Bahrain is a popular choice for expats seeking employment: with no income tax, witholding or capital gains tax it has been ranked as one of the best places in the Middle East for expats. The country has a high standard of healthcare and operates on a two-tier health system consisting of public and private insurance.

Until now, public health insurance has only been available to Bahraini nationals, but recently the government have made the decision to open public schemes up to expats as well.

In May 2018, the government issued a Health Insurance Law, making health insurance coverage compulsory from January 2019 for all citizens, residents and visitors, with a very limited number of exceptions (mainly expats working for diplomatic missions). This was supposed to be activated in January 2019 but missed the due date. Under this scheme, nationals will be subsidized by the government and expats will be subsidized by their employers – and probably also from their own payroll contributions.

From late 2020/early 2021 national health insurance, called Sehati, will be opened up to expat residents. Employers will need to pay a premium for their expat employees, which will enable workers to access both public and private sector healthcare. Bahrainis will also still be able to access public healthcare but may have to pay an additional premium for private treatment.

However, this scheme is still in its infancy. The Supreme Council for Health has yet to establish the terms of the new legislation. Moreover, there is a lack of local insurers with whom Sehati can be implemented. The SCH is working with Marsh Bahrain to set up a scheme for expats. KPMG has been appointed by SCH to draft the scheme for Bahraini nationals. These companies are due to report back to the government in mid 2020.

You cannot currently covered by national insurance if you are an expat, but you will be automatically covered at an unspecified date in the near future. Your insurance will be funded through subscriptions to insurance packages, but the terms of this are still being drawn up.

There has been a suggestion that the cost of visas may increase once the new legislation has been implemented.

Once Sehati has been fully implemented, your employer will be able to discuss registration with you. In the meantime, you will need to take out private cover.

There are currently three public hospitals, plus around 24 primary care centres. Healthcare in Bahrain is of a good standard, with highly trained medical personnel and excellent facilities. Traditionally, American Mission hospitals have provided care on a part private, part public basis (providing free treatment for those who cannot afford to pay, for instance). The Salmaniya Medical Complex is a multidisciplinary public medical facility which provides urgent care. The country also has a centre for geriatric care, a psychiatric hospital, and four birthing centres.

As an expat, you can still access the public sector if you have private health insurance or if you are prepared to pay out of pocket (this includes emergency treatment, for which you will be charged). The cost of a GP’s appointment is between BHD10 – 15 (US$26-40). Specialist appointments are around BHD25 (US$66). Dental treatment is not cheap: for example, costing around US$100 for an extraction.

You can see a specialist without needing a referral from your GP. Waiting times are short, in comparison to many other countries, and the system is efficient.

Medical records can be an issue since there is not currently a centralized system, so if you go to different providers you may find that they do not have access to your records. Part of the new system, however, is the planned streamlining and centralization of medical records.

A national ambulance service has recently been established.

As a retiree in Bahrain, you will need to take out private health cover while Sehati is being put in place.

As an international student, you will need private cover during your stay in the country. Contact your educational institution to see if they have in-house cover or can recommend an approved provider.

You will need to take out private cover for your dependents until national insurance is put in place for expats. However, there is an indication that once the new scheme comes in, insurance via your employer will in some cases cover your dependents.

Dental treatment may not be covered under the new scheme and you will need to access the private sector. Some sample costs are:

• cleaning: BHD25 – 50 (US$66 - 130)
• root canal treatment: BHD150 – 250 (US$400 – 660)
• crown: BHD100 - 400 (US$265 - 1060)
• teeth whitening: BHD 50 - 300 (US$130 - 610)

At present, the contribution rates under the new scheme have yet to be put in place.

Public health insurance is currently not available to expats and you will have no options other than taking out private cover or paying out of pocket. However, some employers will have offered private insurance under group cover and this has been encouraged by the Bahraini government, in order to lessen the burden on the public system.

You may still choose to take out private insurance even if, in the fullness of time, you are covered under Sehati, as a top up: the public scheme may not cover you fully and you may wish to supplement your cover.

Private insurance will cover all primary and secondary care, plus elective procedures such as optical correction surgery, dental implants, and cosmetic procedures. Many Bahrainis choose to have treatment outside the country. With this in mind, you may wish to take out cover which has a medical evacuation clause.

This will depend on factors such as your age and any pre-existing conditions, and the kind of package you opt for (obviously, a more expensive insurance package will give you more a extensive range of treatment and facilities). As so many variables have an effect on the cost of international private medical insurance it becomes very difficult to give accurate estimates without knowing the full details of the coverage required.

However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

Many international providers cover Bahrain, including:

• Allianz
• AXA
• Cigna
• Pacific Prime

Sehati - the new national health insurance scheme