Employee Health Insurance
Health Insurance for Employees
Affordable Cover for Every Staff Member
Employee health insurance is a group insurance product that gives staff access to day-to-day healthcare, such as GP visits, medication and basic tests, plus emergency and accident cover, for a fraction of the cost of medical aid. It’s regulated as insurance rather than as a medical scheme, so benefits are fixed and more limited. For companies with lower-income or entry-level staff, it’s often the most practical way to make sure everyone has some cover. We compare the products and help you build it into your benefits.
Why companies offer health insurance to employees
Many South African employers want every employee to have healthcare cover, but full medical aid is out of reach for a large part of the workforce. For entry-level, operational and seasonal staff, even an entry-level medical aid option can take a big share of take-home pay.
Employee health insurance fills that gap. It gives your people:
- Access to a doctor without paying out of pocket, so minor illnesses are treated early
- Medication and basic tests covered through a provider network
- A safety net for accidents and emergencies
For your business, that means fewer sick days lost to untreated illness, less financial stress among staff and a benefit that people actually use every month.
What employee health insurance typically covers
Benefits vary between insurers and plan levels. We compare them line by line for your workforce.
GP consultations
Visits to network GPs, often with a set number per year or a fair-use limit.
Acute medication
Prescribed medication for short-term illnesses, dispensed through network pharmacies.
Basic tests
Basic blood tests and X-rays when referred by a network doctor.
Dentistry and optometry
Basic dental check-ups and eye tests, with limits on glasses or treatment.
Accident and emergency
Hospital cover after an accident or trauma, plus emergency transport.
Added benefits
Depending on the plan, extras such as hospital cash benefits, counselling lines or funeral cover.
Health insurance vs medical aid for employees
The two products are regulated differently and do different jobs. Our article on medical aid vs health insurance for employees goes into more detail.
| Feature | Health insurance | Medical aid |
|---|---|---|
| Regulated as | Insurance (fixed, defined benefits) | Medical scheme, under the Medical Schemes Act |
| Prescribed Minimum Benefits | Not required to cover them | Must cover them |
| Main strength | Affordable day-to-day care through a network | Comprehensive cover, including hospitalisation for illness |
| Hospital cover for illness | Limited or none on most plans | Included, depending on option |
| Chronic conditions | Limited or excluded on most plans | Covered for Prescribed Minimum Benefit conditions |
| Typical cost | A fraction of medical aid contributions | Higher, depending on option and dependants |
Health insurance is not a replacement for medical aid. It’s a way to give staff who can’t afford medical aid meaningful cover rather than none.
How companies use health insurance alongside medical aid
Most of our clients combine products so every staff grade is covered at a cost that makes sense.
| Approach | How it works | Best for |
|---|---|---|
| Tiered benefits | Medical aid for management and professional staff; health insurance for entry-level staff | Mixed workforces with a wide range of incomes |
| Choice of product | Employees choose between a subsidised medical aid option and a health insurance plan | Companies that want to respect individual budgets |
| Health insurance for all non-members | Everyone not already on medical aid gets health insurance | Making sure no one is left without cover |
| Seasonal or contract staff | Health insurance for fixed-term or seasonal workers only | Agriculture, retail, logistics and project-based businesses |
Pair medical aid members with group gap cover and the rest of your workforce with health insurance, and every employee has cover that fits their situation.
What to check before choosing a product
- Network coverage: are there network GPs and pharmacies near your sites and where your employees live?
- Waiting periods and underwriting: group plans often have shorter waiting periods or none, but this varies.
- Hospital benefits: what is covered for illness, as opposed to accidents, and what limits apply?
- Dependants: can employees add family members, and at what cost?
- Admin: how are joiners and leavers handled, and how does billing work with payroll?
We check all of this for you and give you a clear comparison, so you’re not left decoding policy wordings.
How it works
Workforce review
We look at your staff grades, incomes, locations and current benefits.
Product comparison
We compare health insurance plans on benefits, networks, limits and cost.
Recommendation
You get a clear proposal, including how health insurance fits with any medical aid you offer.
Implementation
We handle enrolment and run sessions so employees know how to use their cover.
Ongoing support
We help with queries, joiners and leavers, and review the product every year.
Frequently asked questions
Is health insurance the same as medical aid?
No. Medical aid is regulated under the Medical Schemes Act and must cover Prescribed Minimum Benefits. Health insurance is an insurance product with fixed, defined benefits, mainly for day-to-day care and accidents. It costs less, but it covers less.
Can we offer health insurance to some employees and medical aid to others?
Yes. Many companies offer medical aid to some staff grades and health insurance to others, or let employees choose between them.
Does health insurance cover hospitalisation?
Most plans cover hospitalisation after an accident or emergency. Cover for hospitalisation due to illness is limited or excluded on many plans, which is why we compare hospital benefits carefully.
Can employees add their families?
On many plans, yes, at an additional cost per dependant. We’ll show you the options and costs for each product.
Is health insurance suitable for seasonal or contract workers?
It often is. Group health insurance can be easier to put in place for fixed-term staff than medical aid, and the monthly cost is lower.
Does it cost anything to use a broker?
No. Our brokers are paid by the insurer, so there’s no fee to your company.
Related services
Group Medical Aid
Scheme comparison, negotiation and admin for companies with 50+ employees.
Request a Company Quote
Tell us about your company and one of our experienced brokers will be in touch within 24 hours.