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Healthcare in South Africa is very much divided along socioeconomic lines. A massive gap in quality exists between the private and public sector and, in practice, these systems cater to different populations. The public healthcare system mainly serves a lower income bracket, while those who can afford it use the private healthcare system.
It's strongly recommended that expats take out health insurance and opt for treatment in private facilities, which generally provide world-class levels of care.
Public healthcare in South Africa
Much of the South African population uses the public healthcare system, which is heavily affected by a lack of resources and funding. The system is not yet universal, although fees are charged according to a patient's income and number of dependants.
Public hospitals, though usually manned by highly qualified professionals, are often poorly maintained. Expats will find minimal creature comforts, and will likely come across long queues, dingy exam rooms and overworked staff members.
Private healthcare in South Africa
In contrast to the public health sector, South Africa's private health sector is excellent. Most cities and towns have a good selection of clinics, hospitals and general practitioners.
The standard of treatment in South African private hospitals is some of the most highly regarded on the continent, and in the opinion of many expats, on par with that of Europe. The medical tourism industry has shown steady growth, and many foreigners travel to South Africa for plastic surgery and dental work.
That said, private healthcare in South Africa comes at a price, especially for those earning a local salary. Although it's possible to pay per treatment, medical costs can quickly add up.
Expats should take out private health insurance to protect against the hefty bills that accompany emergency situations, repeat consultations and specialist treatment.
Health insurance in South Africa
An assortment of local medical aid providers and international health insurance companies are available to expats in South Africa.
Local providers offer various schemes and charge monthly premiums on a progressive scale. Most local health insurance providers in South Africa require claims to be pre-authorised, a stipulation which makes it necessary for people to keep their medical aid card in their wallet.
Insurance plans can either be comprehensive, covering a range of services, or more basic, serving as backup in the case of an emergency. While hospital plans cover the cost of ambulance transport and hospital stays, these are essentially emergency plans which don't cover day-to-day medical expenses such as doctor consultations and treatment, dental treatments, and prescription medications.
Expats interested in getting coverage for day-to-day expenses should compare the different packages offered by local insurance providers. Alternatively, expats may opt to use international insurance providers. Emergency evacuation insurance is unnecessary, as private South African facilities are adequate.
Pharmacies and medicines in South Africa
Pharmacies are readily available in urban centres and are generally well stocked, but expats travelling to outlying rural areas for extended periods should pack basic medications. Those living in rural areas may need to travel to larger towns to fill prescriptions.
Health hazards in South Africa
Contrary to popular belief, malaria is not a wide-scale problem in South Africa. But there is a narrow high-risk area that stretches across the extreme northeast of the country along the borders with Mozambique, Eswatini (formerly Swaziland) and Zimbabwe where taking anti-malarial medication would be wise in peak season. It should be noted that the Kruger National Park is considered a moderate-risk area.
The tap water in South Africa's cities and towns is generally safe to drink and often of good quality, but caution should be exercised in rural areas.
Though decreasing, prevalence rates remain high for HIV/AIDS, but expats who take appropriate precautions against the disease need not be concerned.
Emergency services in South Africa
Public ambulance services in South Africa are run provincially, and standards and response times vary. The close cooperation of fire and ambulance services is the norm, although they are technically separate entities. Emergency paramedics are employed by the government and often work with volunteers, especially in outlying areas.
The South African Red Cross and St John's Ambulance are run by volunteers and supplement the national system. There are also two private, profit-making national ambulance services, ER24 and Netcare 911, which are contacted via their own emergency numbers. Health insurance providers will have a preferred ambulance service and provide their customers with the corresponding contact numbers.
Ambulance contact details
Public ambulance services: 10177
Netcare 911: 082 911
ER24: 084 124
►Frequently Asked Questions about South Africa addresses common expat concerns
"Private hospitals are excellent and on or above European standards. I had to visit our local hospital a few times and the treatment was an extremely positive experience, and the friendliness and efficiency of all the staff was amazing. You have a problem if you have to use public healthcare though." Read more about German expat Arnd's experience in Johannesburg.
"I find South African healthcare to be excellent, convenient, and affordable. You can walk into a private medical clinic and get an appointment quickly, for much less money than in the United States." Heather shares her healthcare experiences in South Africa.
Are you an expat living in South Africa?
Expat Arrivals is looking for locals to contribute to this guide, and answer forum questions from others planning their move to South Africa. Please contact us if you'd like to contribute.
Expat Health Insurance
If you’re thinking about taking out private health insurance, our trusted partner Cigna Global is very aware of all the difficulties that expats can face when it comes to healthcare in a new location, so they have created a range of international health insurance plans specifically designed for expats, which you can tailor exactly to the needs and ensure access to quality care for you and your family.
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