Yes. As a foreigner planning to live in South Africa for a longer period, you can join a medical aid scheme, provided you hold a valid passport, a current work, study, or residence visa, and have a South African bank account to pay your premiums. The benefits you receive are the same as those available to South African citizens.
As a non-South African citizen, you are probably wondering whether you qualify for medical aid in South Africa, especially if you plan on staying for an extended period. If you are in a serious accident or develop a medical condition, seeking medical attention here can become costly. This article breaks down who qualifies, along with the general exclusions and waiting periods you will face when applying.
Who Qualifies for Medical Aid and What Benefits Are You Entitled To?
Most schemes will allow you to join if you have a South African bank account to pay for your cover. That account does not have to be your own. Someone else can pay your premiums from their account on your behalf.
You also need to hold a valid passport and a current work, study, or residence visa. These two documents are the main proviso for foreign applicants, so make sure both are in order before you apply.
If you are only here on holiday, medical aid is not the route for you. You would instead rely on travel insurance to cover any medical costs during your stay.
The benefits you have access to are exactly the same as those for a South African citizen, and your cover depends on the plan you choose. There are two major categories of medical aid in South Africa: a comprehensive option and a hospital plan. A comprehensive plan covers in-hospital treatment along with day-to-day benefits like GP visits, while a hospital plan focuses on in-hospital costs. If anything is unclear, speak to an intermediary at the schemes you are getting quotes from, so you secure the cover that suits your needs.
Exclusions and Waiting Periods
New members of many medical aid schemes may face a specific waiting period, an exclusion, or both, as outlined in the scheme’s terms and conditions. A waiting period means that after joining, you are not eligible for cover until the period ends. This applies to most South Africans too, so it is in no way discriminatory toward someone foreign to South Africa.
A common example is a three-month general waiting period, during which you cannot claim. If you have a pre-existing condition when you sign up, you may not be entitled to benefits related to that condition for at least the first year of membership.
Double-check the benefits and exclusions of your chosen option with an intermediary authorised to give advice, or with the medical aid scheme directly, before you commit to a contract.
What About Gap Cover for Foreigners?
You can also consider Gap Cover, which covers in-hospital shortfalls that your medical aid plan may not pay in full. When a specialist charges more than your scheme’s tariff rate during a hospital stay, you can be left with a shortfall to settle yourself. This is where Gap Cover steps in, paying the difference so the cost does not fall on you.
Gap Cover works alongside your medical aid, not instead of it, so you would hold both together. As a foreigner with a qualifying visa and a medical aid plan in place, the same Gap Cover options available to South African members apply to you.
If you have any more queries regarding TRA Gap Cover, reach out to our specialists or visit our Gap Cover page to get started.
If you are only here on a holiday, you would have to look at your travel insurance to cover any medical costs while you are in South Africa.
The types of benefits you will have access to are exactly the same as if you were a South African citizen and the cover would be dependent on the plan that you opt for. There are two major categories of medical aid, namely a comprehensive option and a hospital plan.
If anything is unclear, make sure that you speak to an intermediary at the medical aid schemes that you are looking for quotes from, to make sure that you get the best cover to suit your needs.
Exclusions and waiting periods
All new members to many medical aid schemes may be subject to a specific waiting period and/or exclusions which would be outlined in the terms and conditions of the medical aid scheme. A waiting period would mean that after joining a medical aid scheme, you won’t be eligible for cover until the waiting period is over. This is the case for most South Africans as well and is no way discriminatory to a person foreign to South Africa.
If you have a pre-existing condition prior to signing up, you may not be entitled to benefits for at least the first year of the membership.
Double check the option benefits or exclusions with an intermediary who is authorised to give advice, or with the medical aid scheme directly.
Medical Gap Cover Questions & Queries
You can also consider Gap Cover, which covers in-hospital shortfalls, where the medical aid plan may not cover these costs in full.
References:
Medical Aid for Foreigners in South Africa
