National Health Insurance (NHI) in South Africa
The National Health Insurance (NHI) Act was signed into law in 2023, setting South Africa on a path toward universal health coverage by 2030. The NHI aims to ensure every South African can access quality health services without suffering financial hardship.
What is the NHI?
The National Health Insurance is a health financing system that pools public funds to provide access to quality, affordable healthcare for all South Africans, regardless of their employment status or ability to pay.
The NHI Fund will purchase healthcare services on behalf of the entire population from both public and accredited private providers. The goal is to eliminate the two-tier health system where your quality of care depends on whether you have a medical aid.
Timeline and Implementation
The NHI Act was signed by President Cyril Ramaphosa in May 2023 after years of consultation. Implementation is phased, with full roll-out of the NHI Fund and universal coverage targeted for 2030.
During the transitional period, South Africans continue to use existing public and private health services. The Department of Health is establishing the governance structures, IT systems, and provider accreditation frameworks required to operationalise the Fund.
| Phase | Period | Key Activities |
|---|---|---|
| Phase 1 | 2012-2017 | Pilot programmes, health system strengthening |
| Phase 2 | 2017-2022 | Legislation, infrastructure development |
| Phase 3 | 2023-2030 | NHI Fund establishment, universal roll-out |
What the NHI Will Cover
The NHI Fund will cover a comprehensive package of personal health services. The exact benefit package is still being finalised by the Health Benefits Advisory Committee (HBAC).
- Primary and preventive health care at clinics and community health centres
- Hospital care at public and accredited private facilities
- Specialist consultations and referrals
- Mental health services
- Chronic disease management
- Maternal and child health services
- Emergency medical services
You do not need to do anything right now. The NHI is still being established. Continue to use your public clinic, hospital, or medical aid as you normally would.
Impact on Medical Aids
Once the NHI is fully implemented, medical aid schemes will only be permitted to cover services not covered by the NHI Fund. This is one of the most debated aspects of the Act, with several legal challenges having been filed by the medical aid industry.
During the transitional period, your current medical aid remains valid and you can continue to use it as normal.
How the NHI Will Be Funded
The NHI will be funded through general tax revenue, a payroll tax, and a surcharge on taxable income. The exact tax mechanisms will be detailed in future legislation.
Currently, government spends significantly more per person on those with medical aid through tax credits. NHI redirects this subsidy to cover everyone.
Contact and More Information
The Department of Health provides updates and information about the NHI on its official website.
- Website: www.health.gov.za/nhi
- Department of Health: www.health.gov.za
- Phone: 012 395 8000
- Minister of Health (2026): Dr Aaron Motsoaledi