Saudi Arabia funds free or subsidised care for citizens through the Ministry of Health, while nearly all expatriate residents are covered instead through mandatory private health insurance regulated by the Council of Health Insurance (CHI, formerly CCHI). Here is what that actually means for an American or Briton living in Saudi Arabia: what the public system gives you, what it does not, and where private cover fits.
Can you use the public system?
- Working for a local employer: Yes, from arrival as a legal resident
- Self-employed: Only in limited cases
- Retired or not working: Only in limited cases
Employers are legally required to buy CHI-approved insurance before or at the point a foreign employee’s visa/iqama is issued, so cover is effectively immediate for sponsored workers; a 2025-2026 rule tightening now requires proof of insurance before a temporary work visa is even issued. Self-sponsored/freelance permit holders have no employer to do this and must arrange their own approved policy. Retirees have no ordinary route in at all: the closest option is the ‘retiree’ tier of the Premium Residency (Saudi green card) programme, which requires meeting income/investment thresholds, and those who qualify must still self-fund CHI-approved insurance indefinitely since there is no employer and no public option.
If you are retiring here
There is no ordinary ‘retire in Saudi Arabia’ option for someone without significant income or investment. The Premium Residency retiree tier exists but requires meeting specific financial thresholds, and even successful applicants must self-fund CHI-approved private insurance indefinitely with no public safety net and no reciprocal US/UK arrangement.
What public cover will not give you
- basic (Class C) plans have low annual caps and often exclude much elective, specialist, dental and vision care
- English-speaking specialist care concentrated in Riyadh and Jeddah private hospitals
- no access to citizen-only subsidised Ministry of Health facilities
So do you need private health insurance?
Legally required and strictly enforced: iqama renewal, school enrolment for dependents, and even domestic flight boarding are tied to having active, valid health insurance. Proof of health insurance is also a condition of the main residence routes here, so most expats need a policy in place before they apply.
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General information, not insurance, immigration or medical advice. Rules change and individual situations differ; check the official position before you commit. Researched from official sources, July 2026.