Saudi Arabia orders health insurers to provide outpatient coverage without prior approval
Unlike conventional plans that may require insurers to approve certain outpatient services before beneficiaries receive care, the new option will remove the pre-approval requirement for eligible outpatient services.
SAUDI ARABIA — The Saudi Insurance Authority has directed health insurance companies to introduce a health insurance product that allows beneficiaries to access outpatient services without obtaining prior medical approval.
The initiative aims to address a longstanding concern among health insurance beneficiaries and make access to covered outpatient care more convenient.
New insurance option
Under the directive, insurers must offer the product as an additional option alongside existing health insurance plans.
This approach will give employers and policyholders greater flexibility when selecting coverage that aligns with their healthcare needs and preferences.
The new product will be available to health insurance customers from November 1, 2026.
Unlike conventional plans that may require insurers to approve certain outpatient services before beneficiaries receive care, the new option will remove the pre-approval requirement for eligible outpatient services.
The Insurance Authority said the move forms part of its broader efforts to improve the health insurance experience and address challenges that beneficiaries have encountered when seeking medical services.
By introducing an alternative product, the authority is also giving policyholders and employers more choice within the health insurance market.
Supporting Saudi Vision 2030
Insurance Authority CEO Eng. Naji Al-Tamimi said the directive reflects the Saudi leadership’s efforts to reduce administrative burdens on citizens and residents while improving quality of life.
According to Al-Tamimi, removing pre-approval requirements for outpatient services supports the broader objectives of Saudi Vision 2030, particularly its focus on improving the quality and accessibility of services.
He added that the initiative demonstrates the authority’s role in developing a more responsive and customer-focused insurance market.
The directive also aligns with the objectives of the National Insurance Sector Strategy, under which the Insurance Authority is working to strengthen the insurance sector and ensure that products respond to the needs of individuals and businesses.
Insurer compliance
The authority said the new product must be available to customers from the specified implementation date.
It has also urged health insurance beneficiaries to report insurers that fail to provide the new option after November 1, 2026.
Customers who encounter difficulties or whose insurer refuses to offer the product can file a complaint with the Insurance Authority.
The authority will use these complaints to address non-compliance with the directive and ensure insurers meet the requirements governing the new outpatient insurance option.
The initiative therefore adds another choice to Saudi Arabia’s health insurance market while establishing a specific product pathway for customers seeking outpatient coverage without prior medical approval.
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