Saudi Arabia’s New Health Insurance Rules for Domestic Workers — What Expats Must Know

From July 1, 2024, Saudi Arabia began enforcing a major change in how households insure domestic workers. The Saudi Council of Health Insurance (CHI) has moved to study and refine the regime that makes health insurance mandatory for domestic workers in certain households and is now exploring options to expand that coverage further. This article explains what the policy means for expats, which services are covered today, what to expect next, and practical steps employers and workers should take to stay compliant.

What changed on July 1, 2024?

The CHI confirmed that households employing more than four domestic workers must provide mandatory health insurance for those workers from July 1, 2024. This is part of a broader effort to align protections for domestic workers with the Kingdom’s national health insurance standards and to improve healthcare access for a vulnerable workforce that includes many expatriates.

CHI study: why it matters and what will be reviewed

To ensure the new rules work in practice and can be extended safely, the CHI is hiring an external consulting firm to evaluate the policy’s effects and recommend any adjustments. The firm’s mandate includes:

• Assessing the real-world impact of mandatory insurance for households with more than four domestic workers—on families, workers, insurers and healthcare providers.
• Providing technical guidance on whether coverage should be gradually extended to employers who hire three or more or even two or more domestic workers.
• Reviewing the current Unified Health Insurance Policy to determine if coverage limits need to be raised to better serve domestic workers’ needs.
• Producing an implementation report with recommendations on timelines, costs, and enforcement mechanisms.

The study will inform possible next steps—any expansion is expected to be phased, with the CHI recommending practical timelines and transitional measures for households and insurers.

What the Unified Health Insurance Policy currently covers

Under the existing Unified Health Insurance Policy that applies to insured domestic workers, standard covered services include:

• Basic healthcare services — outpatient consultations, primary care, and treatment for common illnesses.
• Public healthcare services — access to government-approved facilities where applicable.
• Emergency care — treatment for emergencies, including unlimited emergency clinic visits where required.
• Hospitalisation — inpatient care with no co-payment required for the insured domestic worker in many cases.
• Preventive services — vaccinations and necessary laboratory or diagnostic tests.

These benefits reflect an effort to provide meaningful and practical coverage for domestic workers, including many expatriates who do not always have access to private insurance or employer-provided plans in their home countries.

Enforcement, penalties and employer responsibilities

Enforcement is a central part of the reform. The CHI and relevant authorities have signaled stricter compliance checks and heavier fines for employers who fail to provide required insurance. Employers should be aware that failure to comply can lead to significant penalties and administrative actions.

Key employer responsibilities include:

• Ensuring domestic workers are registered under an approved health insurance policy when thresholds apply.
• Keeping records of insurance receipts and policy documents to show compliance during inspections.
• Communicating coverage details to the domestic worker—what is covered and how to access care in an emergency.

What this means for expats and domestic workers

For expat households and domestic workers, the new rules provide clearer protections and better access to care. Domestic workers should:

• Ask employers to confirm whether an insurance policy is in place and request a copy of the insurance card or policy summary.
• Keep a personal copy of any medical reports or receipts related to treatment to document services received under the policy.
• Contact local worker support or advisory services if they have questions or concerns about coverage or access to care.

Employers should take proactive steps to verify that policies meet CHI standards and keep evidence of payment and registration. Given the CHI’s ongoing review, complexity around coverage levels or provider networks may evolve—so staying informed is crucial.

Possible expansion and timeline

The consulting study will help determine whether mandatory insurance should be extended to households with fewer domestic workers (three or two). If the CHI recommends expansion, the next phase would likely be accompanied by:

• Phased implementation timelines to allow households and insurers to adapt.
• Regulatory guidance on minimum coverage levels and cost-sharing rules (if any).
• Public awareness campaigns and employer support tools to reduce non-compliance.

Industry observers expect any major extension to affect thousands more households and domestic workers, potentially rolling out across 2025–2026 depending on the study’s findings and stakeholder consultations.

How to stay updated and where to check official guidance

Because regulations and technical guidance may be updated following the CHI study, employers and workers should rely on official sources for the latest information. Useful official resources include:

• Saudi Council of Health Insurance (CHI): check CHI announcements and guidance pages for policy updates and technical reports. (Official site: chi.gov.sa)
• Ministry of Human Resources and Social Development (MHRSD): for labour-related rules and support services. (Official site: hrsd.gov.sa)
• Saudi Government portal: central announcements and links to official agencies. (Official site: saudi.gov.sa)

Note: always verify any insurance product directly with the insurer and ensure the policy is approved under the Unified Health Insurance Policy framework.

Practical checklist for employers

• Confirm whether your household exceeds the mandatory-insurance threshold (more than four domestic workers as of July 1, 2024).
• If covered, obtain and retain the insurance policy details, payment receipts and contact information for the insurer.
• Review what services are included, emergency access procedures, and whether there are any exclusions that could affect care.
• Prepare for possible expansion—if you employ fewer workers now, consider options and budgeting in case the threshold is lowered in future.

Bottom line for the expat community

Saudi Arabia’s move to formalize and possibly expand health insurance for domestic workers strengthens protections for a workforce that is largely expatriate. The CHI’s commissioning of a detailed study is a positive step toward evidence-based expansion and clearer enforcement. Employers should act now to ensure compliance and to protect the health and rights of domestic workers; workers should request documentation and understand their entitlements.

Stay tuned to official CHI and MHRSD channels for the consulting firm’s report and any updates on coverage expansion or changes to the Unified Health Insurance Policy.

Need help navigating the requirements or checking a policy? Contact the insurer directly and consult the official agency websites listed above for authoritative guidance.