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Survey Report

Gulf Cooperation Council States: Health insurance mandates across the region

Health and Benefits
N/A

December 13, 2018

All six GCC member states have implemented laws to require foreign visitors and residents to have private health insurance, or intend to adopt such requirements.

All of the six Gulf Cooperation Council (GCC) member states – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates (UAE) – have implemented legislation to require foreigners (both visitors and residents) to have private health insurance or have announced their intention to adopt such requirements. The following is a summary of the current regimes or planned introduction of new health insurance mandates across the GCC.

Key details

  • Bahrain: A new national health insurance system will be introduced for the entire population beginning in 2019, providing funding and insurance for a variety of health services in public and private hospitals and medical centers. Funding for coverage under the new system will come from the central government for Bahraini citizens, GCC nationals and their domestic staff. Coverage for other foreign workers will initially come from additional mandatory employer work permit fees. Details of the actual coverage is still to be determined.
  • Kuwait: In 2016, the Ministry of Health announced plans to require all foreign visitors and workers to purchase local health insurance policies that would link to three special expat-only hospitals and 15 expat-only health clinics. Public hospitals will serve only Kuwaiti nationals and GCC citizens. The new policy, particularly the construction of dedicated health care facilities for foreigners, will take time to implement. Estimates of the annual premium for coverage would be around KWD 130 per person. Details such as specific benefit coverage, policy choices, if any, and cost-sharing provisions for services, if any, are still under development. No specific timetable for implementation has been announced.
  • Oman: The government has suggested that a long-awaited proposal to establish a universal health insurance requirement will be introduced in five stages beginning in 2019 with application of the mandate to foreign visitors in the first stage, foreign workers in the second, companies by size and industry in the third stage and Oman nationals and their dependents in the fourth and fifth stages. The Capital Market Authority is reportedly developing implementing regulations. An exact timetable for launch, the minimum insured benefits and financing are likewise still to be determined.
  • Qatar: A new national health insurance plan (SEHA) launched in 2013 was shut down in 2016. The Ministry of Health indicated that it is working on a new, competitive, mandatory health insurance plan using private insurers, but there has been no further movement on the matter. Today, Qatari nationals receive fully subsidized care and foreign nationals must purchase health cards (Hamad cards) for service.
  • Saudi Arabia: All local and foreign employees (and their dependents) in the private sector must be provided with health insurance under a single employer policy. Employers must be able to prove that they have provided health insurance to all employees or otherwise may be subject to financial penalties and restrictions on work permits for their foreign staff. Saudi citizens are entitled to free services at state-run health care facilities. From July 1, 2019, new minimum coverage requirements were added to any medical insurance plans renewing.
  • UAE: In Abu Dhabi, foreign employees with monthly earnings under AED 5,000 must be insured with the basic plan sold by Daman, the state health insurer or other approved insurers. Higher-paid staff must be insured as well, but it can be arranged with Daman or private insurers. UAE citizens living in Abu Dhabi are insured by the Thiqa program, managed by Daman. In Dubai, foreign employees with monthly earnings under AED 4,000 must be insured with the Care Essential Plan (CEP) sold by Daman or an approved list of private insurers. There is no requirement for the employer to pay for health coverage for dependents of employees. UAE nationals residing in Dubai are covered by the Saada program if they do not have coverage. The other five smaller Emirates do not have insurance mandates in place for foreign or local residents or workers.

Employer implications

Eventually all of the GCC States are expected to develop national insurance plans to finance health care benefits and regulate the provision of care, but to date, progress has been slow, hampered by a variety of factors. For one, the local populations already have free or mostly free access to care, so consumer interest in health care reforms is relatively muted. The primary focus for reforms to date has been on how best to finance and arrange care for foreign workers. Companies operating in the GCC should monitor the changing environment to ensure compliance.

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