Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Our Top Picks
South African expats are everywhere—UK, Australia, UAE, New Zealand, and beyond. Your insurance choice should reflect where you're going and whether you plan to return. Here's what we recommend:
- Cigna Global: Best overall for SA expats. Strong global networks, USD billing (protecting against rand volatility), excellent service.
- Bupa Global: Premium option with outstanding UK and UAE networks. Ideal for SA expats in Britain or the Gulf.
- Discovery Global: The familiar option. Same Discovery you know, but with international reach. Good if you want SA coverage included.
- IMG Global: Budget-friendly alternative with solid global coverage. Good for younger expats.
- Allianz Care: Strong European coverage, good for SA expats in the EU.
Currency Protection Matters
The rand has lost significant value against hard currencies over time. USD or EUR-denominated policies protect you from currency risk—your premiums stay stable regardless of ZAR movements.
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Leaving SA Medical Aids
South Africa's medical aid system is among the best in the developing world, but it doesn't travel well. Here's what happens when you leave:
Discovery Health and Other Medical Aids
Most SA medical aids (Discovery, Bonitas, Momentum, etc.) are designed for South African residents. International coverage is typically limited to 90 days of emergency treatment. Options when emigrating:
- Cancel: Most people cancel their SA medical aid when emigrating. You can rejoin when you return (subject to waiting periods)
- Discovery Global: Discovery offers an international product specifically for SA expats. It's more expensive than local alternatives but maintains the Discovery ecosystem
- Continue for SA trips: Some expats maintain a cheap SA plan for visits home, combined with international coverage elsewhere
Late Joiner Penalties
If you cancel your SA medical aid and return later, you may face late joiner penalties and waiting periods. These apply if you're over 35 and have gaps in coverage. Keep records of your international insurance—some medical aids may credit continuous cover abroad.
Tax Emigration
If you're formally emigrating (tax emigration), you can withdraw retirement funds and have more flexibility with exchange controls. This also affects healthcare planning—once you've tax emigrated, returning to SA medical aids may be treated as a new application.
Currency Considerations
Currency is a bigger issue for South African expats than for those from hard-currency countries. The rand has depreciated significantly against the USD, EUR, and GBP over time. This affects your insurance in several ways:
ZAR-Denominated Policies
If your policy is priced in rand, your premiums are low (in hard currency terms) but your coverage limits may not keep pace with international healthcare costs. A R1 million limit that seemed adequate years ago might cover only $50,000 today.
USD/EUR-Denominated Policies
Most international insurers quote in USD or EUR. While premiums seem higher, your coverage maintains its purchasing power. A $1 million limit is $1 million regardless of what the rand does. This is generally the better choice for long-term expats.
Payment Methods
Exchange controls complicate paying foreign premiums from South Africa. Options:
- Pay from your foreign income (easiest)
- Use your single discretionary allowance (R1 million/year)
- Use your foreign investment allowance (requires tax clearance)
- Pay with an international credit card
Quick Comparison
| Provider | Currency | SA Coverage | USD Billing | Starting Price |
|---|---|---|---|---|
| Cigna Global | USD/EUR/GBP | Add-on | Yes | $180/mo |
| Bupa Global | USD/EUR/GBP | Add-on | Yes | $200/mo |
| Allianz Care | USD/EUR | Add-on | Yes | $190/mo |
| Discovery Global | USD/ZAR | Included | Yes | $250/mo |
| IMG Global | USD | Add-on | Yes | $150/mo |
Detailed Reviews
Cigna Global
Cigna Global is our top recommendation for South African expats. They offer USD-denominated coverage that protects against currency risk, strong global networks, and excellent customer service. Plans come in three tiers with coverage up to unlimited.
South Africa coverage can be added as an option—useful if you visit home regularly. Claims processing is efficient, with direct billing available at major hospitals in the UK, UAE, Australia, and most popular SA expat destinations.
Best for: SA expats who want comprehensive coverage with currency protection.
