health insurance for Saudi student overseas

 

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Student

Health Plan provided by
Saudi Arabian Cultural

Mission (SACM)

Student Guide

16

COL

3

5

4

7 Version Date: March

10

, 20

17

Good health is essential to your academic success.

UnitedHealthcare remains committed to supporting
students to ensure they can achieve their academic
goals, and we are uniquely qualifi ed to meet that
commitment.

Our nationwide networks are robust and
highly competitive, our innovative eligibility and
administrative systems are built specifi cally to
support student health benefi t plans and our
employees are dedicated to the needs of the
schools and their students.

Within this guide, you will fi nd valuable information
about the services available to you. Please note that
Medical and Dental services are separate from each
other. We recommend you become familiar with this
guide and the corresponding resources for medical
and dental to learn about your plan and how to use
your benefi ts.

INTEGRITY

COMPASSION

RELATIONSHIPS

INNOVATION

PERFORMANCE

Contents
UHC at a Glance 3
Welcome to UHCSR 4

Your Medical Coverage – PPO Plan 5
My Account and Access your Medical ID Card

8

Find a Medical Health Care Provider

9

Which provider should I see? 9
Defi nitions 10
Global Emergency Services

12

Telemedicine by HealthiestYou 12
Hospitalization Pre-Admission Notifi cation

13

Submit a Claim for Member Reimbursement

14

How to reach UHC for Medical Information

15

Your Dental Coverage 16
Access your Dental ID Card 17
How to Find a Dental Health Care Provider 17
How to reach UHC for Dental Information 17

Your Vision Coverage

18

ID Card for Vision Benefi ts

19

How to Find a Vision Care Provider 19
How to reach UHC for Vision Information 19

On your home page, www.uhcsr.com/SACM:

 Medical, Mental Health and Dental Provider Search

 Pharmacy Locator

 Benefi t Information
 Details on your medical and dental benefi ts

 SACM Student Guide

 Helpful Information
 Create Account Guide

◦ Create/log in to My Account

◦ Download the Mobile App

On your My Account page:

 Network Medical Provider Search

 Dental Provider Search

 View Current Coverage

 View Personal Information

 View/Print/Download/Request ID Card

 View Claims Information

 Submit Accident Details

 Personal Representative Appointment (for authorizing someone to
act on your behalf in matters of your benefi t plan)

 Links to Value Added Benefi ts
 Global Emergency Services

 HealthiestYou

 UHC Dental

 Message Center
 My Messages

 My Documents

(See page 8 for details about creating My Account)

UHC at a Glance
Where to fi nd helpful information

For customer service,
please call

1-866-808-8461
Monday–Friday

7:00AM–7:00PM CST

Your home page is:

www.uhcsr.com/SACM

Use it to access your
benefi t information,
including locating a
provider, viewing claims,
and other features of your
My Account page.

Helpful Links

3

Welcome to UnitedHealthcare StudentResources
(UHCSR)

UHCSR is the dedicated student health division of UnitedHealthcare (UHC). UHCSR will
be your fi rst point of contact for all questions. Below is where to fi nd helpful information.

Provider
Search

You can search
for health
care preferred
providers online at our website
www.uhcsr.com/SACM or on
your mobile device with our free
UHCSR Mobile App.

Benefi t
Information

You can fi nd
your Student
Guide and other
helpful information regarding the
available services as well as general
health information and FAQs at
www.uhcsr.com/SACM.

Account
Information

Log into your My
Account page
on our website at
www.uhcsr.com/SACM. From there
you can download your medical ID card,
access medical claims information, see
any messages sent to you, and access
other helpful information.

4

Your Medical Coverage – PPO Plan
A generous health benefit plan is provided by SACM for its students and their dependents. SACM students are
covered at 100% for Preferred Provider In-Network care. The UHC network is one of America’s largest health
care networks, with over 800,000 network providers. For questions pertaining to your medical benefits, call
Customer Service at 1-866-808-8461.

