South Africa Expat Health Insurance Guide
If you are planning on visiting or living in South Africa it is important that you understand the healthcare system it has in place. Unlike many countries around the world which have little discrepancy between public and private healthcare services, this is not the case in South Africa. The public healthcare is mainly used by those from a lower-income bracket, whilst those with a higher income tend to use the private healthcare facilities.
We’ve put together a complete guide to health insurance in South Africa to help you ensure that you can get the treatment you need while away…
Is Healthcare Free in South Africa?
Public healthcare treatment is not free in South Africa and fees are charged based upon a patient’s income and number of dependants. Many of South Africa’s public facilities lack resources and funding so will experience overcrowding, lack of modern equipment, basic facilities and overwork staff.
Who is Eligible for Healthcare in South Africa?
Anybody visiting or living in South Africa can receive healthcare. The majority of cities and towns have a number of clinics and hospitals but expats in more rural areas may have to travel some distance to receive treatment.
Most expats living in South Africa take out comprehensive healthcare insurance to ensure they can utilise private medical facilities and avoid the crowded and ill equipped public hospitals.
Coverage from Employers
Many expats moving to South Africa will be migrating due to an opportunity from an employer. Some companies, when they relocate an employee, will cover health insurance fees. If you are moving to South Africa for work it is worth discussing health insurance cover with your employer.
Moving to South Africa
South Africa is an extremely geographically diverse country, ranging from the wild savannahs of Kruger National Park, to the vast cities of Pretoria, Johannesburg and Cape Town. It is a beautiful and intriguing destination, offering plenty of opportunities for expatriates settling there.
The country is known as the Rainbow Nation, for its rich tapestry of ethnicities, with people from India, France, The Netherlands, Germany and Malaysia all calling South Africa home. However vibrant and positive the population seems now, South Africa suffered immensely under white minority rule during apartheid between 1948 and 1994. Despite the abolishment of apartheid, segregation can still be seen in the country today.
Whether you’re moving to South Africa to work in a busy metropolis, study nature in the expansive open spaces or take a university course, there’s plenty to learn about the country before you pack up your bags and board the airplane.
South Africa’s triangular shape, engulfed by ocean on two sides, affects the weather of the country greatly. South Africa is a subtropical region and the temperate conditions that are so popular with visitors are due to the sea border and altitude of the interior plateau. The Atlantic Ocean to the west and Indian Ocean in the east meet at Cape Agulhas, the southernmost tip of the continent.
Many head to South Africa to bask in its glorious sunshine. On average, the country receives 464mm of rain per year. Considering the world average is 860mm, you can be sure that you will spend the majority of your travels or expat life enjoying the blissful rays of the sun.
Due to South Africa’s altitude, you will not receive the same temperatures of countries on a similar latitude, such as Australia. Due to its elevated position above sea level, the temperature drops by a few degrees compared to similar countries. For example, Johannesburg lies 1694 metres above sea level but average summer temperatures are usually a comfortable sub 30°C. However, this also means that night-time temperatures in the winter can drop below freezing.
Due to South Africa’s location in the southern hemisphere, the seasons are the opposite to those in the northern hemisphere. So, Christmas is often enjoyed on the beach!
Winter in South Africa tends to span from May to July and the interior plateau receives sunny, crisp days with heavy morning frosts. In the highest areas of the Western and Northern Capes, it is extremely cold and heavy snowfall is not abnormal. The Western Cape, in general, tends to receive heavy rainfall throughout the winter which can cause flooding and damage from high winds. However, even the mediocre winter days in South Africa rival the best days of summer for those who live in the UK!
Summer in South Africa is exactly how you would picture it; hot, sunny days with the occasional sharp afternoon thunderstorm that quickly clears. Summer lasts from mid-October to mid-February.
Rainbow Nation, the term coined by former Archbishop Desmond Tutu, perfectly describes South Africa’s multicultural diversity. Black South African’s make up 80% of the population. However, the remainder is made up of Afrikaans and English speakers due to the country’s colonial history, as well as Indians, Germans, Portuguese, and French.
Art, dance, and music are the foundations of traditional African culture. Amongst the many different ethnic groups of native South Africans, Zulu and Xhosa people are the largest tribes. However, Pedi, Sotho, Tswana, Tsonga, Swazi, Venda, and Ndebele are all active communities. Each different tribe has its own unique traditions, with stories and poems being shared from generation to generation.
