The new executive bylaw for medical insurance in the Kingdom, which puts maximum coverage at SR500,000 for a subscriber, will be implemented within two months, sources have told Arab News.
The bylaw prepared by the Cooperative Health Insurance Council (CHIC) links the issuance of resident permits (iqamas) for expat workers throughout their stay in the Kingdom to the scheme.
“The coverage has been doubled from SR250,000 to SR500,000. This will naturally double the premiums charged from companies and individuals,” Dr. Nadeem Khan of MedNet Saudi Arabia told Arab News.
Khan indicated that the CHIC has not yet finalized the amount for maximum coverage. “They will take a final decision shortly based on market reaction and opinion of service providers,” he added.
The new law allows hospitals to charge a minimum consultation fee of SR50 for general practitioners and a maximum of SR500 for specialty consultants, Khan said while explaining policy changes. Maximum shared-room charge is SR600 while optical coverage is increased from SR200 to SR400. Maximum limit of hearing aid has been raised to SR6,000 while maximum charge for cardiac valve replacement has been fixed at SR70,000.
Other changes are: Donor operation cost for transplant raised to SR50,000, Alzheimer’s disease will be covered up to SR15,000 and autism up to SR15,000.
The maximum charge for neonatal full scanning after delivery is SR100,000, disability treatment SR100,000 and circumcision SR500, he pointed out.
As per the new bylaw, the scheme would cover children born through artificial fertilization, but treatment for infertility, sexual weakness or artificial fertilization is out of its bounds.
The scheme would cover foreign workers in the private sector and non-Saudi residents who do not work at any public or private organizations as well as Saudis working in private institutions and their family members.
“If the Saudi worker is male the scheme would cover his wife (wives) and all his children below 25, his unmarried daughters and parents who are taken care of by him and who stay with him,” the law said.
“The insurance company is not allowed to reject any health coverage request so long as it complies with the law,” the source said.
The government has delayed applying the insurance scheme for citizens by at least five years to ensure the establishment adequate infrastructure facilities. The introduction of medical insurance for Saudis is likely to double the Kingdom’s insurance market, which is now estimated at more than SR25 billion.