Health Coverage & Insurance for Expats in Cape Town & South Africa
South Africa’s health coverage consists of parallel private and public sectors. The public system is chronically understaffed and underfunded and was powerfully affected by the nationwide brain drain that followed the 1994 elections.
In addition, while the ruling ANC party is pushing to pass a bill for universal health insurance, the bill’s actual passing into law will probably not be approved until the distant future, and not really feasible considering the current dilapidated state of public hospitals. At present, the government only spends around 3.1 billion U.S. dollars on a population of 35 million people.
The result is that public hospital patients are forced to pay for their treatment on a ‘means tested’ basis, a sliding-scale system of calculation that factors in income and number of dependants. In other words, if you can afford to pay for it, you’re going to pay for it, even if doing so requires you to drastically curtail your lifestyle. If not, it will be partly or entirely funded by the government with funds sourced on a federal (20 per cent) and provincial (80%) level. (This applies to locals and residents, so if you’re only in South Africa for a visit you may be forced to foot the entire bill. Applicants for student visas will find that they are required to have South African medical coverage for the duration of their stay so that they don’t become a burden on an already floundering system). Furthermore, general and dental check-ups are not provided for by the state.
Meanwhile, private healthcare spends around 36.5 billion dollars on the 7 million people who can afford to subscribe to medical aid schemes. It has around 24,000 beds compared to the government’s 110 000, and 50 MRI scanners to the government’s meagre 4.
The private system was recently ranked 39 out of 162 countries by the United Nations for its technological achievements and innovations. In fact, South Africa is known as a sort of medical tourism destination, with many visitors flying in for the sole purpose of getting surgery, from the crucial to the cosmetic, at relatively inexpensive rates (due to the country’s weak currency).
The verdict: South Africa’s private hospitals are far superior in terms of the quality of treatment they offer, and the only way for most people to afford treatment in them is by virtue of a comprehensive medical aid scheme. Medical aid schemes in South Africa do not tend to be affiliated with particular doctors, hospitals or hospital groups, and as such will cover you for treatment in any hospital, and by any doctor – provided, of course, that your scheme is sufficient to pay the fees. As such, it’s not necessary to register with a hospital before you need one.
Most companies offer to pay 50 percent of their employees’ health insurance premiums. If you’re working for a local firm it can help greatly with making health insurance fees, which have grown quite hefty in the past few years, less of a financial burden.
Local Health Insurance
If you take out a local medical aid scheme, it should at the very least provide cover for accidents and injuries. Often the young and fit take out only limited coverage (restricted to a list of about 50 conditions). Common schemes for older people are those providing 80% coverage (you’ll need to pay the remaining fifth of the bill out of pocket).
The largest medical insurer in the country is Discovery Health, which at present has around 1.5 million subscribers, and owns a claim payout record of AA, the highest possible in the industry. That said, its prices continue to grow in sync with the rising costs of private healthcare in South Africa. An annual increase in premiums of 12 to 15 percent is considered normal.
There are also numerous smaller health insurance providers in the country. They include:
- Fedhealth Medical Scheme (http://www.fedhealth.co.za/)
- Resolution Health Medical Scheme
- Momentum Health Medical Scheme (http://health.momentum.co.za)
- Genesis Medical Scheme (http://www.gmed.co.za/)
- Medihelp Medical Scheme (http://www.medihelp.co.za/)
- Oxygen Medical Scheme
- Profmed Medical Schemes (http://www.profmed.co.za/)
- Bonitas Medical Scheme (http://www.bonitas.org.za/)
- Liberty Medical Scheme (http://www.libmed.co.za)
- Multimed (http://www.multimed.co.za)
- Selfmed (http://www.selfmed.co.za)
Pricing
Below are price ranges for two different companies for the benefit of price comparisons.
- Discovery ranges in its offerings from the Executive Plan at the top end to the minimal Delta Plan.
The Executive Plan provides comprehensive coverage, including chronic disorders. It charges R2601 for the main member, the same for any adult dependants, and R496 for additional children. For its full benefits, visit http://bit.ly/EedWx.
The Delta Plan charges premiums at a rate of R812 for the main member, R609 for adult dependants, and R324 per additional child. For the full benefits of this plan, visit http://bit.ly/qLQDf.
For a comparison of Discovery’s health plans, visit http://bit.ly/WrfV1.
- Selfmed works out a bit more expensive at the top end, and about the same at the bottom. Its comprehensive 80% plan is charged at R3180 for the principal member, R2755 for adult dependants, and R549 for children.
Its MedXXI Hospital Plan, on the other hand, is charged at R779 for the principal member, R719 for adult dependants, and R439 for adult dependants.
For the benefits of these and other Selfmed schemes, visit http://www.selfmed.co.za/benefits09.aspx.
International Health Insurance
There are also numerous foreign health insurance companies that offer coverage for people residing in South Africa. Expats in Cape Town and other parts of South Africa can obtain an international health insurance quote via our website:
The companies that can be quoted via our site provide special coverage to expatriates, including evacuation and repatriation cover in the event of injury or illness. They offer widely different levels of insurance, so keep in mind that it’s advisable to have coverage of at least R5 million a year at current private hospital rates. If you get a quote via our site, you will receive a link to a very informative global health insurance guide!
The cost of the coverage provided will also vary greatly with the age at which you enroll. With many companies, you’ll need to be signed on by age sixty to have any coverage into your old age. For this reason, if you’re already covered by a non-South African company, you may want to look into ways to extend that policy to incorporate South Africa, rather than taking out an entirely new insurance plan.
