Health Insurance

Health Insurance is one of the types of insurance that covers the risks of health conditions or a part of them in the Kingdom of Saudi Arabia. It typically includes the costs of medical examinations, diagnosis, treatment, and preventive services. It is one of the ways to provide healthcare to individuals and groups, aiming to alleviate the burdens and costs of treating medical conditions that the insured may face. It ensures their access to healthcare in exchange for a fixed amount paid by the insured individuals. The Cooperative Health Insurance Law mandates that any sponsor of a resident must subscribe in favor of the resident. Medical insurance covers the employee, their family, visitors to the Kingdom, Umrah pilgrims, and tourists.

The implementation of health insurance in the Kingdom began on August 11, 1999, after a royal decree was issued approving the Cooperative Health Insurance Law. The aim was to provide and regulate healthcare for all residents (non-Saudis), and it may be applied to citizens by a resolution from the Council of Ministers.

On May 3, 2009, implementing regulations were issued requiring employers in companies and institutions of the private sector to implement the Cooperative Health Insurance Law to all employees and their family members covered by the law, regardless of age, nationality, and gender.

The General Secretariat of the Council of Cooperative Health Insurance adopted the Implementing Regulations of the Cooperative Health Insurance Law on February 13, 2014. The unified health insurance policy was implemented on October 1, 2022.

The Kingdom established a health insurance council responsible for overseeing the implementation of the Cooperative Health Insurance Law, qualifying insurance companies and entities related to cooperative health insurance, and accrediting health facilities that offer health insurance services.

The annual increase in population rates, the rise in health services costs in the private sector, the increased demand for health services, the emergence of new health needs, and the global trend toward the privatization of the public health sector represent the main factors driving the adoption of health insurance in the Kingdom.

The Cooperative Health Insurance Law aims to contribute to the development and regulation of health services in the Kingdom, alleviate the burden on government facilities, develop the private health sector, create investment opportunities, provide health services at reasonable prices, and improve the population's health level.

The General Secretariat of the Council of Health Insurance conducted updates to the benefits package, coverage limits, and the Insurance Drug Formulary (IDF), including focusing on the prevention for beneficiaries, enhancing women's and children's health, improving the physical capacity and functions of beneficiaries, reducing complications of certain diseases, and facilitating access to services.  ​​

Within the Health Sector Transformation Program and to provide free medical insurance for citizens, the Center for National Health Insurance was launched. It is a national entity concerned with covering healthcare costs and providing free insurance coverage for citizens and all segments of Saudi society without exception for all diseases at 100 percent, without any financial hardship to citizens. This is achieved through the Center for National Health Insurance's purchase of health services from health cluster operators by contracting with them according to international trends, to offer high-quality free care based on a budget built on the healthcare services they need, without any additional financial payments.