Your medical plan includes:
 Doctor office visits and preventive care (routine

physicals, immunizations, cancer screenings)
 Diagnostic lab and radiology tests
 Vision care
 Pharmacy coverage
 Inpatient and outpatient care

 Mental health services
 Home health care
 Maternity care
 Short-term rehabilitation (physical, occupational

and speech therapy)
 Emergency and urgent care

 
Your full summary of benefits is listed below. The benefits are provided by your plan sponsor (SACM) and are subject to
change by SACM. A complete description of your benefits and any limitations and exclusions are provided in the SACM
Benefits Booklet, Plan Number 2016-1965-1/2.

Eligibility Provisions 
Students  Any sponsored Saudi national enrolled in a scholarly program in the United States pursuant to a 

valid student visa issued by the United States 
Diplomat or Staff  Any sponsored Saudi national in the United States on a valid visa serving as a Diplomat or Staff of 

the Saudi Government is eligible to be enrolled in the plan. 
Dependents  Dependents of insureds that are in an Eligible Class are also eligible to be covered under the plan. 
Plan Features  Preferred Provider  Out‐of‐Network Provider 
Maximum Benefit  No Overall Maximum Dollar Limit (Per Covered Person, Per Plan Year) 
Deductible   $0 ( Per Covered Person, Per Plan Year )  $10,000 ( Per Covered Person, Per Plan Year ) 
Coinsurance  100% except as noted below  20% except as noted below 
Notes on your Benefits Plan 

The Preferred Provider network for this Plan is UnitedHealthcare Choice Plus PPO. 

If care is received from a Preferred Provider any Covered Medical Expenses will be paid at the Preferred Provider level of Benefits.  If a 
Preferred Provider is not available in the Network Area, Benefits will be paid at the level of Benefits shown as Preferred Provider Benefits.  If 
the Covered Medical Expense is incurred due to a Medical Emergency, Benefits will be paid at the Preferred Provider level of Benefits.  Covered 
Medical Expense incurred at a Preferred Provider facility by an Out‐of‐Network Provider will be paid at the Preferred Provider level of Benefits. 
In all other situations, reduced or lower Benefits will be provided when an Out‐of‐Network provider is used. 

Benefits will be reimbursed at one hundred percent (100%) of billed charges under the following circumstances:  1) All Covered Medical 
Expenses for services rendered in Saudi Arabia; and 2) Covered Medical Expenses when due to a Medical Emergency occurring in any 
country outside of the United States. The Plan Deductible will not apply. 

The Benefits payable are as defined in and subject to all provisions of the Benefits Booklet and any endorsements thereto. Benefits are subject 
to the Plan Maximum Benefit unless otherwise specifically stated.  Benefits will be paid up to the maximum Benefit for each service as 
scheduled below.  All Benefit maximums are combined Preferred Provider and Out‐of‐Network unless otherwise specifically stated. 

Plan Payments 
Inpatient  Preferred Provider  Out‐of‐Network Provider 
Room & Board:  Preferred Allowance 

Usual and Customary Charges 

(Includes guest bed and meal trays for adult accompanying a minor while confined as an Inpatient.) 
Intensive Care: 

Preferred Allowance  Usual and Customary Charges 

Hospital Miscellaneous Expense:  Preferred Allowance  Usual and Customary Charges 
Routine Newborn Care: 

Paid as any other Sickness  Paid as any other Sickness 

Surgery:  Preferred Allowance  Usual and Customary Charges 
(If two or more procedures are performed through the same incision or in immediate succession at the same operative session, the 
maximum amount paid will not exceed 50% of the second procedure and 50% of all subsequent procedure.)  
Assistant Surgeon Fees:  Preferred Allowance  Usual and Customary Charges 
Anesthetist Services:  Preferred Allowance  Usual and Customary Charges 
Registered Nurse’s Services:  Preferred Allowance  Usual and Customary Charges 
Physician’s Visits:  Preferred Allowance  Usual and Customary Charges 
Pre‐admission Testing:  Preferred Allowance  Usual and Customary Charges 

