South Africa Healthcare Insurance Market Analysis

South Africa Healthcare Insurance Market Analysis


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South African healthcare insurance market is projected to grow from $13.17 Bn in 2022 to $25.92 Bn by 2030, registering a CAGR of 8.83% during the forecast period of 2022-30. The main factors driving the growth would be increasing demand for private healthcare, rising healthcare costs, regulatory reforms and technological advancements. The market is segmented by the component, provider, coverage, health insurance plans and end-user. Some of the major players include Bonitas, Discovery Health, Momentum Health, Afrocentric Health and Bestmed Medical.

ID: IN10ZAHS008 CATEGORY: Healthcare Services GEOGRAPHY: South Africa AUTHOR: Neha Davda

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South Africa Healthcare Insurance Market Executive Summary

South African healthcare insurance market is projected to grow from $13.17 Bn in 2022 to $25.92 Bn by 2030, registering a CAGR of 8.83% during the forecast period of 2022-30. South Africa's national healthcare spending as a share of GDP in 2019 was 9.11% or $547 per person.

An integrated public and private healthcare system exists in South Africa. The bulk of the population receives healthcare services from the public sector, although it frequently struggles to keep up with demand due to understaffing and funding issues. Contrarily, the private sector serves a smaller proportion of the population but is better supported and has access to more resources.

The market for health insurance has expanded as a result of the rise in private healthcare demand in South Africa during the past few years. Several companies, including Momentum Health, Discovery Health, and Bonitas, provide private health insurance. These companies provide a variety of health insurance plans to meet the needs of different individuals and groups.

South Africa Healthcare Insurance Market

Market Dynamics

Market Growth Drivers

The South African healthcare Insurance market is expected to be driven by factors such as:

  1. Increasing demand for private healthcare- With the increase in the need for private healthcare services in South Africa, more people are searching for healthcare insurance solutions that can provide them access to these services, particularly the individuals who are dissatisfied with the quality of care offered by the public healthcare system
  2. Rising healthcare costs- In South Africa, healthcare costs are increasing rapidly, due to the reasons such as increased demand for healthcare services, ageing population, developments in medical technology, and an ageing population. As a result, more people are searching for strategies to control these expenses, such as by purchasing health insurance
  3. Regulatory reforms- Recently, the government of South Africa has undertaken a number of regulatory measures to encourage more competition in the health insurance market. These reforms have encouraged the entry of new players, resulting in rising competition and more options for customers which help in market expansion
  4. Technological advancements- Technological advancements are increasing the demand for more advanced and expensive healthcare services in South Africa. For individuals who want to obtain these services without having to incur a significant amount out of pocket expense, healthcare insurance solutions are becoming more and more crucial

Market Restraints

The following factors are expected to limit the growth of the healthcare insurance market in South Africa:

  1. Inequality- South Africa has a wide imbalance between the rich and the poor, and the healthcare system reflects it. People who can afford health insurance have access to high-quality medical care, while those who cannot often receive mediocre treatment. This is severely causing hindrances to the health insurance market expansion
  2. Affordability- In South Africa, health insurance premiums can be very expensive, particularly for those with a low level of income. As a result, a large number of people are not able to pay for health insurance and restrict themselves from using private healthcare services
  3. Regulatory challenges- South Africa has a complex regulatory framework for the healthcare insurance sector which is governed by a number of regulatory authorities. This might make it difficult for new players to enter the market as well as challenging for consumers to select from limited healthcare insurance plans for them

Competitive Landscape

Key Players

  • Bonitas (ZAF)- Bonitas, which was founded in 1982, is the second-largest provider of medical insurance in South Africa. A variety of cost-effective medical aid alternatives are available from Bonitas, including coverage for outpatient benefits, chronic medicine, and catastrophic medical costs
  • Discovery Health (ZAF)- Discovery is a proudly South African-founded financial services company that provides services in life insurance, healthcare, short-term insurance, long-term savings, banking, and wellness sectors
  • Momentum Health (ZAF)- Momentum is leading the way in new-age thinking in the health sector and offering the people of South Africa services that are unmatched. It is a financial services firm that offers investment, insurance, and healthcare solutions
  • Afrocentric Health (ZAF)- One of the cornerstones of the group's business structure is AfroCentric Health, which is supported by interests in the technology and resource industries. The Medscheme service inside AfroCentric Health offers complete service packages for both healthcare management and risk management
  • Bestmed Medical (ZAF)- Bestmed is the largest self-administered medical scheme in South Africa. It provides a variety of health insurance packages to single people, families, and businesses. These goods come in the form of hospital plans, savings plans, and conventional medical scheme options

Notable News

2019- In the field of Service Design, Momentum's Smart Underwriting solution took home a Silver Loerie Award. Customers can interact with the insurer in real time on common channels thanks to the solution, which reinvents the underwriting process.

2021- The South African Customer Satisfaction Index (SA-CSI) 2020 and 2021 gave Bestmed the greatest ratings for perceived quality, perceived value, customer service, and customer loyalty in the Medical Scheme Industry Category.

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Healthcare Insurance Market Segmentation

By Provider (Revenue, USD Billion):

It mainly includes healthcare insurance that provides safety against the increasing cost of medical treatments and in case of health emergencies such as critical illnesses. Hence, it is the best way to safeguard medical expenses.

  • Public
  • Private

By Coverage Type (Revenue, USD Billion):

In terms of sales and market share, it is anticipated to rule the market over the projection period. This is explained by a number of benefits provided by life insurance, including guaranteed death payout and permanent coverage. Additionally, investing in these kinds of plans enables working professionals to save taxes

  • Life Insurance
  • Term Insurance

By Health Insurance Plans (Revenue, USD Billion):

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Exclusive Provider Organization (EPO)
  • Point of Service (POS)
  • High Deductible Health Plan (HDHP)

By Demographics (Revenue, USD Billion):

  • Minors
  • Adults
  • Seniors

There is a high prevalence of lifestyle disease in the adult population that can increase health risks in the future. The population is more prone to cardiac and other diseases that require hospitalization. Healthcare insurance plans for seniors are more of a necessity, especially in the case of retirement. Also, it carries various advantages such as no medical screening before buying plans, includes coverage of the outpatient department, and provides the benefit of fee annual checkups along with lifetime renewability.

By End-user (Revenue, USD Billion):

  • Individuals
  • ?Corporates

A large number of people buy individual health plans as they are also customizable. Also, it gives more control over deductibles, co-pays, and benefits limits and is not dependent on employment status.

Insights10 will provide you with the reports within 10 key parameters which are:

  1. Market Overview
  2. Market Growth Drivers & Restraints
  3. Epidemiology of Disease Type
  4. Market Segmentation
  5. Market Share
  6. Competitive Landscape
  7. Key Company Profiles
  8. Healthcare Policies & Regulatory Framework
  9. Reimbursement Scenario
  10. Factors Driving Future Growth

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The study on the market covers the analysis of the leading geographies such as Asia-Pacific, Africa, Europe, Middle East, North America, and  Latin America for the period of 2022 to 2030. The qualitative analysis covers the industry landscape and trends, market opportunities, competitive landscape, and policy and regulatory scenario, and the quantitative analysis covers different market estimates and forecasts.

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Stage III: Interpretation and Presentation

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Last updated on: 18 September 2023
Updated by: Ritu Baliya

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