New Outpatient Insurance Without Pre-Approval in 2026

All health insurance providers operating in the Kingdom of Saudi Arabia will be required to offer a new optional product that removes the need for prior medical approval when receiving outpatient services. The product will become available to customers starting 1 November 2026.

Under the new product, beneficiaries can obtain outpatient treatment at licensed healthcare providers directly, without submitting pre-authorization requests to their insurer. It is an additional option within the existing range of health insurance products, not a replacement for current policies.

How it differs from current rules

National rules already exempt outpatient clinic treatments costing less than 500 SAR meaning such visits are handled directly. Higher-cost outpatient services, however, normally require pre-approval. The new product goes further by removing the pre-approval requirement for outpatient services more broadly, subject to each policy's specific terms and network coverage.

Pricing and coverage

As of August 2026, no unified national premium, copayment, or coinsurance amounts have been set for the new product. Pricing is left to individual insurance companies within regulatory limits, and each firm is expected to file and market its own compliant design. Standard copayments, network restrictions, and benefit limits of each policy still apply.

The product is available to both employers and individual policyholders in the commercial health insurance market. Employers can choose it for their staff to cut waiting times and reduce administrative steps for outpatient care — a change likely to be welcomed by residents and expats who rely on clinic visits.

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