5

Outpatient  Preferred Provider  Out‐of‐Network Provider 
Surgery:  Preferred Allowance  Usual and Customary Charges 
(If two or more procedures are performed through the same incision or in immediate succession at the same operative session, the 
maximum amount paid will not exceed 50% of the second procedure and 50% of all subsequent procedure.)  
Day Surgery Miscellaneous:  Preferred Allowance  Usual and Customary Charges 
(Day Surgery Miscellaneous charges are based on the Outpatient Surgical Facility Charge Index.) 
Assistant Surgeon Fees:  Preferred Allowance  Usual and Customary Charges 
Anesthetist Services:  Preferred Allowance  Usual and Customary Charges 
Physician’s Visits:  Preferred Allowance  Usual and Customary Charges 
Physiotherapy:  Preferred Allowance  Usual and Customary Charges 
(12 visits maximum (Per Plan Year)) 
Medical Emergency Expenses:  Preferred Allowance 

$100 Copay per visit 
Usual and Customary Charges  
$100 Deductible per visit 

(The Copay/per visit Deductible will be waived if admitted to the Hospital.) 
(Benefits include the use of the Emergency Room for a non‐emergency Injury or Sickness.) 
Diagnostic X‐ray Services:  Preferred Allowance  Usual and Customary Charges 
Radiation Therapy:  Preferred Allowance  Usual and Customary Charges 
Laboratory Procedures:  Preferred Allowance  Usual and Customary Charges 
Tests & Procedures:  Preferred Allowance  Usual and Customary Charges 
Injections:  Preferred Allowance  Usual and Customary Charges 
Chemotherapy:  Preferred Allowance  Usual and Customary Charges 
Prescription Drugs: 
Ancillary Charge applies when 
prescription is dispensed from a 
higher tier at the Covered Person’s 
request and a chemically equivalent 
prescription drug is available at a 
lower tier. 

UnitedHealthcare Pharmacy (UHCP) 
$0 Copay per prescription for Tier 1 
$0 Copay per prescription for Tier 2  
$0 Copay per prescription for Tier 3 
up to a 31 day supply per prescription plus any 
Ancillary Charge 
(Mail order Prescription Drugs through UHCP with a 
$0 Copay per prescription plus any Ancillary Charge 
up to a 90 day supply per prescription.) 

Usual and Customary Charges 

Other  Preferred Provider  Out‐of‐Network Provider 
Ambulance Services:  Preferred Allowance  Usual and Customary Charges 
Durable Medical Equipment:  Preferred Allowance  Usual and Customary Charges 
Consultant Physician Fees:  Preferred Allowance  Usual and Customary Charges 
Dental Treatment:  Preferred Allowance  Usual and Customary Charges 
(Includes benefits for Injury to Sound, Natural Teeth, and treatment of cleft lip and cleft palate only.) 
Mental Illness Treatment:  Paid as any other Sickness Paid as any other Sickness 
Substance Use Disorder Treatment:  Paid as any other Sickness Paid as any other Sickness 
Maternity:  Paid as any other Sickness  Paid as any other Sickness 
Complications of Pregnancy:  Paid as any other Sickness  Paid as any other Sickness 
Preventive Care Services:  Preferred Allowance  Usual and Customary Charges 
(Routine Children Physicals: Includes all services given in connection with the exam. Limited to 7 exams in the first 12 months of life, 3 exams in the 
second 12 months of life, 3 exams in the third 12 months of life, and 1 exam per calendar year thereafter up to age 18.) 
(Routine Adult Physical Exams: Includes all services given in connection with the exam.  Limited to 1 exam per calendar year for adults age 18 and over.) 
(Routine Gynecological Exams: Includes all services given in connection with the exam. Limited to 1 exam and pap smear per calendar year.) 
(Mammograms:  Unlimited) 
(Prostate Specific Antigen (PSA):  Limited to 1 PSA test per calendar year for males age 40 and over.) 
(Digital Rectal Exam (DRE):  Limited to 1 DRE per calendar year for males age 40 and over.) 
(Cancer Screening:  Limited to 1 flexible sigmoidoscopy and double barium contrast every 5 years.  Limited to 1 colonoscopy every 10 years for adults age 
50 and over.) 
(Fecal Occult Blood Test:  Limited to 1 per calendar year.) 
(Testing for Tuberculosis.) 
Reconstructive Breast Surgery 
Following Mastectomy: 

Paid as any other Sickness  Paid as any other Sickness 

Diabetes Services:  Paid as any other Sickness  Paid as any other Sickness 
Home Health Care:  Preferred Allowance  Usual and Customary Charges 
(Unlimited visits per Policy Year.) 
Hospice Care:  Preferred Allowance  Usual and Customary Charges 
(Inpatient: 30 days lifetime maximum.  Outpatient: $10,000 lifetime maximum.) 

