Botswana is a highly habitable place to study in, particularly in big towns such as Gaborone and Francistown.However, it is a place where a basic health plan does not necessarily coincide with actual family requirements.The following is the reality on the ground.
Everyday care is typically taken care of within town, but complicated situations may include referral, treatment outside Botswana, usually in South Africa, and private treatment may need evidence of funds or advance payment.That is one fact that ought to influence your insurance policy.
Assuming you are coming with a spouse and kids, you are not just looking to fulfill school or visa requirements, but to create a system that will serve on an average Tuesday and keep you safe even in case of an emergency costing a pretty penny.
This is a guide to the way international student families tend to arrange cover in Botswana, what to watch in the fine print (and not drown in it), as well as how to make decisions that you can justify in future.
Why many families “stack” cover in Botswana
A common approach is a two-layer setup:
- Layer A: a Botswana medical aid (local scheme) for day-to-day care, local provider networks, and smoother access to routine services.
- Layer B: an international health policy for evacuation, cross-border treatment, and higher-cost specialist care.
This is not about buying “more insurance.”
It is about buying the right insurance for the way healthcare is actually accessed.Botswana travel-health guidance from the UK government highlights why: healthcare is generally good in major towns, limited in rural areas, and serious treatment may require evacuation to the UK or South Africa; private hospitals may not treat you unless you can pay, and outpatient care may require payment up front.
So families often want two things at once.
They want convenient local access and strong protection if the care pathway moves across borders.
Botswana’s insurance landscape in plain terms
Botswana’s insurance environment includes:
- Local medical aid funds (what many people call “medical aid”).
- International insurance business for cross-border policies aimed at people who are not ordinarily resident in Botswana (or where policy relationships span borders).
A useful legal summary of Botswana’s framework notes that NBFIRA is the regulator for the insurance industry, and explains that Botswana’s International Insurance Act regulates undertakings carrying on “international insurance business,” which is defined around insured persons (or policy beneficiaries/owners) not ordinarily resident in Botswana.
What that means for you, practically:
A global insurer can cover you while you live in Botswana, and a local medical aid can cover you for Botswana-based care, and many families use both.
Local option spotlight: Bomaid’s International Student Health Plan (ISS)
If you want a Botswana-based plan designed specifically for students, Bomaid’s International Student Health Plan is one of the clearest “student-branded” options marketed in-country.
Bomaid states that its International Student Scheme (ISS) is “a comprehensive student medical cover” and advertises these terms:
- No 10% co-payment
- No 3 months waiting period
- No 14% VAT
- Renewable annually
It also lists exclusions, including:
- No specialised dentistry
- Chronic conditions not covered under the Managed Care Program
- Hospitalisations for pre-existing conditions subject to a 2-year waiting period
That last point matters a lot for families.
If anyone in the household has a known condition, you must treat pre-existing waiting rules as a decision-making “gate,” not a footnote.
How families use ISS in the real world:
Often as the local “everyday” layer for the student, while dependants are covered either under a family-style local plan (if available and suitable) or under an international family policy that includes spouse and children.
Waiting periods and family rules you should not ignore
Waiting periods are not there to annoy you.
They are there because insurance is priced around risk timing, and insurers protect themselves against immediate high-cost claims.
Bomaid’s general waiting-period structure (example)
Bomaid’s Book of Rules sets out a general waiting period of up to three months and a condition-specific waiting period of up to twelve months for new membership.
It also notes situations where benefits are not payable during the first 12 months, including maternity confinement and certain other benefit categories.
Adding a baby: timing matters
Bomaid’s member FAQs explain the practical rule many schemes follow:
- A newborn can be added immediately, and
- To avoid waiting periods, the scheme may require adding the baby within 30 days
- Adding later may trigger a 3-month general waiting period or 12 months for a condition-specific case
This is one of the most common mistakes new student families make.
They assume “birth automatically means coverage,” then discover the timing rule after a claim.
Pregnancy: assume a 12-month clock unless proven otherwise
Bomaid’s FAQs also state that if you join while already pregnant, pregnancy-related costs may not be covered for 12 months.
So if you are planning pregnancy during the study period, you need to plan early.
And if you are already pregnant when you arrive, you must build a budget and insurance plan around the waiting period reality.
Dependants are broader than many people think
Bomaid’s FAQs say a cohabiting boyfriend/girlfriend can be added as an adult dependant if you can prove financial dependence.
This matters for families who are not married but are living as a household.Ask what documents they accept before you arrive, so you do not lose months of coverage while you chase paperwork.