Despite the vibrant culture in South Africa, there are aspects of the country that can be a real culture shock to foreigners. Many visitors are taken aback by the country’s glaring wealth disparity and racial segregation. Despite apartheid being eradicated over twenty years ago, there is still a painfully obvious divide between black and white citizens. This is only further perpetuated by 60% of top management positions in South Africa being filled by white citizens, and 45% of black South Africans being unemployed, compared to only 5% of white nationals. Inequality is very prevalent in South Africa and it is often something foreigners rarely get used to.
South African people are extremely welcoming and warm and at the cornerstone of South African culture is family. For many expats, the term ‘family’ rarely extends beyond the nuclear. However, in South Africa, this includes the extended family or the entire tribe. This warmth and inclusion can often have expats considering their way of life and how they interact with their family and friends.
For those who have never visited South Africa, many assume that the most widely spoken language is Afrikaans. However, the West Germanic language spoken by Dutch settlers is spoken by only 13.5% of the population. The Rainbow Nation has 11 official languages and numerous unofficial dialects. English is most commonly spoken in official or businesses circumstances but tends not to be used at home, although it is understood by most of the population.
The majority of South African people are multilingual but the most widely spoken language is IsiZulu but it will really depend on where you live or visit. In the Eastern Cape you will mostly hear IsiXhosa, whilst in KwaZulu-Natal, IsiZulu is the common language.
The traditional tongues of South Africa are often split into two language families; Nguni and Sotho. Sotho includes Setswana, Sepedi, and Sesotho. Whereas Nguni includes IsZulu, IsiXhosa, SiSwati, and IsiNdebele.
If you are visiting or moving to South Africa, take a look at our handy guide below to help you started in picking up one of the widely spoken languages of the nation.
|How are you?||Unjani?||Unjani?||Hoe gaan die met jou?|
|I am fine, thank you||Ngisaphila, ngiyabonga||Ndiyaphile, enkosi||Goed dankie|
|Goodbye||Hamba kahle||Hamba kakuhle||Totsiens|
If you have the budget, purchasing a car as an expat in South Africa can be a viable option. It is worth remembering, however, that whilst petrol and diesel prices are low the price of cars is high. Furthermore, dangerous driving is the norm and some roads are pothole ridden. However, if you are ready to take on the chaotic roads of South Africa, you can legally drive using your own country’s driver’s license as long as it is valid and has a photograph.
Another option, if you are determined to hit the roads, is to rent a car. This is a relatively inexpensive option and major car rental companies are well represented at main airports and within cities. However, for long-term car rentals, it is best to visit a local dealership in your vicinity.
Buses are a great option for those wanting to travel long distances and companies such as Greyhound, Intercape and SA Roadlink will be able to help you travel from city to city. Local bus routes, even in major cities, tend to be limited. Cape Town has a bus service called MyCiTi which offers a shuttle service between the airport and the city centre, but the regular buses aren’t reliable.
The main form of public transport in South Africa is minibus taxis; a hybrid service that is a cross between a bus and a taxi. They are run on informal routes and they can be hailed down at the roadside. Despite their popularity with South African citizens, they are rarely used by expats as they are cramped, often look unroadworthy and are prone to accidents.
Outside of Johannesburg and Cape Town, train services are sparse. In Johannesburg, the high-speed Gautrain has been in operation since 2010 and provides reliable, clean, and safe travel. However, unless you live near one of the stations, it isn’t a viable mode of city transport yet. However, if you are living in Cape Town, their Integrated Rapid Transport trains (IRT) run on an extensive network. They are used mainly by commuters and are championed for their punctuality and inexpensive fares. They also run cohesively with the MyCiTi shuttle buses.
For expats and tourists who want to explore South Africa but do not want to be stuck on a long-haul bus journey, hop on one of the luxury trains in Cape Town or Johannesburg. It is not a cheap way to travel but it is very comfortable and, if needed, you can take your car aboard. It is a great way for visitors to discover South Africa’s magnificent landscapes.
Like many countries, South Africa has a large public sector healthcare system. However, a small but fast-growing private sector also exists, which offers specialised treatments and high-tech equipment.
The public system offers all patients basic primary care, but it is also extremely stretched and under-resourced. This is not helped by the burden placed on the system by the serious challenges of an HIV epidemic and tuberculosis (and visitors and expatriates should take precautions to avoid catching these diseases themselves). In addition, there’s a shortage of key medical personnel across the country, particularly in more rural areas.
In response to the country’s public healthcare issues, the government is working to restructure the system and revitalise it. Plans include implementing a National Health Insurance scheme, as well as upping the fight against diseases, injury and violence and improving human-resource management. In addition, healthcare teams will be deployed to underserviced areas and schools, while costs will become more regulated.