6

Other (continued)  Preferred Provider  Out‐of‐Network Provider 
Inpatient Rehabilitation Facility:  Preferred Allowance  Usual and Customary Charges 
Skilled Nursing Facility:  Preferred Allowance  Usual and Customary Charges 
Urgent Care Center:  Preferred Allowance   Usual and Customary Charges  
Hospital Outpatient Facility or Clinic:  Preferred Allowance  Usual and Customary Charges 
Approved Clinical Trials:  Paid as any other Sickness  Paid as any other Sickness 
Transplantation Services:  Paid as any other Sickness  Paid as any other Sickness 
Acupuncture in Lieu of Anesthesia:  Paid as any other Sickness  Paid as any other Sickness 
Hearing Aids:  Preferred Allowance  Usual and Customary Charges 
($3,500 maximum (Per Plan Year). A written prescription is required). 
Infertility Services:  Preferred Allowance  Usual and Customary Charges 
Medical Foods: 
(A written prescription is required.) 

Preferred Allowance  Usual and Customary Charges 

Ostomy Supplies:  Preferred Allowance  Usual and Customary Charges 
TMJ Disorder:  Preferred Allowance  Usual and Customary Charges 
($5,000 maximum (Per Plan Year)) 
Repatriation:  Benefits provided by UnitedHealthcare Global 

or reimbursed by SACM 
Benefits provided by UnitedHealthcare Global 
or reimbursed by SACM 

Medical Evacuation:  Benefits provided by UnitedHealthcare Global  Benefits provided by UnitedHealthcare Global 
Other:  Note Below  Note Below 
Spinal Disorder Treatment: Preferred Allowance / Usual and Customary Charges – (Caused by or related a biochemical or nerve disorders of the 
spine. Unlimited visits per Plan Year.)  Ear Piercing provided in the Physician’s office for Females age 10 and under: Preferred Allowance / Usual 
and Customary Charges.  Treatment for Congenital Defects and Pre‐mature Born Babies: Preferred Allowance / Usual and Customary Charges.  
Braille Machines: Preferred Allowance / Usual and Customary Charges ($700 maximum per Plan Year.). Sickle Cell Anemia Testing During 
Pregnancy:  Preferred Allowance/Usual and Customary Charges. Obesity Treatment: Paid as any other Sickness / Paid as any other sickness.
Routine Hearing Exams:  Preferred Allowance  Usual and Customary Charges 
(Includes one audiometric routine exam per Plan Year.) 

7

Sign up for My Account and Access your Medical ID Card

Continuously enrolled SACM members were mailed a new UHCSR medical ID card in December
2016 to the U.S. mailing address that we have on file. If you’re a new member, you should receive
your medical card sometime in January 2017.

You can visit www.uhcsr.com/SACMCreateAccount to create your MyAccount and download an
electronic copy of your UHCSR medical card. You may also download our UHCSR Mobile App from
your App Provider so you can have your account information and medical ID card for you and your
dependents (if applicable) readily available on your Smart Phone.

Once you’ve created your My Account, just
log in with your user name and password at
www.uhcsr.com/SACM and begin to access
your account online, at your own convenience.

Create your account today and:

• View coverage details

• View or print your medical ID card

• Review information about your dental plan

• Review Message Center electronic
notifications

• Check Claim status and Explanations of
Benefits (EOB)

• Review claims letters

• Search for a preferred provider

• Provide accident details or Personal
Representative Appointment

• Review your personal information –
if we don’t have your U. S. mailing
address, be sure to update it in the
SACM Database, through the Ministry
of Higher Education student portal/
Safeer as soon as possible.

Creating your My Account is easy!

Visit www.uhcsr.com/SACM and click
the Create an Account link

Follow the onscreen prompts – you’ll
need your First and Last Name, Date
of Birth and your Saudi National ID.