What a good international plan should do for Botswana-based families
A strong international plan is not defined by “worldwide cover” in big letters.
It is defined by how it behaves when the situation is stressful and expensive.
Here are the features worth prioritising for Botswana:
A) Area of cover that matches referral reality
Assuming that you are studying in Botswana, you should take into consideration that cross-border treatment can be conducted in South Africa.
You like a spot of protection that encompasses it, and you need not pay for territories that you will never visit.Stated differently, Allianz Care, in particular, expressly permits the area to be selected as either Worldwide, Worldwide without USA, Africa, or Europe, but includes in the list such benefits like hospital care and medical evacuation.
That option of the Worldwide without USA is a frequent cost-management control.It is able to offer reduced premium and yet cover you in case of referral care outside Botswana.
B) Medical evacuation and repatriation, clearly stated
In nations where serious care might be needed, evacuation is not a nice thing to have.It manages to connect a local diagnosis and a suitable facility.
The international health materials issued by Cigna indicate that evacuation and repatriation benefits are a fundamental service of international health insurance plan covering transportation to appropriate facilities or home to seek treatment depending on the condition and where that is.
Your action item:Request the specific language in the policy that provides information on when evacuation is approved, by whom and what will be covered (air ambulance, commercial flight with medical escort, support travel, family travel, etc.).
C) Clear rules for pre-existing conditions
There are those plans in which pre-existing conditions are under full medical underwriting, and others in which a waiting-period method (also known as a moratorium) is applied.
The information provided by Allianz Care, in their FAQ format, reveals that pre-existing coverage is subject to underwriting conditions, and moratorium approach might need the need to remain without symptoms or treatment on a continuous basis (e.g., 24 months) before a pre-existing condition is eligible.
This is precisely the reason why families can fail because of cheap global insurance.When the policy is inexpensive since it does not cover the exact risk you are concerned about then it is not value.
D) Dependants must be explicitly included
Some student plans cover dependants; others do not.
International Student Insurance markets options that include dependants on certain plans (and clearly labels which options are designed for students and their dependants).Even there, pricing can change sharply once you add spouse and children.
So do not guess.
“But what will it cost?” Use drivers, not wishful numbers
You asked for credible sourcing only, and healthcare premiums vary by age, medical history, and cover design.So rather than inventing a neat price range, here are the cost drivers that reliably move premiums up or down.
The biggest premium levers
- Geographic zone
Worldwide is usually the most expensive.
Worldwide excluding USA often costs less, and an Africa-only zone can cost less again, depending on the insurer. - Deductible / excess
Higher deductibles usually reduce premium, but raise your out-of-pocket cost when you claim. - Outpatient cover
Inpatient-only (“catastrophic”) policies can be far cheaper than comprehensive plans with outpatient, dental, optical, and maternity. - Maternity and chronic benefits
Adding maternity and chronic care can materially increase premiums, and waiting periods can still apply, depending on the plan rules.
VAT and local billing reality
Botswana’s standard VAT rate is 14%, and it is used widely across taxable supplies in the country.
Bomaid’s ISS highlights “No 14% VAT” as a plan term, which signals that VAT treatment can affect what members pay on some products.
So when you compare local options, ask:
Is VAT included in the contribution, added to certain charges, or not applicable in that plan category?
A practical structure that works for many student families
Below are three realistic “recipes.”
They are not prescriptions, but they give you a decision framework you can adapt.
Recipe 1: Local student plan + international catastrophe plan
Best for: families who want everyday affordability, and want strong protection for major events.
- Student uses a Botswana student plan such as Bomaid ISS for routine local access.
- Whole family (or at least spouse/children) has an international inpatient-focused plan with evacuation and cross-border cover.
Watch-outs:
Pre-existing rules and maternity waiting periods can still apply on both layers.
Recipe 2: Local family medical aid + international “top-up” plan
Best for: families living in Botswana longer term who want smoother local claims.
- Local medical aid set up for the household, with dependants properly registered (especially newborn timing).
- International plan chosen primarily for South Africa referrals, evacuation, and higher limits.
This approach often feels easiest day-to-day.But you must ensure the two policies coordinate benefits cleanly, so you do not get stuck between “primary vs secondary payer” rules.
Recipe 3: International comprehensive plan only (with a cash plan for local care)
Best for: short stays, or families who want one policy and accept local out-of-pocket friction.
- A global plan with outpatient + inpatient + evacuation.
- Keep a dedicated emergency fund for up-front payments where direct billing is not available, which travel-health guidance flags as a real possibility.
