Health insurance in South Africa for foreign expats

The public healthcare system in South Africa faces significant funding and resource challenges, but private healthcare delivers great levels of care to those who can afford it. For this reason, taking out international health insurance in South Africa means you can reliably access good-quality care from the private system.

South Africa has both public and private healthcare systems. In total, there are more than 400 public hospitals and over 200 private hospitals.²

Government efforts to improve the public system are underway. In May 2024, a new ‘National Health Insurance’ scheme was introduced, with the aim of improving access to healthcare for everyone in South Africa.

Employee and employer contributions combine with general taxation to improve both the quality of, and access to, healthcare services. However, the NHI scheme has yet to be implemented, which means their Uniform Patient Fee Schedule system (UPFS) remains in place for now.

The standard of healthcare in South Africa differs significantly between the public and private healthcare systems.

Many public healthcare professionals face heavy workloads and resource constraints, causing knock-on effects on the quality of care provided and the cleanliness of hospitals and clinics. This can also lead to long waiting times at accident and emergency. And, as is the case in many developing countries, the quality and availability of facilities tend to be better in big cities, such as Cape Town and Johannesburg than in rural areas.

On the other hand, South Africa’s private healthcare facilities are generally considered to be of excellent quality. Expats living and/or working in South Africa can expect levels of service and care similar to Western Europe and other highly developed nations. Private hospitals can offer much higher salaries than their public equivalents, and therefore employ the best doctors in sufficient quantities.

Public healthcare in South Africa is charged according to the three-tier Uniform Patient Fee Schedule, whereby  the Government sets out the fixed cost of different treatments and care.³ These charges are reviewed by the authorities on an annual basis, although there are some treatments that are available free of charge. Some patients and treatments may be fully or partially subsidised, depending on the circumstances and the patient’s income.

On the other hand, private healthcare in South Africa is available through the Medical Aid system, where people pay for their own cover with their choice of provider. The providers that have the largest networks of hospitals and facilities around the country are Life Healthcare, Mediclinic and Netcare.

Different levels of cover are available with each provider, although it’s common for extra fees to be charged for overnight hospital stays. These can reach:

• R4000 per night (approx. £170; $215; €205) for a bed in a general ward
• R4900 per night (approx. £210; $265; €250) for a private ward
• Over R16,000 (approx. £680; $860; €820) for an overnight stay in intensive care.²

Other private healthcare facilities can be accessed by taking out international health insurance cover with a recognised global provider.

Any non-South Africans who have been granted permanent or temporary residency are means-tested under the UPFS system in the same way as South African Citizens, and so there are no additional requirements or restrictions on expats who lie or work in South Africa legally.

This doesn’t apply to anyone in South Africa on tourist or visitor visas, who are expected to cover all healthcare costs themselves. This is a particularly important point to note if you only intend to stay in South Africa for a short time or are a digital nomad.

What kind of documentation do I need to access healthcare in South Africa?

Registering for public healthcare in South Africa is relatively simple. All you need to do is take your passport, proof of South African residency and proof of your home address in South Africa to a local GP surgery. To register with a private doctor, you’ll need to provide proof of valid healthcare cover.

Using the private healthcare system is the only way to be sure that you can get the care you need, whenever you need it, from everyday outpatient treatments to accidents and emergencies.

With that said, the Medical Aid system that South Africans use to access private healthcare can be very costly and is out of reach for many working people beyond the most basic entry-level plans. This is a particularly sensitive issue in South Africa as the private healthcare system is unregulated, and some of the fees and tariffs charged by private providers have risen sharply in recent years.³

So, for expats, taking out international health insurance in South Africa will prevent costs spiralling out of control, and makes access to the best care much more affordable.

What are the benefits of private health insurance in South Africa?

Securing private healthcare coverage in South Africa opens the door to numerous benefits:

Exceptional care: Private healthcare providers in South Africa attract some of the country’s top doctors. This access to professionals enhances the quality of care, meaning you’re more likely to get the right treatment quickly, helping you feel better faster.    

Reduced waiting times: Private facilities often have more staff, so you can expect shorter waiting times for appointment and surgeries. In emergencies, you’ll be seen much quicker.

Enhanced privacy: With private cover, you have the option of private rooms during hospital stays or, at the very least, smaller and quieter wards to provide a more comfortable and peaceful environment for recovery.

Better facilities:  Private hospitals and clinics are generally better placed to invest in new technology and equipment, and provide more space for each patient.

Direct access to specialists: Private healthcare allows for faster access to specialist clinicians. Many cover options also include the convenience of virtual appointments and consultations via telephone or video call.

Peace of mind: Knowing you can easily access these high-quality services can take away any concerns about receiving the best possible care when you need it.

Would I need dental insurance in South Africa?

The level of service and dental care can vary substantially across the country, and some Medical Aid providers cover more areas of dentistry than others. Many private international health insurer’s cover dental, so it can prove easier and more cost-effective to have this cover included as as part of your policy.

South Africa has several different emergency numbers available to use, depending on the nature of the emergency and the type of help that is needed.

The general emergency number is 112, from which an operator will be able to direct your call (similar to 999 in the UK or 911 in the United States). Alternatively, 10177 is the number to call for an ambulance and/or the fire department for help with an accident or incident where there is no crime involved. The emergency number for the police is 10111.

Some of the larger private healthcare providers also have their own emergency contact numbers, including Netcare (082 911) and ER24 (084 124).