Although the country is taking some big steps to improve its system, it’s generally recommended that those who travel to South Africa or move there permanently take out international healthcare insurance, as this will help to mitigate the costs, and ensure an excellent level of care.
Before 31st May 1961, South Africa were still using the money of Britain forced upon the nation through colonialism. However, South Africa became a republic in 1961 and the South African rand that we know today was put into circulation. Often abbreviated as ZAR or R, the rand is subdivided into 100 cents. Currently there are five rand notes in circulation; R10, R10, R50, R100, and R200. Coins include R1, R2, R5 and 5c, 10c, 20c, and 50c.
The four major banks are ABSA, First National Bank, Standard Bank and Nedbank. However, many expats choose to open a bank account with a bank that has an international presence such as Barclays, NatWest, HSBC, or Lloyds. Investec and Old Mutual are actually two banks with an international presence that are based in South Africa. It is best for expats to seek advice from their current bank, or potential provider, with regards to different accounts and set-up.
Most main banks will have ATMs dotted throughout South Africa. Expats should be aware that they can use any ATM, regardless of which bank they are with, but there may be fees involved.
South Africa has a three-tier education system: primary school, secondary school and tertiary education. In recent years, South Africa has made some excellent advances towards improving education across the country – such as by introducing technology and creating schools that specialise in academic areas like business, commerce, engineering, arts and culture. Typically, school lasts for 12 years and the first nine are compulsory. Grades 10, 11 and 12 are optional and for entrance to university. Many of South Africa’s universities are recognised as world-class institutions and a number of them are on the cutting edge of research in their areas of expertise.
Standards in public schools vary immensely throughout South Africa as each province is responsible for their own educational budget. Overall, due to lack of finances and monitoring from the government, many children in public schools receive low standards of education. In some of the bigger cities, some of the public schools are of a better quality. Generally, wealthier areas have better schools that meet the requirements of some expat families. It is a great way for children to make South African friends and immerse themselves in a new culture.
Aside from the families who live in wealthier areas and benefit from great public schools, many expat parents tend to send their children to private or international schools. Fees for international schools are higher, but both options offer internationally-recognised exams and excellent teaching facilities. Interestingly, children who attended private or international schools in South Africa have excellent acceptance rates into further education worldwide.
Home-schooling has become increasingly popular with expat parents wanting to educated their children in South Africa. For expat parents to be able to teach their children at home, they must apply to the head of the relevant provincial Department of Education and register their child. The lessons parents offer must follow government guidelines and records of the child’s coursework and grades must be scrupulously maintained.
Food & Drink
Cuisine in South Africa is mostly influenced by the indigenous population. However, French, Dutch, Indian and Malaysian flavours also grace many of the exciting dishes. South African food is famed for being high nutritious and exceptionally tasty.
If travelling or living in South Africa, you will soon become au fait with traditional braai. Braai is a South African barbecue that is usually a hit with the carnivores amongst us. Meat makes up a huge part of the South African diet and a popular method to preserve meat is by dry curing it. Beef or game, such as springbok, biltong and droewor sausages are traditionally eaten as snacks as they are high protein and low fat. Biltong is now available in many other countries and is a thinly sliced air-dried meat. A take on the traditional droewor sausage is the boerewors. They are incredibly fragrant coiled sausages made of pork, lamb, or beef and laden with spices.
The national dish of South Africa is bobotie and it is very similar to moussaka. Typically, spiced beef or lamb is mixed with dried fruit and laid into a baking dish, before an egg based topping is applied. Many South African households and restaurants create different versions of bobotie based upon their favourite meats, fruits, and spices.
Another favourite with the South African population is the South African meatball, or frikkadel. Taking influence from Dutch settlers, beef or lamb mince are laden with onion, bread, eggs, vinegar and spices before being baked or deep fried. They are presented on a stick, much like the South African version of a kebab, soastie.
If your palette craves curry and spice, do not turn down the offer of a Cape Malay curry. In the 17th century Dutch and French inhabitants brought across slaves from Indonesia, India and Malaysia. This meant that South Africa was influenced by their traditional cooking methods and ways of spicing. Your favourite meat can be mixed with cinnamon, saffron, turmeric, and chilli and served on a steaming mound of fragrant rice.
If you need something to wash all this heart fare down with, chances are you will be offered a beer. South African’s are keen beer enthusiasts and their own brew, Castle lager, is American in style. However, if anybody offers you mampoer, run for the hills! Mampoer is a powerful homemade brandy, often referred to as firewater. It is essentially moonshine and it is typically brewed by African women.
