Do foreigners pay in government hospitals in South Africa-pretoria-sandton-capetown-durban


Do foreigners pay in government hospitals in South Africa? Different laws and legislation say different things regarding this, but based on the South African Constitution, everyone is entitled to basic healthcare, even foreign nationals who are documented or not. Payment is determined by a means test, meaning that you pay according to what you can afford while the rest is subsidized by the government. If you want more than basic healthcare services, then that is when you’ll have to pay the full amount as a foreign national.

When do foreigners pay in Government Hospitals?

According to the South African Constitution (Section 27)

Do foreigners pay in government hospitals in South Africa-midrand-pretoria-capetownThe South African Constitution states that everyone is entitled to basic healthcare whether they are a South African Citizen or not. This means that Foreign nationals have the right to free basic health care and only pay when they need more than primary healthcare. In an emergency, everyone is entitled to free healthcare, whether a South African citizen or not.

According to the Refugees Act (Section 27(g))

Basic health care should be provided for refugees and asylum seekers and should be applied equally as it is applied to South African citizens.

According to the National Health Act (Section 4(3))

This act applies to everyone regardless of whether they are South African or not. Within this act children under the age of six, pregnant and breastfeeding women are all entitled to health care at either public hospitals or public clinics. And all women have the right to a free abortion at any government health facility. And also including those that have to take HIV and TB treatment.

According to the Department of Health Circular

Asylum seekers and refugees whether documented or not have the right to the same basic healthcare services, as South Africans do – including HIV treatment.

According to the Immigration Act

The immigration act is different from all the other above-stated laws, according to it ⧿ clinic and hospital staff must first find out about the legal status of foreign nationals, before they can provide healthcare unless it’s an emergency.

According to the National Uniform Patient Fee Schedule

Do foreigners pay in government hospitals in South Africa-capetownIf asylum seekers, undocumented migrants and refugees from the Southern African Development Community (SADC) that is Mozambique, Lesotho and Zimbabwe need healthcare services from South Africa, then they should be treated like any other South African citizen who needs healthcare services. They too would take a means test to determine how much they’ll be able to pay. While asylum seekers, undocumented migrants and refugees from countries who are not part of the SADC are expected to pay the full amount of medical care, except if it’s primary health care. The only ones who are exempt from this are breastfeeding and pregnant women and children under six years of age. 

Contradictory laws

The rights of whether foreign nationals should have access to basic healthcare is a complex matter, as seen above ⧿ the policies and laws put in place tend to clash with one another. And this often leaves medical professionals confused and each implementing the laws differently. 

The legislation’s wording is vague, which means it can be interpreted differently by different people meaning it is often used more than it should be and oftentimes incorrectly. Yes, hospitals need proof of identification and proof of income in order to attend to a patient, but the vagueness of the legislation and miscommunication between staff and patients often leads to patients being turned away if they fail to produce an asylum document, refugee permit or a South African ID Book.

Below was an instant when the legislation was misconstrued: 

The National Health Department circular, in mid-January 2019 instructed hospitals and clinics to start charging foreign nationals the full amount for healthcare services even primary healthcare services, including maternity care, emergency care and basic healthcare services. Only low-come refugees were exempt from this and would’ve been means-tested. Gauteng was the only province that passed down these instructions. The National Health Department has since said the circular should’ve never went out.

To minimise the confusion here’s a simple breakdown

  • If your condition isn’t serious it is advised that you go to the clinic. Basic health care services at clinics are free for all ⧿ refugees, asylum seekers, whether you are South African or not or whether you are undocumented or not.
  • If your condition is serious then you should go to the hospital. At the hospital is either you pay or don’t pay based on certain circumstances:
    • If it’s an emergency, you are pregnant or your child is under 6 years then you don’t have to pay, whether you are a refugee, an asylum seeker, or whether documented or not. 
  • If none of the above fits then you might have to pay. To determine that, then you have to answer the following question ⧿ Do you hold a permit?
    • If you have a refugee, asylum or residency permit, then you’ll have to be means-tested, like South African citizens are.
    • This means that if you have a job you’ll have to pay according to how much you earn.
    • If you don’t work, then you don’t have to pay, but you’ll have to provide proof of no income.
  • If you are undocumented, but from the SADC countries, then you’ll be means tested, in order to have access to hospital health care.
  • If you are undocumented and not from the SADC countries, then you’ll have to pay the full amount.

Benefits of having medical aid as a foreigner in South Africa

Foreign nationals who have medical aid have the benefit of going to private hospitals instead of public hospitals. The care at private hospitals is far superior to those at public hospitals, which are often understaffed, underfunded and mismanaged.

Frenchside Translation and Interpretation

Frenchside translation is a translation-based agency, that helps with document translations. We have diligent, high-quality translators who are proficient in the language that they translate into. Our translators will translate your asylum document, refugee permit and your proof of income, to make the process easy for you to receive basic healthcare from South African government healthcare services. We specialise in the following languages French, German, Portuguese, Spanish and the 11 official South African languages. Contact us, for the best translation you can get. Call: 081 347 6060 | 012 348 3134 or you can email us at | Website: 

Do foreigners pay in government hospitals in South Africa
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Do foreigners pay in government hospitals in South Africa
Do foreigners pay in government hospitals in South Africa? Different laws and legislation in South Africa help explain this and a process to follow if you are a foreigner who needs healthcare services in South Africa.
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