The state of healthcare in South Africa is very much a tale of two distinct systems.

The state funded public healthcare system serves 80% of the population but patients experience overcrowded, understaffed and poorly resourced facilities.

The private healthcare system features world class facilities staffed by the most talented staff and is paid for privately – mostly by individuals with private health insurance.

The poor standards available to those who are reliant on the state system are exacerbated by widespread HIV infection and frequent TB outbreaks.

The government encourages citizens and residents to take out private health insurance wherever possible in order to ease the burden on the state – there are plans to introduce a universal social insurance programme (National Health Insurance) but this is currently a long way off.

Private health insurance

For new permanent and temporary residents it is therefore highly recommended to obtain private medical insurance. It is the only way to ensure that the treatment you receive is of an equivalent standard to that found in Europe or the US.

Basic health insurance schemes only cover hospital care while comprehensive health insurance plans will also cover primary (GP) care.

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Optional extras which you may want to consider include air ambulance cover – South Africa’s roads are often poor outside major cities and congestion is a problem inside, so the air ambulance service is widely used – and evacuation cover in case you want to return home for certain treatments or intend travelling within Africa.

Health insurance companies

There are over 100 different companies offering private medical cover in South Africa ranging from local insurers offering basic cover for as little as £17 GBP per month to large international health insurance providers like Bupa International and Allianz.

The cheapest schemes offer only hospital in-patient cover and the insurance companies which offer them have been known to cancel policies when they learn of upcoming treatment.

More comprehensive plans are essential in order to receive appropriate preventative and diagnostic care, treatment for chronic diseases and advanced medicine.

Discovery is a large South African health insurance provider and offers a wide range of schemes which require contributions of between £55 GBPand £209 GBP per month for the principal member or between £7 GBPand £40 GBP per month for a child.

Momentum is another and offers plans priced from £22 GBP to £275 GBP per month for the principal member.

Health hazards in South Africa

South Africa, like most African countries, has problems with infectious disease due to the climate.

Low altitude areas – particularly in the Northern Province and Eastern Transvaal – are conducive to malaria which persists year round. Anti-malaria drugs may therefore be recommended for expatriates and steps should be taken to avoid mosquito bites.

Cholera and TB outbreaks are also fairly common, especially in poorer rural communities. A recent cholera epidemic in the Limpopo region originated on the Zimbabwe/South Africa border. Cholera can be avoided by drinking only bottled or pre-boiled water.

In general you should seek advice about vaccinations from a doctor before travelling to South Africa.

HIV/Aids is widespread in South Africa and until recently many insurance companies would not include treatment for the disease in their plans. That has changed in recent years but many companies will still only grant cover to HIV-negative customers who have been members for at least five years.