Bupa Global
Bupa Global offers premium international coverage with particularly strong networks in the UK and UAE—two of the most popular destinations for South African expats. Their service is excellent, claims processing is fast, and the Bupa name is well-recognized internationally.
Plans are USD-denominated and include comprehensive benefits. South Africa coverage is available as an add-on. Mental health and maternity coverage are strong across all tiers.
Best for: SA expats in the UK or UAE who want premium coverage.
Discovery Global
Discovery Global is the international arm of South Africa's largest health insurer. The advantage is familiarity—you know the brand, you may already use Discovery Bank or Vitality, and SA coverage is built-in rather than an add-on.
Plans integrate with the Vitality wellness program, offering rewards for healthy behavior. Coverage is comprehensive, and claims for SA treatment are processed through the familiar Discovery system. However, pricing is typically higher than international competitors.
Best for: SA expats who value the familiar Discovery ecosystem and visit SA frequently.
IMG Global
IMG Global offers solid international coverage at competitive prices. They're a good option for younger SA expats or those on tighter budgets. USD-denominated plans provide currency protection, and coverage levels are adequate for most situations.
The network is global with direct billing available in major cities. Customer service is US-based but available 24/7. South Africa coverage is available as an add-on.
Best for: Budget-conscious SA expats who want reliable coverage at lower cost.
Compare Your Options
Get quotes from multiple providers to compare pricing for your age and destination. Currency denomination and SA coverage options vary significantly.
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Popular Destinations
Insurance needs vary by destination. Here's what SA expats should consider in the most popular locations:
United Kingdom
The NHS provides free healthcare to residents, but waiting times can be long for non-urgent care. Many SA expats supplement NHS access with private insurance for faster access and specialists. Cigna and Bupa both have strong UK networks.
Australia
Australia requires visa holders to have health insurance. Medicare is available to permanent residents but not most visa holders. International insurance is typically required for the initial years until PR is granted.
United Arab Emirates
Health insurance is mandatory in the UAE. Many employers provide coverage, but quality varies. International insurance ensures you can access the best hospitals (often private facilities staffed by SA doctors) without employer restrictions.
New Zealand
NZ's public healthcare is available to residents, but waiting times are significant. Private insurance provides faster access and is common among SA expats. ACC covers accidents for everyone.
Common Questions
Can I keep my Discovery Medical Aid abroad?
Standard Discovery plans only cover 90 days of international emergency treatment. For longer stays, you need Discovery Global or a separate international policy.
What happens to my medical aid savings?
Medical savings accounts (MSA) typically revert to the scheme when you cancel. Some schemes allow you to claim outstanding balances. Check your specific scheme rules.
Should I get USD or ZAR coverage?
USD is almost always better for long-term expats. Currency depreciation has historically eroded ZAR coverage value. Only consider ZAR if you're earning in rand abroad.
Will I face penalties returning to SA medical aid?
Possibly. Late joiner penalties apply to those over 35 with coverage gaps. Some schemes credit continuous international insurance. Get confirmation in writing before leaving.
Can I pay premiums from SA?
Yes, using your single discretionary allowance or international credit card. Exchange control rules apply. Many expats prefer paying from foreign income to avoid complications.
Are SA doctors covered abroad?
International insurance covers any qualified doctor. Many expat hubs (Dubai, London, Sydney) have SA-trained doctors you can use with your international cover.
Final Verdict
South African expats should prioritize USD-denominated international coverage to protect against currency risk. Cigna Global is our top recommendation for comprehensive coverage with excellent service. Bupa Global is ideal for those in the UK or UAE who want premium coverage.
Discovery Global makes sense if you value the familiar Discovery ecosystem and visit SA frequently. IMG Global offers good value for budget-conscious expats.
Before you leave, confirm with your current medical aid how they'll treat your absence and what happens when you return. Get any commitments in writing—SA medical aids' policies on returning members can be unclear.
