documents for the correct complaints channel.