Create your user name. Your
user name must contain 6 – 30
alphanumeric characters. Verify your
email address and submit.

You will receive a return email with
a pin that you will use to verify your
account and create a password.
Your password must have 8-12
characters and include at least
three of the following: an uppercase
character, a lowercase character,
a numeric character (0-9), and a
special character (e.g., *, ~, $, etc.).

Œ


Ž



8

How to Find a Medical Health Care Provider
Choose a UnitedHealthcare medical provider to help maximize health care dollars and lower out-of-pocket costs.
Use the UHCSR Mobile App or go to www.uhcsr.com/SACM. Click the links under “Search for a Provider”. Or call
Customer Service at 866-808-8461.

1. Access your SACM Welcome page at www.uhcsr.com/SACM

2. In the Search for a Provider section click the Medical – UHC Choice Plus link

3. Click Change Location and specify a ZIP code or city/state to narrow down the location. Click OK.

4. In the Search box, specify Doctor Name or Specialty, Facility Name, Clinic Name, or Medical Group Name.
Click SEARCH.
• You may also click the Find Health Care by Category buttons below the Search box to search by

People, Places, Tests and Imaging, Services and Treatments or Care by Condition.

5. Follow the prompts to further refi ne your search criteria.
• The search results will indicate the providers’ address, phone number and other details.

Which provider should I see?
Sometimes it may be diffi cult to decide if a sudden illness or injury needs immediate emergency care. Choosing
the right health setting – Primary Care Physician, Urgent Care, or Emergency Room is important; knowing which
provider to see, depending on the medical situation, can save you time and money.

Primary Care Physician
When you or a loved one is hurt, you want the best care. Your primary care physician knows you and your health
history. He or she can access your medical records. And, he or she can provide you follow-up care or refer you to
specialists. If it’s not urgent, it’s usually best to go to your own physician’s offi ce.

Urgent Care
Sometimes you may need care fast. But, your Primary Care Physician may be unavailable. You may want to try
an urgent care center. They can treat many minor ailments. Chances are, you won’t have to wait as long as at an
emergency room. You may pay less, too.

An urgent care center can help with:
• Sprains & Strains
• Minor broken bones (example: fi nger)
• Minor infections
• Small cuts
• Sore throats
• Rashes

Emergency Rooms
You may be tempted to go to an emergency room (ER). But, this may
not be the best choice. At the ER, true emergencies are treated fi rst.
Other cases must wait–sometimes for hours. And, it may cost you more.

Go to an ER for:
• Heavy bleeding
• Large open wounds
• Sudden change in vision
• Chest pain
• Sudden weakness or trouble talking
• Major burns
• Severe head and spinal injuries
• Diffi culty breathing
• Major broken bones

9

Defi nitions
Below, you will fi nd a defi nition of what’s considered a medical emergency for the purpose of plan benefi ts in
addition to other relevant terms that will help you navigate your benefi t plan.

ANCILLARY CHARGE means a charge, in addition to the Copayment and/or Coinsurance, that the Covered
Person is required to pay when a covered Prescription Drug Product is dispensed at the Covered Person’s or
the Physician’s request, when a Chemically Equivalent Prescription Drug Product is available on a lower tier.
For Prescription Drug Products from Network Pharmacies, the Ancillary Charge is calculated as the difference
between the Prescription Drug Cost or MAC list price for Network Pharmacies for the Prescription Drug Product
on the higher tier, and the Prescription Drug Cost or MAC list price of the Chemically Equivalent Prescription Drug
Product available on the lower tier.

BENEFITS means Plan payments for Covered Medical Expenses, subject to the terms and conditions of the Plan
and any Addendums and/or Amendments.

CLAIMS ADMINISTRATOR OR ADMINISTRATOR means United HealthCare Services, Inc., and its affi liates,
which provide certain claim administration services for the Plan.

COINSURANCE means the percentage of Covered Medical Expenses that you must pay.

COPAY/COPAYMENT means a specifi ed dollar amount that the Covered Person is required to pay for certain
Covered Medical Expenses.

