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How foreigners will be covered by NHI in South Africa

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How foreigners will be covered by NHI in South Africa

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The South African Government recently published a new NHI draft bill. The bill seeks to create a new single fund that will provide healthcare financing for every South African citizen who may need healthcare at any point. The draft bill specifies types of individuals who will covered by the NHI fund. 

Permanent Residents

Permanent Residents will be fully covered under the NHI. Permanent residents here being, individuals who have applied for, and have been granted permanent residence status by the Department of Home Affairs.


Refugees who are holders of Refugee Identity Cards will also receive cover under the proposed NHI bill. This excludes Asylum Seekers, who will have partial cover as detailed below.

Asylum seekers

Asylum seekers will have limited under NHI. They will be covered for emergencies and for ‘notifiable’ conditions such as TB. Notifiable conditions are those that if untreated, may pose a danger to the general public. An extreme example here would be a case of Ebola, that if uncontrolled could have devastating effects on the rest of the populations.

Another exception here is that the children of asylum seekers will be covered for basic health care services as stated in section 28 (1) c of the South African constitution which states that:

Every child has a right:

c) to basic nutrition, shelter, basic health care services and social services;

Undocumented/Illegal immigrants

Illegal immigrants will receive the same treatment as asylum seekers. They will be covered for emergency and ‘notifiable’ conditions.

Foreigners on work or study permits

The NHI Bill does not name foreigners on work or study permits directly but it does state that individuals covered by NHI fully will include:

certain categories or individual foreigners determined by the Minister of Home Affairs, after consultation with the Minister and the Minister of Finance, by notice in the Gazette.

It appears that this will include individuals on study or work permits. This makes sense for those on work permits as they will contribute to NHI through their taxes. It is unclear how students on study permits will pay or be covered.

Visiting tourists and short-term travelers

These will be required to purchase travel insurance covering them for the duration of their stay.


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Thando is currently the Group Actuary at Clinix Health Group, having previously served as Actuary in Discovery Limited's R&D Lab. Thando loves tech, design, reading and is very passionate about the development of the African continent. Thando also runs, an omnichannel retail-tech startup. All views expressed are Thando's own and neither reflect nor are influenced by the views of affiliated companies.

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