This can work well.It just requires discipline and documentation.
Questions to ask insurers
Use these questions in email so you get written answers.
- Area of cover: Does this policy cover treatment in South Africa if Botswana clinicians refer us there?
- Evacuation trigger: Who approves medical evacuation, and what clinical thresholds must be met?
- Direct billing: Which hospitals/clinics in Gaborone and Francistown do you pay directly, and which require reimbursement?
- Maternity: What is the waiting period for pregnancy and delivery costs?
- Newborn cover: How long do we have to register a newborn to avoid waiting periods?
- Pre-existing conditions: Are pre-existing conditions covered, excluded, or covered after a defined symptom-free period?
- Dependants definition: Who qualifies as a dependant (spouse, partner, children), and what documents are required?
- Claims timing: What is the typical claim turnaround time, and what documents are required for reimbursement?
- Emergency support: Is there a 24/7 assistance line for emergencies and evacuation coordination?
These nine questions prevent most unpleasant surprises.
They also make quotes comparable.
A short comparison table to make your decision clearer
A simple step-by-step action plan
Step 1: Confirm your institution’s requirement in writing.
Ask your university/college what minimum cover is required for the student and for dependants.
Step 2: Decide your “referral map.”
If your likely referral is South Africa, choose an area of cover that includes it.
Step 3: Identify family risks before shopping.
Pregnancy plans, child chronic needs, and known conditions should drive your plan choice, because waiting periods can block claims.
Step 4: Choose your structure (one of the three recipes).
Then request quotes using identical inputs so you can compare properly.
Step 5: Build an “arrival buffer.”
Because up-front payment can be required, keep accessible funds for the first months while you learn which providers bill directly.
Step 6: Lock down dependent registration documents.
Prepare passports, birth certificates, marriage certificate (if applicable), and proof of cohabitation/financial dependency if relevant.
Step 7: Store your policy documents where you can reach them fast.
Keep digital copies on your phone and a printed copy at home, because emergencies are not organised.
Pro Tips:
Most students do not find Botswana a high drama healthcare environment.However, the families are confronted with a reality other than that of the solo students, children do not fall ill at the most convenient time and the aspect of pregnancy never understands the timing of the semesters.
The best method is the calm and organized one.Take a local plan of local life, a cross-border risk plan international, and regard waiting periods and dependant rules as important contents of a decision, not paperwork.
References:
- Allianz Care. (n.d.). *International health insurance plans*. Allianz Care. Retrieved December 24, 2025, from https://www.allianzcare.com/en/personal-international-health-insurance/products-and-services/international-healthcare-plans.html
- Allianz Care. (n.d.). *Insurance cover queries* (FAQ). Allianz Care. Retrieved December 24, 2025, from https://www.allianzcare.com/en/support/member-resources/frequently-asked-questions/topics/cover-queries.html
- Bomaid. (n.d.). *International student health plan*. Bomaid. Retrieved December 24, 2025, from https://bomaid.co.bw/health-plans/international-student-health-plan
- Bomaid. (n.d.). *New members FAQs*. Bomaid. Retrieved December 24, 2025, from https://bomaid.co.bw/new-members-faqs
- Bomaid. (2024). *Book of Rules 2024* [PDF]. Bomaid. Retrieved December 24, 2025, from https://bomaid.co.bw/sites/default/files/2024-11/Book-of-Rules2024.pdf
- Botswana. (2005). *International Insurance Act, 2005 (Act No. 5 of 2005)* [PDF]. BotswanaLaws. Retrieved December 24, 2025, from https://botswanalaws.com/StatutesActpdf/2005Actpdf/INTERNATIONAL%20INSURANCE%20ACT%2C%205%20OF%202005.pdf
- Cigna Global. (n.d.). *International health plans*. Cigna Global. Retrieved December 24, 2025, from https://www.cignaglobal.com/international-health-plans
- Foreign, Commonwealth & Development Office. (n.d.). *Botswana travel advice: Health*. GOV.UK. Retrieved December 24, 2025, from https://www.gov.uk/foreign-travel-advice/botswana/health
- International Student Insurance. (n.d.). *InternationalStudentInsurance.com: Student health and travel insurance plans*. Retrieved December 24, 2025, from https://www.internationalstudentinsurance.com/
- PwC. (2025, September 25). *Botswana—Individual: Significant developments*. PwC Worldwide Tax Summaries. Retrieved December 24, 2025, from https://taxsummaries.pwc.com/botswana/individual/significant-developments