COVERED MEDICAL EXPENSES means reasonable charges which are: 1) not in excess of Usual and
Customary Charges; 2) not in excess of the Preferred Allowance when the Plan includes Preferred Provider
Benefi ts and the charges are received from a Preferred Provider; 3) not in excess of the maximum Benefi t amount
payable per service as specifi ed in the Schedule of Benefi ts; 4) made for services and supplies not excluded under
the Plan; 5) made for services and supplies which are a Medical Necessity; 6) made for services included in the
Schedule of Benefi ts; and 7) in excess of the amount stated as a Deductible, if any.

DEDUCTIBLE means if an amount is stated in the Schedule of Benefi ts or any other section of this Plan as a
deductible, it shall mean an amount to be subtracted from the amount or amounts otherwise payable as Covered
Medical Expenses before payment of any Benefi t is made. The deductible will apply as specifi ed in the Schedule of
Benefi ts.

ELECTIVE SURGERY OR ELECTIVE TREATMENT means those health care services or supplies that do not meet
the health care need for a Sickness or Injury. Elective surgery or elective treatment includes any service, treatment
or supplies that: 1) are deemed by the Plan Sponsor to be research or experimental; or 2) are not recognized and
generally accepted medical practices in the United States.

HOSPITAL means a licensed or properly accredited general hospital which: 1) is open at all times; 2) is operated
primarily and continuously for the treatment of and surgery for sick and injured persons as inpatients; 3) is under
the supervision of a staff of one or more legally qualifi ed Physicians available at all times; 4) continuously provides
on the premises 24 hour nursing service by Registered Nurses; 5) provides organized facilities for diagnosis and
major surgery on the premises; and 6) is not primarily a clinic, nursing, rest or convalescent home. Hospital also
means a licensed alcohol and drug abuse rehabilitation facility and a mental hospital. Alcohol rehabilitation facilities
and mental hospitals are not required to provide organized facilities for major surgery on the premises or on a
prearranged basis.

10

INJURY means bodily injury which is all of the following:
1) directly and independently caused by specifi c accidental contact with another body or object.
2) unrelated to any pathological, functional, or structural disorder.
3) a source of loss.
4) treated by a Physician within 30 days after the date of accident.
5) sustained while the Covered Person is covered under this Plan.

All injuries sustained in one accident, including all related conditions and recurrent symptoms of these injuries will
be considered one injury. Injury does not include loss which results wholly or in part, directly or indirectly, from
disease or other bodily infi rmity. Covered Medical Expenses incurred as a result of an injury that occurred prior to
this Plan’s Effective Date will be considered a Sickness under this Plan.

MEDICAL EMERGENCY means the occurrence of a sudden, serious and unexpected Sickness or Injury. In the
absence of immediate medical attention, a reasonable person could believe this condition would result in any of the
following:

1) Death.
2) Placement of the Covered Person’s health in jeopardy.
3) Serious impairment of bodily functions.
4) Serious dysfunction of any body organ or part.
5) In the case of a pregnant woman, serious jeopardy to the health of the fetus.

Expenses incurred for “Medical Emergency” will be paid only for Sickness or Injury which fulfi lls the above
conditions. These expenses will not be paid for minor Injuries or minor Sicknesses.

NETWORK AREA means the 50 mile radius around the local school campus the Covered Person is attending.

OUT OF NETWORK means those providers who have not agreed to any prearranged fee schedules. Covered
Persons may incur signifi cant out-of-pocket expenses with these providers. Charges in excess of the amount paid
by the Plan are the Covered Person’s responsibility.

PLAN means The Saudi Arabian Cultural Mission Student Health Plan.

PLAN ADMINISTRATOR means The Saudi Arabian Cultural Mission or its designee.

PLAN SPONSOR means The Saudi Arabian Cultural Mission.

PREFERRED PROVIDER means the Physicians, Hospitals and other health care providers who have contracted
to provide specifi c medical care at negotiated prices. The Plan offers the network of Preferred Providers which is
known as: UnitedHealthcare Choice Plus PPO. The availability of specifi c providers is subject to change without
notice. Covered Persons should always confi rm that a Preferred Provider is participating at the time services
are required by calling the Administrator at 1-800-767-0700 and/or by asking the provider when making an
appointment for services.

