Health insurance represents one of the systems of the Kingdom of Saudi Arabia, which in turn aims to provide healthcare to its citizens and receive treatment at a completely lower cost, in order to create the best insurance solutions to serve the Kingdom, such as Its implementation is overseen by the Saudi Health Council and the Central Bank of Saudi Arabia, in addition to the Saudi Health Insurance Council.
What are the steps to inquire about health insurance using the border number?
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The Saudi Council for Health Insurance has made it possible for all citizens and residents of the Kingdom of Saudi Arabia to obtain information regarding the validity of health insurance through the border number for the year 1445. Below are the most important steps to inquire about health insurance using the border number:
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Access the official website of the Health Insurance Cooperative Council by clicking.
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Choose medical insurance companies after clicking on the e-services icon.
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Determine what information the individual prefers to learn about regarding health insurance.
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Record the applicant’s border number and accurately enter the code in the image, then press the OK icon.
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In the final stage, all the details and information regarding the entered border number will appear.
The most important information about the health insurance system in the Kingdom of Saudi Arabia
There is a lot of information related to the health insurance system, the most important of which are:
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The health insurance market in the Kingdom of Saudi Arabia was regulated on 2/6/1424 AH by the cooperative insurance companies issued by the Royal Decree of the Central Bank.
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The health insurance system is responsible for insuring medical expenses and medicines related to citizens’ affairs, including services, medical supplies and treatments, as well as managing medical programs in their various forms.
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There are 24 qualified health insurance companies and qualified claims management companies in the Kingdom of Saudi Arabia, as well as more than 5,000 certified healthcare providers.
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Cosmetic surgeries are excluded from health insurance, unless they are necessary due to a deformity resulting from the surgery. The system also refuses insurance for routine medical tests or chronic diseases from which a person suffers before of the entry into force of the health insurance policy.
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The owner of the health insurance policy is not required to participate in the payment of a percentage of the costs which may be greater than the value of the policy in which the insured participates by paying a percentage of the costs.
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However, depending on the agreement between the company and the insured, a certain percentage of the costs may be required to be paid.
What services does the health insurance policy in the Kingdom of Saudi Arabia provide?
The health insurance system provides numerous services to serve all health insurance policy holders, the most important of which are:
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It covers the treatment of all dental diseases, including tooth and gum disease, excluding orthodontic surgery and the installation of dentures.
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Pay attention to all preventive measures for citizens, including vaccinations and providing health care to the child and mother.
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Coverage of the costs of medical visits, provision of treatment methods and provision of medicines in clinics for users of the health insurance policy.
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Provide laboratory, radiological and medical tests that may be necessary in some cases.
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Coverage of all costs of hospitalization in government hospitals in the Kingdom, including natural birth, caesarean section and other operations, except plastic surgery.
The most important obligations of health insurance companies
All health insurance companies in the Kingdom of Saudi Arabia try to adhere to many issues that can help those who hold a health insurance policy, as such obligations are as follows:
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The insurance cards must be issued to the insured within a maximum period of five days, starting from the date of entry into force of the policy and its delivery to the customer, but the insurance company remains responsible for all claims that may arise from the beginning of the contract. issuance of the policy. health policy.
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Uploading the names of insured persons into the network system of the National Cooperative Health Insurance Company within two days, as well as informing the network of approved service providers that the policyholder has signed up for insurance coverage in accordance with the needs of the beneficiary and his work position .
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Commitment to establish units to receive complaints and suggestions from beneficiaries of the health insurance policy, as well as commitment to guarantee the minimum benefits of the cooperative health insurance policy in a unitary manner.
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Provide beneficiaries with explanatory brochures at the start of insurance coverage, such as information on the network of approved service providers and limits on the scope of insurance coverage.
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The insurance company must quickly grant service providers approval to provide treatment to beneficiaries within one hour and quickly settle service providers’ claims within two months so that the service provider can provide treatment services exactly adapted to the customers of the health insurance company.
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Provide adequate insurance coverage to beneficiaries and provide health services to them by contracting health services with service providers approved by the board of the health insurance company.
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2024-01-04 04:20:00
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