Health Insurance in South Africa
Thinking of moving to South Africa? The country is renowned for its dramatic mountain ranges, golden sandy beaches, and slower pace of life, so there's certainly a lot to look forward to!
But before you start making your way to the airport, you’ll want to look into the different healthcare options in South Africa. Compared to the UK’s NHS, the healthcare systems in the Rainbow Nation are a little different, and tend to not be so generous.
So take a scroll through this page to get the lowdown on the different healthcare options available, and discover whether public or private healthcare is the best option for you and your family.
If you’ve already decided that private health insurance is right for you, we recommend Cigna. Helping more than 95 million customers all over the world, Cigna has the experience and expertise to get you just the right cover.
Start building a customised plan with a free quote today.
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South Africa’s healthcare system explained
While many countries have a centralised healthcare system in place, South Africa has two parallel systems: the underfunded, mostly government-funded public programme, and the private system.
The less-than-ideal public system leaves lots of people stuck with long waiting times for their treatment. South Africa’s private healthcare system, on the other hand, has a much more efficient service, but tends to be quite pricey.
There is a huge divide between these two facilities, which is mostly financially driven. A significant amount of funding, along with the best specialists, gives the private sector the upper hand – leaving the public sector understaffed and in dire need of some TLC.
Despite this, a lot of people can’t afford to swap to private healthcare – around 80% of the population use the public service, with the remaining 20% opting for the private service.
Access to healthcare in South Africa
Good news for British expats – everyone can access public healthcare in South Africa, regardless of nationality or immigration status.
Though this might sound ideal for expats moving to South Africa, the majority of foreign residents decide to take out a private insurance policy, so that they can receive the best healthcare available in the country.
But it’s nice to know that you have the public service to fall back on if you can’t afford to take out private health insurance.
For comparison, there are at least 327 public hospitals and 217 private facilities in the country, according to a 2017 study.
If you decide that private health insurance is right for you and your family, we recommend looking into Cigna. You can rest assured that Cigna has the experience and expertise to get you just the right cover. Start building a customised plan with a free quote today.
Is healthcare free in South Africa?
When it comes to the cost of healthcare in South Africa, there’s a lot of grey areas.
The public healthcare system is subsidised to up to 40% of total costs. When you need to visit the doctor or go to hospital, you’re likely to need to pay some money for treatment, but the specific amount depends on how much you earn and the number of children you have.
Generally, visits to the doctor can cost around R55 (about £2.56), whereas hospital stays can cost up to £50 a night if you are in the top income bracket. Ultimately, it all depends on your financial status. If you’d rather opt for private healthcare, you’ll end up having to fork out R350-400 (£16.14-£18.45) for a private consultation. Of course, a private medical plan will cover these costs.
Funding for public healthcare in South Africa currently comes from government spending through taxation, as well as income from the public using the services.
If you’re planning on moving to South Africa in the next few years, keep an eye out for any developing news on its healthcare system. The government has recently put plans in place to implement a National Health Insurance (NHI) scheme, which is set to start by 2026. The main goal for this new system is to improve the overall quality of healthcare in the country, whilst also making it free for more people.
Though this sounds optimistic, many have criticised the plans for simply not being realistic – estimating the funding will range from an ambitious R165bn to a staggering R450bn (£77 billion-£209 billion).
Healthcare in South Africa for expats
You’ll be pleased to know that registering for healthcare in South Africa is less paperwork-heavy than it is in other countries. If you’re a resident, all you need to do is sign up at a local doctor’s surgery by filling out a form. Just remember to bring along proof of address, personal ID such as a passport, and proof of South African residency.
Accessing private medical care is also very simple. You just need to register with a private GP surgery, bringing along the same documents as above, as well as proof of private health insurance coverage.
You can also buy medications at pharmacies all over the country – and at subsidised prices, thanks to the government. Check the government's medicine prices database to see what your local pharmacist should be charging you.
In an emergency, call 112 for an ambulance. It'll generally end up costing you between 1,000 and 5,000 rand (£50-£250), and will take around 15 minutes to get to an urban location, rising to 40 minutes for a rural destination.
When it comes to maternity care, all services before and after the birth are free across the country, though abortion is only legal up to 12 weeks.
Children under six years of age are also treated for free.
And through South Africa has improved its national approach to mental health, it still falls short in this area. Only 4.6% of the health budget goes towards mental services, which is less than half the equivalent percentage in England.