SICKNESS means sickness or disease of the Covered Person which causes loss while the Covered Person is
covered under this Plan. All related conditions and recurrent symptoms of the same or a similar condition will be
considered one sickness. Covered Medical Expenses incurred as a result of an Injury that occurred prior to this
Plan’s Effective Date will be considered a sickness under this Plan.

URGENT CARE CENTER means a facility that provides treatment required to prevent serious deterioration of the
Covered Person’s health as a result of an unforeseen Sickness, Injury, or the onset of acute or severe symptoms.

USUAL AND CUSTOMARY CHARGES means the lesser of the actual charge or a reasonable charge which is:
1) usual and customary when compared with the charges made for similar services and supplies; and 2) made to
persons having similar medical conditions in the locality where service is rendered. The Administrator uses data
from FAIR Health, Inc. valued at the 75th percentile to determine Usual and Customary Charges. No payment will
be made under this Plan for any expenses incurred which in the judgment of the Administrator are in excess of
Usual and Customary Charges.

11

Global Emergency Services
Your global emergency services benefi t through UnitedHealthcare Global is a comprehensive program that
provides 24/7 medical and travel assistance to participants who call their Emergency Response Center. A
multilingual case manager takes the call and immediately provides assistance. Participants can even call the
Emergency Response Center before traveling to get a pre-trip destination report that covers subjects like
health and security risks, immunization and vaccination recommendations, crime, culture, weather, and so
much more.

Foreign national students studying in the US – You’re eligible for services for the duration of your studies while
traveling 100 miles or more from your campus in the US and traveling outside of your home country. You have
access to doctors, hospitals, pharmacies, and certain other services when faced with a travel or medical
emergency while outside the US.

One phone call to UnitedHealthcare Global connects you to:

 Medical Assistance Services
 Medical Evacuation and Repatriation Services
 Security and Natural Disaster Evacuation Services
 Worldwide Destination Intelligence
 Travel Assistance Services
 Experienced crisis management professionals
 A global network of over 41,000 pre-qualifi ed medical providers

Please visit www.uhcsr.com/UHCGlobal for the UnitedHealthcare Global brochure which includes service
descriptions and program conditions and limitations. To access services, call or email:

Toll-free within the US: 1-877-294-2038
Collect outside the US: 1-410-453-6330
Email: assistance@uhcglobal.com

Telehealth with HealthiestYou
We’ve partnered with HealthiestYou to provide you with round-the-clock access to board-certifi ed physicians.
SACM members* can connect with a physician via phone and/or video chat** using this nationwide telehealth
service. During a physician consult, you will be able to speak to a physician for diagnosis and treatment of
many different acute illnesses.

Healthiest You also offers notifi cations via smart phone app – students may receive a notifi cation when
they arrive at an Emergency Room or Urgent Care Center. This notifi cation will serve to remind you of your
telehealth benefi t that allows you to speak to a doctor without having to sit in a waiting room.

*When services are obtained during the policy effective dates. Non-SACM members will be charged a $40 consultation fee.

**Telephone services and/or video chat availability is determined by state requirements.

To access services:

Toll-free within the US: 1-855-777-4856
Web: www.telehealth4sacm.com

12

Hospitalization Pre-Admission Notifi cation
UnitedHealthcare should be notifi ed of all Hospital admissions:

• Pre-notifi cation of medical non-emergency hospitalizations: The patient, Physician or Hospital
should call the phone number on the covered person’s ID card at least fi ve working days prior to a
planned admission.

• Notifi cation of medical emergency hospitalizations: The patient, patient’s representative, Physician
or Hospital should call the phone number on the covered person’s ID card within two working days of
an emergency admission.

UnitedHealthcare is open for Pre-Admission Notifi cation calls from 8:00 a.m. to 6:00 p.m. C.S.T., Monday
through Friday. Calls may be left on the Customer Service Department’s voice mail after hours.

Note: Failure to follow the notifi cation procedures will not affect benefi ts otherwise payable under the policy;
however, pre-notifi cation is not a guarantee that benefi ts will be paid.

