Health Insurance in Zambia
Updated March 2026 · 6 providers compared
Compare health insurance plans and costs in Zambia — from NHIMA (mandatory, 1% of salary) to private comprehensive cover up to USD 4 million. Find the right plan for you and your family.
Insurance Plans & Costs
NHIMA (National)
Outpatient, inpatient, maternity, emergencies, dental, optical, lab tests, prescriptions at accredited facilities
1% each (employee + employer)
NHIMA — Informal Sector
Same benefits package — covers up to 7 family members (principal + 6 dependents)
K50/household/month
Basic Private
GP visits, basic tests, pharmacy, limited hospital stays
ZMK 150 – 400/month
Standard Private
GP + specialist visits, hospital, advanced imaging, maternity, chronic conditions
ZMK 400 – 800/month
Comprehensive Private
Full cover — private/international hospitals, specialists, evacuation, cancer treatment, chronic conditions
ZMK 800 – 2,000+/month
Corporate Group
Customised — typically standard + dental + optical + wellness programmes
ZMK 200 – 600/employee/month
NHIMA — What's Covered?
| Benefit | NHIMA Cover |
|---|---|
| Outpatient Consultations | ✓ Covered |
| Inpatient Hospital Care | ✓ Covered |
| Maternity & Delivery | ✓ Covered |
| Emergency Services | ✓ Covered |
| Lab Tests & Diagnostics | ✓ Covered |
| Prescription Medicines | ✓ Covered |
| Dental Care | ✓ Covered |
| Optical / Spectacles | ✓ Covered |
| Chronic Condition Management | ✓ Covered |
| Cancer Treatment | ✓ Covered |
| Private Hospital Rooms | ✗ Not covered |
| International Medical Evacuation | ✗ Not covered |
| Cosmetic Procedures | ✗ Not covered |
Note: NHIMA proposed removing dental and optical services in May 2024 but reversed the decision following public outcry and a directive from the Ministry of Health. Both remain covered as of March 2026.
Insurance Providers
NHIMA
Universal — mandatory for all formal employees
4.6M+ members (June 2024). Accredited facilities nationwide. eNHIMA online registration.
SES-Unisure
Expat & premium plans (local, regional, international)
Plans up to USD 4M (international), USD 500K (regional), USD 150K (local). 24/7 emergency call centre. Medical evacuation cover.
Madison Life
Group medical insurance for employers
Part of Madison Financial Services Ltd. First private insurer in Zambia (1992). Presence in 7 of 10 provinces.
ZSIC Life
Affordable basic plans
Operating since 1968. Wide branch network across all 10 provinces. Government-backed.
Professional Insurance (PICZ)
Individual & corporate plans
Over 30 years of experience. Listed on the PIA register of licensed insurers.
Hollard Insurance
Comprehensive car & health insurance
South African insurer. Detailed online claims process. Growing presence in Zambia.
Health Insurance in Zambia — Guide
Zambia's healthcare system combines public facilities (government hospitals and clinics) with a growing private sector. Since its launch, NHIMA has grown to over 4.6 million members (as of June 2024), including 1.4 million from the informal sector, making it the cornerstone of Zambia's push toward universal health coverage.
NHIMA Contributions Explained
Formally employed workers pay 1% of basic salary — the employer pays a matching 1%, totalling 2% of basic salary. There is no ceiling on the contribution amount. In the informal sector, self-employed individuals can register voluntarily through the eNHIMA online platform at K50 per household per month, covering up to 7 family members (the principal contributor plus 6 dependents). Vulnerable groups linked to the Social Cash Transfer (SCT) programme receive free NHIMA coverage.
Public vs Private Healthcare
Public hospitals (UTH, Levy Mwanawasa) offer free or low-cost care but face long waiting times and limited specialist availability. Private hospitals (Medland, Fairview, Coptic) offer faster service and better facilities but charge significantly more. Health insurance bridges this gap by giving access to private care at managed costs.
Choosing the Right Plan
- Employed individuals — NHIMA covers the basics. Add a private basic plan (ZMK 150-400/month) for GP visits and preferred pharmacy access.
- Informal sector workers — Register for NHIMA at K50/month for comprehensive family cover.
- Families — Consider corporate group rates if your employer offers them, or family float plans (ZMK 400-800/month).
- Expats & executives — SES-Unisure or similar providers offer international coverage with medical evacuation and limits up to USD 4 million.
- Always verify — Check the insurer's list of accredited facilities in your area before purchasing.
Frequently Asked Questions
Is health insurance mandatory in Zambia?
Yes. NHIMA (National Health Insurance Management Authority) contributions are mandatory for all formally employed individuals in Zambia. The contribution is 1% of basic salary from the employee AND 1% from the employer — totalling 2% of basic salary. There is no ceiling on the contribution amount. Self-employed individuals in the informal sector can voluntarily register at K50 per household per month through the eNHIMA online platform.
How much does health insurance cost in Zambia?
NHIMA costs 1% of basic salary (employee share). Informal sector: K50/household/month covering up to 7 family members. Private basic plans start from ZMK 150/month per person. Standard family cover costs ZMK 400-800/month. Comprehensive expat plans (SES-Unisure) range from ZMK 800-2,000+/month with limits up to USD 4 million for international coverage.
What does NHIMA cover?
NHIMA covers outpatient consultations, inpatient hospital care, maternity services, emergency treatment, laboratory tests, prescription medicines, dental care, optical services including spectacles, chronic condition management, and cancer treatment at accredited facilities. It does NOT cover private hospital rooms, international medical evacuation, or cosmetic procedures. NHIMA attempted to remove dental and optical in May 2024 but reversed the decision after public outcry and a directive from the Ministry of Health.
Can I have both NHIMA and private insurance?
Yes, many Zambians combine NHIMA with private insurance. NHIMA serves as the base cover at accredited public and private facilities. Private insurance gives access to premium private hospitals, shorter waiting times, international specialists, and medical evacuation. SES-Unisure offers plans with international coverage up to USD 4 million. Some private insurers coordinate benefits with NHIMA.
How many members does NHIMA have?
As of June 2024, NHIMA reported over 4.6 million members, of which 1.4 million come from the informal sector. NHIMA's Revised Strategic Plan (2023-2026) targets further expansion, including registering over 100,000 Social Cash Transfer (SCT) beneficiaries for free health insurance coverage. The informal sector scheme at K50/month per household is a key driver of membership growth.
Which hospitals accept NHIMA in Lusaka?
NHIMA maintains a list of accredited healthcare providers, which included 235+ facilities as of 2022. In Lusaka, major facilities include University Teaching Hospital (UTH), Levy Mwanawasa University Teaching Hospital, and various accredited private clinics, opticians (Optical Express Zambia, Tokyo Opticians), and dental clinics (Kano Dental Clinic, Ultra-Dental Centre). Always verify the latest list on the NHIMA website as facilities can be de-registered for non-compliance.