Introduction: individuals residing in Limpopo, KwaZulu-Natal and the Eastern Cape provinces who had access to public health services were surveyed to determine public knowledge and awareness of the new National Health Insurance (NHI).

Methods: a descriptive cross-sectional study was conducted and a total of 748 adult respondents were sampled using a two-stage systematic sampling design. Data were collected using mobile phone assisted personal interviews.

Results: the study found that 80.3% of the respondents were aware of the NHI and slightly less than half (49.8%) of the respondents did not have knowledge of how the NHI works and 71.8% lacked awareness about the origin of the development of the NHI concept in South Africa. The knowledge of what the NHI would pay for was poor and 48.1% knew that the NHI Fund would pay for medical expenses if a person got sick and 45.7% knew that with health insurance, basic health requirement is ensured and that if one becomes ill, medical treatment would be paid for by the NHI Fund, 50.9% of respondents did not understand how the NHI Fund will pay for health care received, only 44.8% understood how the NHI will pay for health care services received.

Conclusion: the public education campaigns to increase knowledge and understanding of the NHI scheme might have been inadequate hence might not have penetrated many communities. It is recommended that a comprehensive community consultation plan be established to increase awareness and knowledge of the NHI among community members targeting clinics, schools, pension pay points and other community sites.