Article 12 of the Saudi Cooperative Health Insurance Law
المادة 12 من نظام الضمان الصحي التعاوني
Employees of government entities covered by the Law, and their families, are treated in government health facilities if they are contracted directly with those entities and under their sponsorship and their contracts state a right to treatment.
Official text (Arabic)
This article has not been amended since the law was issued.
يكون علاج العاملين في الجِهات الحُكومية المشمولين بهذا النِظام وأفراد أُسرِهم في المرافِق الصحية الحُكومية متى كانوا مُتعاقدين مُباشرة مع هذه الجِهات وتحت كفالتِها، وكانت عقودُهم تنُص على حقِهم في العلاج.
This is the official Arabic wording, the only legally binding version. We do not translate the law itself; the explanation below is ours. Official source: Bureau of Experts at the Council of Ministers
Article 12 explained in plain English
This article deals with a special category of those covered by the Law, employees of government entities. Their treatment and that of their family members is in government health facilities, on condition that three conditions are met together:
- They are contracted directly with these government entities.
- They are under their sponsorship.
- Their contracts state their right to treatment.
If one condition is missing, for example if the person works at a government entity through a company contracted with it and not by a direct contract, or his contract does not state his right to treatment, the provision of this article does not apply to him.
This article differs from Article 11, which allows, when needed, government health facilities to provide the holder of a cooperative health insurance policy with the services covered by his policy for a fee borne by the health insurance body. Article 11 concerns the policy holder, while this article concerns employees of government entities under its conditions.
It is followed by Article 13, which allows the Council of Health Insurance, by decision, to exempt institutions and companies that own qualified private medical institutions from subscribing for the services they provide to their personnel. The two articles deal with cases in which treatment is available from a source other than the policy.
Practical example
A non-Saudi doctor is contracted directly with a government entity in Riyadh and is under its sponsorship, and his contract states his right to treatment. His treatment and that of his family is in government health facilities. His colleague who works at the same entity through an operating company is not covered by this article because he is not contracted directly with it.
Translated from our Arabic explanation with machine assistance. For guidance only; it does not replace advice from a lawyer on your situation.
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Frequently asked questions about Article 12 of the Saudi Cooperative Health Insurance Law
Does a foreign employee at a government entity need health insurance?
If he is contracted directly with the entity, under its sponsorship, and his contract states his right to treatment, his treatment and that of his family is in government health facilities.
Does a government employee's treatment cover his family?
Yes. The article covers employees and their family members when the conditions are met.
What if my contract does not state my right to treatment?
One of the article's conditions is that contracts state the right to treatment; if this condition is missing, its provision does not apply.
More articles on Persons Covered by Health Insurance
- Article 1
The article sets the Law's objective: providing and organizing health care for all non-Saudi residents in the Kingdom, with the option of applying it to citizens and others by decision of the Council of Ministers.
يهدف هذا النِظام إلى توفير الرعاية الصحية وتنظيمِها لجميع المُقيمين غير السعوديين في المملكة، ويجوز تطبيقُه على المواطنين وغيرِهم بقرار مِن مجلس الوزراء .
- Article 2
Cooperative health insurance coverage includes everyone to whom the Law applies and their family members, as the Council of Health Insurance determines under paragraph (b) of Article 5.
تشمل التغطية بالضمان الصحي التعاوني جميع من ينطبق عليهم هذا النِظام وأفراد أُسرِهم وِفقاً لما جاء في الفقرة (ب) مِن المادة الخامسة.
- Article 3
Anyone who sponsors a resident must subscribe to cooperative health insurance for him, and a residence permit is not granted or renewed without a policy covering the period of residence.
مع مُراعاة مراحِل التطبيق المُشار إليها في الفقرة (ب) من المادة الخامسة، وما تقضي بِه المادتان الثانية عشرة والثالثة عشرة مِن هذا النِظام، يلتزم كُل من يكفل مُق
- Article 13
The Council of Health Insurance may, by decision, exempt institutions and companies that own qualified private medical institutions from subscribing for the services they provide to their personnel.
يجوز بقرار مِن مجلِس الضمان الصحي إعفاء المؤسسات والشركات التي تملك مؤسسات طبية خاصة مؤهلة من الاشتِراك في الضمان الصحي التعاوني عن الخدمات التي تُقدِّمُها لمنس
- Article 15
A resident who is not under a work sponsorship takes the employer's place in the obligations the employer would otherwise bear under the Cooperative Health Insurance Law.
يحل المُقيم غير المشمول بكفالة عمل محل صاحِب العمل في الالتِزامات المُترتِبة على هذا الأخير بموجب هذا النِظام.
The texts are reproduced from the official website of the Bureau of Experts at the Council of Ministers for reference; where they differ, the officially published Arabic text prevails. This content is not legal advice.