Outpatient treatment limit raised to 1000 Riyals
The Insurance Authority has increased the approved treatment costs in outpatient clinics from 500 to 1,000 riyals in order to expedite approval procedures and reduce cases requiring prior authorization for low-cost medical services. The new adjustments include hospitalization cases, same-day treatments, non-emergency surgeries, emergency admissions within 24 hours, as well as physical therapy sessions after the initial session. In cases of medical disagreement, the project proposes consulting an independent, non-exclusive specialist from the public or private sector, with the consultation costs covered by the insurance company, and the expert’s opinion to be binding. This aims to enhance neutrality, improve approval mechanisms, and minimize medical disputes between the insurance parties. This initiative is part of the Authority’s efforts to develop health insurance regulations and improve the efficiency of medical approval procedures. The project is open for public consultation from August 25 to September 25, 2026.
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