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While South Africa has the best health infrastructure in sub-Saharan Africa, access to quality healthcare is still somewhat uneven. Facilities are not evenly distributed across the country, and public hospitals often face overcrowding and a lack of resources. For these reasons, most expatriates choose to take out personal health insurance in order to get treatment in the private sector and benefit from guarantees adapted to their profile.
Currently everyone can access public healthcare in South Africa, regardless of immigration status. However, services in public hospitals are subsidised at different rates, based on the patient’s income and ability to pay. The fees for the various treatments and services adhere to the Uniform Patient Fee Schedule, with a number of services being free across the board.
In the private sector, on the other hand, the costs―which are considerably high in relation to the average income―must be fully absorbed by the patient. Private care, though, offers a much higher standard of care than the public sector, with more modern facilities and specialised services. Almost 80% of the country's doctors work in the private system, so waiting times are also much shorter.
Most expats in South Africa take out private health insurance to cover their expenses in the private sector.
Some employers offer local plans as an employee benefit. However, in order to have sufficiently comfortable coverage to suit their needs, foreigners usually opt for supplementary international health insurance. These plans will cover you outside South Africa, continue to cover you if you change employers, and provide essential benefits such as repatriation assistance, or a free medical telemedicine service.
For those living in rural South Africa, it is particularly important to choose a healthcare plan that offers emergency evacuation coverage. Rural areas of the country are poorly served by the health system, and sometimes difficult to access.
Examples of reimbursements with MyHealth International COMFORT in relation to the cost of care in South Africa in the private sector*.
*Reasonable costs in the private sector, APRIL International data 01/2022
In South Africa, primary healthcare is provided by general practitioners (GPs), often grouped in community health centres or clinics. Patients with private health insurance can choose their own GP and consult a specialist without a referral.
The quality of South African public hospitals varies, with those associated with universities providing the best care (they are located in Cape Town, Johannesburg, Durban, Mthatha and Bloemfontein). However, these hospitals generally have very long waiting times, as they look after the health of about 80% of the country's citizens.
The country's 215 private hospitals are much more widely available and provide access to care and services close to international standards. Mediclinic and Netcare are the two largest networks.
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