What is Private Health Insurance?
Private health insurance refers to any health insurance coverage that is offered by a private entity instead of a state or federal government. Insurance brokers and companies both fall into this category.
Private Health Insurance In South Africa
Who should get private health insurance in South Africa?
More than half of the healthcare budget in South Africa goes towards private services. With this in mind, some of the best doctors and specialists who train in Western countries use their expertise solely in the private sector; thereby increasing the service gap between state and private healthcare.
Opting for private healthcare means you will be able to attend specialised clinics with a better standard of care and shorter waiting times.
The advantages of getting private health insurance coverage in South Africa
If you have a private healthcare insurance policy in your home country, it might not work in South Africa unless it is specifically designed for expats.
In this instance, you can speak to your insurer about switching to an international cover policy for when you move to South Africa. Alternatively, you can start up a new local policy once you move.
Ideally, a private policy should cover you for medical costs in South Africa, your home country, and any medical evacuation costs; as these can be very expensive if you have to pay for them yourself.
If your trip to South Africa is only a temporary one, you may be better taking out travel insurance; make sure this provides a sufficient level of coverage for your stay.
How does private health insurance work?
Private health insurance providers in South Africa are regulated by the Medical Schemes Act, and healthcare packages are available for individuals and families.
In some industries, health insurance is offered as an employee benefit, with the costs shared between the employer and employee.
Some insurers prefer their customers to give notice before getting treatment, and your provider might offer rewards if you lower their likely liability by exercising or having regular medical check-ups.
With so many different options available, it is important that you take your time to find the right provider; some have a better reputation when it comes to paying out than others. Once you have signed up for a plan you should get a healthcare card; you will need to show this when applying to see doctors or specialists.
How to choose a health insurance provider
When choosing a company, it is important to make sure that you have long-term coverage; one-year contracts can be troublesome because your insurer could refuse to renew the contract if you become unwell.
Also, make sure to steer clear of companies that reserve the right to cancel policies if you have a serious illness; instead, choose one with a longer period under which you can’t be excluded.
Healthcare plans in South Africa will cover care up to a certain cost each year. These vary significantly in their terms, however, from those covering emergency issues through to comprehensive plans which, in some cases, include dentistry in South Africa. You may find that some healthcare plans include more coverage than you are likely to need; therefore, shop around for the best health insurance quotes to meet your individual needs.
In addition to checking your coverage, get your head around how premium scales work and what excess charges you will have to pay if you become unwell. While premiums can often paid either monthly, quarterly or annually, some companies will ask for a year’s payment upfront.
If you are in good health, it may be worth getting a scheme where only specialist and hospital treatment is covered, meaning you pay the small charges to see your South African doctor and get prescriptions yourself. Before you take out a plan, you will need to fill out forms and provide details of your medical history; this includes information about any pre-existing conditions.
Private health insurance companies in South Africa
Some of the largest private health insurance companies in South Africa include:
- Allianz Care
- Cigna Global
- Globality Health
- William Russell
Health insurance costs and reimbursements
As an expat living in South Africa, you are likely to have to pay towards public healthcare. Fees are payable for working residents, and the co-payment you will make for treatment depends on how much you earn.
When you receive treatment in South Africa, you will usually need to pay on the day by cash or card; then recoup the payments from your health insurer afterwards. The maximum payment you can make (assuming you are a top earner) for a consultation with a doctor is R55; however, you will also need to pay for any tests and treatment on top.
These fees might seem low, but for a hospital stay this rises to a maximum of R485 a day, plus any treatment or operating costs. With this in mind, it is helpful to arrange health insurance before you move to South Africa.
How much does private health care cost in South Africa?
Private consultation costs are around R350-400, compared to around R55 through state healthcare. If you have private health insurance, you will be able to choose your own doctor.
You will also likely have a shorter waiting time for an appointment and should be able to access specialist healthcare without a referral.
What is the best health insurance in South Africa?
These are the top-tier schemes that typically have unlimited hospital cover, and comprehensive day-to-day benefits.
Hospital Plans.
| Scheme | Cost for principle member |
|---|---|
| Discovery Health Keycare Core | R665 – R1 281 |
| Genesis Private Choice | R950 |
| Momentum Custom Option 1 | R1 152 |
| FedHealth Entryzone | R1 179 |
Is there private health insurance in South Africa?
The South African healthcare system boasts both public and private hospitals. Expats and higher earners generally take out private health insurance to benefit from better conditions and shorter waiting times.