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The purpose of this paper is to establish the level of usage of e-services (websites and e-mail) by Botswana Public Officers Medical Aid Scheme (BPOMAS) and PULA Medical Aid (PULA) customers; the level of satisfaction; perceived value; and benefits derived from the website and e-mail services.

In total, 200 BPOMAS members and 100 PULA members were sampled. Systematic sampling technique was used to select the participants. A questionnaire mainly guided by the E-S-QUAL and E-RecS-QUAL scales was designed to gain an in-depth understanding of customers’ perceptions and experiences of e-service quality.

It was established that there is a positive and significant relationship between the usage of e-services and benefits derived from e-services and between the usage of e-services and satisfaction. In addition, a nexus of relationship was observed between perceived value of the e-services and satisfaction.

The management of healthcare services in Botswana needs to understand customers’ value perceptions of e-services and e-service quality in order to establish where to make the most of their efforts.

The managers of healthcare insurance providers should consider stepping up e-service usage and satisfaction levels, supported by client-centred training programmes, to assist clinicians deliver care to the expectation of patients.

There is an acute lack of research in the Botswana context, particularly into the link between e-service usage and satisfaction in the health insurance industry. This paper contributes to the extant literature by elucidating the nexus of relationship between e-service usage and satisfaction in Botswana.