Healthcare in South Africa | What You Need to Know

South Africa’s healthcare is rated the top healthcare system in Africa, ranking 49th out of 89 countries in the 2024 Global Healthcare Index. Offering both public and private healthcare, South Africa can provide quality health services that suit both your needs and your budget.

With the hopeful implementation of the National Health Insurance (NHI) on the horizon, healthcare in South Africa is only going to get more accessible and affordable.

Here’s everything you need to know about healthcare in South Africa

Healthcare in South Africa Overview

South Africa presents a two-tier healthcare system — a public healthcare system and a private healthcare system. Unfortunately, there is still a massive gap between public and private healthcare in South Africa due to a major difference in funding, resources and support.

With public healthcare being subsidised by the government, most South Africans opt for the public system. However, those who can afford it know that the quality, convenience and care of the private system are worth the extra costs.

Public Healthcare

South Africa offers comprehensive and extensive public healthcare. South Africa’s public healthcare system is used by 84% of South Africans with over 400 public hospitals across the country.

The South African public healthcare system is available to everyone — all citizens, immigrants, refugees and asylum seekers. It works by subsidising up to 40% of the medical costs. But while South Africa does not currently offer free healthcare, this may become a reality in South Africa with the implementation of the National Health Insurance (NHI)

Unfortunately, many public hospitals are underfunded and understaffed, leading to long waiting times, outdated equipment and overcrowding. That’s not to say there are excellent and competent public hospitals out there — the first-ever heart transplant was performed at Groote Schuur, a major public hospital in Cape Town.

Private Healthcare

South Africa offers an excellent private healthcare system with over 200 private hospitals across the country. They provide you with state-of-the-art equipment as well as the top doctors and specialists in South Africa

Offering much better pay, private hospitals employ 79% of doctors in South Africa, despite serving only 16% of South Africans. The three major private healthcare providers with private hospitals in every corner of South Africa include:

• Netcare

• Life Healthcare

• Mediclinic

With private healthcare, you can expect the best of the best, but you can also expect a very high price tag. That’s why most private healthcare users opt for health insurance.

Cost of Healthcare in South Africa

The cost of healthcare in South Africa greatly depends on whether you’re opting for public or private care healthcare.

Because private healthcare is subsidised up to 40% by the government, costs tend to be very low. For example, a doctor’s consultation may cost around R55. Using the Uniform Patient Fee Schedule (UPFS) to manage patient billing, medical costs are calculated based on the patient’s income and family size.

On the other hand, private healthcare can cost between R300 - R400 for a doctor’s consultation. However, depending on your medical aid plan, most of your medical costs can be covered with approval from your health insurance provider.

However, things are set to change by 2026 with the hope of the NHI which will be able to provide free healthcare services for all South Africans.

Health Insurance in South Africa

If you can afford it, health insurance is an essential in South Africa, giving you access to top-quality and convenient private hospitals and healthcare.

Some of the top health insurance providers in South Africa are:

• Discovery

• Momentum

• Bonitas

• MediHealth

• MedShield

• Fedhealth

Most health insurance providers offer different types of medical aid, such as:

• Hospital Plan

• Hospital Plan with Savings

• Income-Based Plan

• Semi-Comprehensive Plan

• Comprehensive Plan

The cost of health insurance, depending on your medical aid plan, can cost on average between R5 500 - R18 000 for a family of 3. But health insurance costs will depend on a multitude of factors, including age, medical history, BMI, lifestyle habits, geographical location, occupation and your chosen health insurance plan.

NHI South Africa

In June 2023, South Africa passed the National Health Insurance (NHI) Bill. This could mark a major turning point in South Africa’s healthcare system, as its purpose is to provide universal, free healthcare to all South Africans, bringing equality to South Africa’s divided healthcare system.

How Will NHI Work?

NHI is essentially a fund that is financed by taxes. With this fund, NHI works by purchasing healthcare services for NHI-registered users from healthcare providers both in the public and private healthcare sectors.

So if you’re feeling unwell, you can go to your nearest NHI-accredited healthcare provider, receive the medical attention you require and not worry about any of the costs. The government covers the medical costs by paying the NHI-accredited healthcare provider a set rate.

When Will NHI Be Implemented in South Africa?

The NHI has been signed into law by President Rhamaphosa on 15 May 2024 and the aim is for it to be fully implemented by 2026. It will be carried out through multiple phases over the next few years. Critics believe that it could be decades before it's fully implemented.

Who Will be Covered by NHI?

With the goal of universal healthcare for all, NHI will cover the medical costs of everyone, including South African citizens, permanent residents, refugees, inmates and specific categories of foreign nationals. And, especially, unemployed people.

How Do I Register for NHI?

Once NHI is officially implemented, you’ll be able to register when you visit an NHI-accredited healthcare provider for the first time. Here’s how registration will work:

1. Visit the nearest NHI-accredited healthcare provider for the first time.

2. Bring your ID card, passport or other identity document.

3. Your fingerprints will be taken to register you in the NHI system.

4. You won’t have to pay any registration fee or medical costs for your visit.

5. Once you’re registered and have completed your first visit, you must bring your proof of identity to every following visit at an NHI-accredited healthcare provider.

Advantages and Disadvantages of NHI in South Africa

While NHI promises incredible things for the South African healthcare system, many are concerned that it may do more harm than good, depending on how it is implemented.

Here are the main advantages and disadvantages of NHI in South Africa:

Pharmacies in South Africa

Pharmacies are very accessible across South Africa, with the major chains being Clicks, Dis-Chem and Medirite. Plus, most areas have their own pharmacy at their local shopping mall.

Medication from pharmacies in South Africa is relatively affordable due to the government fixing the pricing, but you will find that prices can vary slightly depending on the pharmacy and area. You can use the Medicine Price Registry to search the estimated price that your medication should cost.

Most pharmacies will also have a small clinic or in-house nurse that can administer vaccinations and have consultations.

Emergency Services in South Africa

South Africa offers top-quality and responsive emergency healthcare services in the public and private sectors.

To access public emergency services, you can call:

• 10111 — Nationwide emergency response

• 10177 — Ambulance response

Private healthcare providers will have their own emergency services. So if you’d prefer private emergency services, you can call:

• (+27) 82 911 — Netcare 911

• (+27) 084 124 - ER24

South Africa also has national mental health emergency services, such as:

• (+27) 086 132 2322 — National Crisis Line (LifeLine)

• (+27) 011 234 4837 — Mental Health Line

Conclusion

While there is definitely lots of room for improvement and major work still to be done in the public sector, South Africa definitely proves itself as the top healthcare system in Africa.

South Africa’s world-class private hospitals provide top-quality care with speed and convenience. With the promise of the NHI on the horizon, the public sector is set to change, bringing more equality into South African healthcare and making it more accessible and affordable for all.

It’s exciting to see the massive leaps the South African healthcare system will take in the next few years and completely change the game!