Health Insurance in South Africa

You need health insurance in South Africa.

The country’s health system comprises a growing private health care sector and a large public sector. Health insurance ranges from very basic primary health care insurance, which is free from the state, to special services available from both sectors.

Public and private sector

When it comes to the public sector, health insurance in South Africa is somewhat stretched and under-resourced.  The state contributes approximately 40% of all expenditure on health. However, the public sector needs to deliver services to nearly 80% of the country’s population.

However the private sector is typically run by commercial medical aid schemes who offer medical aid and life insurance to middle- and high-class income earners. There are schemes however who do cater for low income earners.

Health insurance in South Africa

So what is health insurance in South Africa? In a nutshell, health insurance is cover for various in and out of hospital treatments. It also cover medications and in certain instances eye care and dentistry.

Various schemes offer an array of plans to suite pockets and needs – from basic hospital plans that cover major treatments in case of emergencies and illnesses to top of the range plans that cover Health Insurance in South Africahospitalization, chronic medication treatment and care, dentistry, optometry as well as value added benefits like savings accounts and discounts when it comes to health-related activities like joining a gym or quitting smoking.


Improving healthcare

The Department of Health, however, is now focusing on implementing an upgraded health system in the country. The emphasis on public health.

They aim to improve hospital infrastructure as well as human resource management. That is, while procuring the required skills and equipment to provide the country with top-class health care.

Upgrades are on the way for health facilities such as nursing colleges and tertiary hospitals. In fact, the aim of the National Health Insurance is to improve overall service provision and delivery in the industry. At the same time, it should promote efficiency ensure that citizens have access to affordable and quality health care.

Plan for the future

The plan won’t be a quick fix though – it has been planned to be implemented over a period of 14 years and a sum of R1 billion has been earmarked for the process. Overall, the plan is to make health insurance more affordable to all South Africans.

With the number of poverty-related diseases in the country, such as Aids and tuberculosis as well as cholera, citizens cannot be without health cover. Such diseases are placing an enormous amount of strain on the health care system which sees the necessity of NHI.

Other health issues

Child health is another big concern in the country and immunization is imperative against death and disease. The government has taken various measures to improve child health care whilst expanding and strengthening school health services as well as establishing teams of district clinical specialists.

For now though, health insurance is a must in order to be able to cover instance of in-hospitalization, chronic medication if necessary and various other health care requirements.

Choosing the right medical aid scheme and plan needs to be carefully considered and members need to ensure that they fully understand what is and is not covered in their chosen plan.


All info was correct at time of publishing