For something non-alcoholic, ginger beers, fizzy pop and rock shandy (lemonade and a sweet pink liquid) are readily available. Amasi is a thick soured milk with an acquired taste but is fantastic for digestive health. Lastly, rooibos or redbush tea is drunk by the bucket load and usually served black with lemon or honey.
South Africa has a high threat of terrorism and above average crime rates. There is considered to be an elevated threat of terrorist attacks against British nationals from those motivated by the conflict in Iraq and Syria. However, attacks could be indiscriminate and foreigners should be vigilant when visiting Johannesburg and Cape Town.
Rape and murder are commonplace in South Africa but violent crime against foreigners generally tends to be low. The South African government take great care in protecting tourists and expats, with most large towns and cities having dedicated ‘tourist police’. The majority of violent crime takes place in South Africa’s townships; generally undeveloped urban areas that, until the end of apartheid, were lived in by only black South African and Indian citizens. However, expats and tourists should always be vigilant in popular or crowded areas.
A crime that could affect foreigners living in South Africa is home burglary. Although levels of robberies and burglaries have remained stable, they are well above the international average. Many expats who live in South Africa invest in electric fencing, guard dogs, and armed response security providers to help them feel safe. However, the vast majority of expats live in highly-protected suburban estates that have controlled access, and crime levels in these neighbourhoods is virtually non-existent. However, despite the abolishment of apartheid, segregation in South Africa between black and white citizens is still very present and the gated communities only add to this.
Thieves do not just target homes in South Africa. Scamming is a big issue, as is vehicle hi-jacking and luggage theft. If driving in South Africa always make sure you stick to well-lit streets and ensure your suitcases are vacuum-wrapped in plastic, particularly when flying into OR Tambo International in Johannesburg.
Expats and tourists should keep in mind the following safety precautions:
- If lost when driving, or having car trouble, contact the AA on 083 843 22
- Be aware of your surroundings and do not have any valuable items on show
- Stick to populated areas and steer clear of alleys or side streets
- Walk with purpose and plan routes beforehand: looking lost can make you a potential target
- If you find yourself a victim of robbery, comply with the criminal’s demands and do not look at them
Below are some vital numbers for expats and tourists in South Africa:
- Emergency Services from Mobile Phone – 122
- Police/Fire – 10111
- Police Flying Squad – 10111
- Ambulance – 10177
- Private Ambulance – 082 911
- Ambulance from a South African mobile phone – 122
- Tourist Crisis Incident Report – 0861 874 911
- AA – 083 843 22
- Poison Information Centre – 086 155 5777
Places to Visit
On most people’s bucket lists is a visit to South Africa. Many dream of a sun-drenched safari across the Savannah and, whilst this is a highlight of any trip to South Africa, there are valuable chances to explore its culture and history in-depth.
Kruger National Park
Undoubtedly one of the world’s most magnificent national parks, Kruger encapsulates Africa’s iconic safari animals, and then some. The incredible landscapes are teeming with incredible vegetation and over 500 varieties of bird and 137 mammals. Those who safari within the 19,485 sq km park will witness elephant, lion, zebra, cheetah, giraffe and hippo on guided tours. However, the vast network of roads can, in part, be enjoyed without a guide, on foot or bicycle.
South Africa’s Cities
You cannot visit South Africa without experiencing life in one of the four cities. South Africa has no capital, but a visit to Johannesburg, Cape Town, or the often-forgotten Pretoria or Bloemfontein. Cape Town is a beautiful seaside playground that rivals the likes of Sydney or San Francisco whereas Johannesburg is the financial and entertainment capital of South Africa. Pretoria is very stately, with a high number of embassies, monuments and museums whereas Bloemfontein (despite its size) has the feel of a country village.
Cape of Good Hope
Part of the Table Mountain National Park, the Cape of Good Hope is a rocky headland on the Atlantic coast of the Cape Peninsula. It is famed for being one of the most beautiful spots to enjoy in South Africa and many hike and walk around the Cape and watch the whales and dolphins in the ocean.
Located in Johannesburg is the incredible moving Apartheid Museum. Having opened in 2001, the museum is acknowledged as the world’s pre-eminent museum relaying South Africa’s 20th century history, at the heart of which is the apartheid story. 22 individual exhibitions take visitors through an emotional journey as they understand the racial discrimination and tyranny that the indigenous people of South Africa faced.
Dwarfing the city of Cape Town is the incredible landmark of Table Mountain. Visitors can hike to the flat top of the mountain or take to the skies in the aerial cableway. Take the cableway gives visitors unbelievable views of Cape Town, the surrounding land, and the glorious South Atlantic Ocean.