lifestyle
Urgent – Mechanism for compensation allowance in the mandatory health insurance policy
policy allows health insurance its holder to be reimbursed for medical expenses in case of an emergency outside the network, after applying the co-payment rate.
Compensation mechanism
- The beneficiary is entitled to receive emergency treatment at any medical facility.
- Coverage is subject to the terms and conditions of the policy.
- The beneficiary will be compensated within a maximum period of 15 working days from the date of submission of the invoices and required documents
- The insurance company bears the reimbursable expenses according to the approved rates.
The beneficiary is obligated to provide the insurance company with the required invoices and documents within 30 working days from the date of service.
Health insurance beneficiaries in the Eastern Province
Mandatory health insurance document
The number of primary beneficiaries enrolled in the mandatory health insurance program reached 10 million, while the number of dependents reached 4 million, including 4.5 million Saudi beneficiaries and 9.5 million non-Saudi beneficiaries.
This reflects the Council's commitment to implementing its strategy as a leading regulatory body in enabling patient-centered healthcare services based on quality and efficiency, thus contributing to increasing insurance coverage rates and achieving a sustainable, healthy society.