What should be noted though is that South Africa's private healthcare remains amongst the continent's best options, especially for expats living in other African countries such as Kenya.
Expats should also be aware that the country is still struggling to combat an HIV epidemic that kills tens of thousands every year. The burden this places on the public healthcare system makes it harder to tackle other common conditions like cancer, diabetes, and tuberculosis.
112. Whether it's to get assistance for a medical issue, fire, or a crime, calling 112 will allow an operator to patch you through to the relevant department.
The glowing streetlights in Cape Town illuminating the city during dusk
Quality of healthcare in South Africa
To put it lightly, there’s a lot of room for improvement in the South African healthcare system. The country ranked 49th out of 89 countries on the 2019 Global Healthcare Index – the highest-ranking African country, although still sitting below countries including India, Sri Lanka, and the Philippines.
Plus, the average life expectancy doesn’t paint a very optimistic picture, with men living for roughly 61.1 years and women for 67.3 – a number of years below the global averages of 67 years and 71.1 years respectively.
The country’s poorest people do have access to free treatment at about 3,800 clinics and hospitals, though these facilities are often plagued by broken equipment and shortages of medicine. As the working conditions have worsened over the years, doctors and nurses often find more well-paid work in the private sector, with safer working conditions and more up to date equipment.
This has resulted in South Africa’s public healthcare system having a miserable doctor-patient ratio of 0.9 per 1,000 – lower than in Brazil, Russia, China and Mexico. According to Expatica, The Western Cape’s public healthcare is a few strides ahead of the rest of the country, as its irregular expenditure is much lower than the other eight provinces. So, if you can’t afford private healthcare, perhaps this area of South Africa might be a good option for your next home?
To give you a rough idea of just how under-funded the public healthcare system is, here’s a comparison of annual expenditure in South Africa and the UK.
Data from theworldbank.org
So, if you’re moving to South Africa from the UK, swapping the NHS for the South African public healthcare might be a bit of a shock.
Roughly 39% of people agreed that “the health system frequently lets patients down” in South Africa.
Private vs public healthcare in South Africa
There are pros and cons to both healthcare options, but ultimately, expats tend to go for the private service – this way, you can experience better conditions and shorter waiting times.
South Africa has an extensive network of doctors, specialists, hospitals, and clinics in the private sector, which are often more expat-friendly than their public counterparts. Plus, around 79% of all doctors in South Africa work across 200 private hospitals in the country, meaning you’re much less likely to have a long wait to see a doctor.
But remember, though the private sector has the upper hand, it’s also come under harsh criticism for over-pricing and being monopolised by a small number of large providers. In fact, only around 18% of the local population regularly use private providers because of the price tag.
Again, it’s worth keeping an eye out for any news on the government’s National Health Insurance plans. If they are successful in introducing the NHI system, it’s likely that the private sector will be overhauled and more tightly regulated.
Benefits of private medical cover in South Africa
For a lot of expats, private healthcare is worth the money. Here are some of the key benefits that you can look forward to if you’re planning on going private:
- Shorter waiting times
- Better facilities
- Fewer shortages of medication
- Cleaner facilities
- Access to more doctors
- Coverage for any financial surprises
An areal view of the bustling city of Johannesburg: the capital of the Gauteng Province, the wealthiest province in South Africa
How much is health insurance in South Africa?
Prices of private policies will always vary and can be difficult to generalise, but on average, health insurance in South Africa can cost from R1,000 (£46) to R2,000 (£93) per month for a family of four. If you’re after comprehensive cover, or you’re above 55, you’ll probably need to pay a little more each month.
There are ways around the price tag, however, with many companies, retirement groups, and other organisations offering lower rates. If you’re moving to South Africa for work, your company might cover the costs, since some employers offer to pay 50% of key employees’ health insurance costs.
More info for expats moving to South Africa
Hopefully you’re now feeling a little more clued up on South African healthcare. If you’re moving to this country, you should consider whether you would rather settle for public healthcare, or upgrade to the private service and ensure that you can give your family the best treatment.
Although it is a much pricier option, the standards of the private service really are miles ahead – you can sleep easy knowing you’re putting the health of you and your family first. Plus, it doesn’t necessarily need to break the bank – you just need to make sure you get the right insurance provider.
To find out exactly how much private medical cover will cost you in South Africa, you can start building a plan with Cigna today.
In the meantime, why not get a little more familiar with your new home?