13

Submit a Claim for Member Reimbursement
Use this procedure to be reimbursed for medical claims you paid to out-of-network providers in the
U.S. or for care outside the U.S.:

• A claim form is not required.

• All documentation submitted must be legible.

• Provide a copy of the front and back of your ID card as well as the patient information, if different
than the primary insured member.

• Medical claims bills must include Provider name, address and phone number, diagnosis code
(nature of illness), procedure code (service performed), service date, and cost.

• For prescription claims, provide your receipt or computer printout from the Pharmacy which in-
cludes patient name, doctors name, medicine name, date dispensed, quantity, and purchase price.

• Valid proof of payment must also be submitted with your claims, otherwise there may be a delay in claim
reimbursement. See below for a list of requirements.

• Mail the claim to the address or below. Be sure to keep a copy for your records.

Valid Proof of Payment:
Please submit the following as proof of payment.

• Medical bills and perscriptions paid in cash:
◦ Verification of cash payments detailed on provider letterhead and signed by the Provider.

• Medical bills and perscriptions paid by check:
◦ Copy of front and back of cancelled check

• Medical bills and perscriptions paid with a credit card:
◦ Copy of the credit card statement showing payment for the services billed

Mail Claims to
the Claims Administrator:
UnitedHealthcare StudentResources
P.O. Box 809025
Dallas, TX 75380-9025

If you have any questions, please contact our Customer Service Department:

Phone: 866-808-8461 or ATT Access Code + 866-808-8335 (outside the U.S.)
eMail: sacmcustomerservice@uhcsr.com

14

How to reach UHC for Medical Information

Our live Customer Service Representatives can be reached Monday through Friday from 7am-
7pm Central Standard Time. After hours, calls are directed to our Interactive Voice Recognition
automated system which allows you to check claim status and coverage dates.

Customer Service may also be contacted via e-mail for claims at claims@uhcsr.com or for general
Customer Service inquiries at sacmcustomerservice@uhcsr.com. Our e-mail team responds to all
inquiries within two business days. Correspondence received during business hours is replied to
within 3 hours or less.

Customer Service 1-866-808-8461

ATT Access Code + 866-808-8335 (from outside the U.S.)

Mailing Address UnitedHealthcare StudentResources
P.O. Box 809025
Dallas, TX 75380-9025

Email sacmcustomerservice@uhcsr.com
claims@uhcsr.com

Website www.uhcsr.com/SACM

15

Account
Information

Log into
www.myuhc
to download your dental ID
card, access dental claims
information, and access other
helpful information.

Welcome to UHC Dental
A generous dental benefi t plan is provided by SACM for its students and their dependents for care
sought inside the U.S. with In-Network providers. SACM students are covered at 100% for In-Network
care. The UnitedHealthcare Dental network has over 385,000 dental access points for our members.

Your dental plan includes:

Plan Features
Deduc ble $0/$0
Annual Max $2000
Life me Ortho Max $2000

Plan Payments
Diagnos c Service Preferred Provider
Periodic Oral Evalua on 100%
Radiographs 100%
Lab and Other Diagnos c Tests 100%

Preven ve Services Preferred Provider
Dental Prophylaxis (Cleaning) 100%
Fluoride Treatment 100%
Sealants 100%
Space Maintainers 100%

Basic Services Preferred Provider
Restora ons (Amalgams or Composite) 100%
Emergency Treatment/General Services 100%
Simple Extrac ons 100%
Oral Surgery (incl. surgical extrac ons) 100%
Periodon cs & Endodon cs 100%

Major Services Preferred Provider
Inlays/Onlays/Crowns 100%
Dentures and Removable Prosthe cs 100%
Fixed Par al Dentures (Bridges) 100%

Orthodon c Services Preferred Provider
Orthodon a 100%

Note: There is no out of network dental benefi t.

Did you
know?

When SACM
members receive
dental services from a network
dentist, the dentist submits the
claim and is paid directly by
UHC Dental.

16

Access your Dental ID Card
Your benefi t plan includes Dental benefi ts administered by UHC Dental. If
you are a new SACM member, you will receive a dental ID card in the mail.
Continuously enrolled SACM members will use the dental ID card initially
sent with their 2015 plan materials.

If you do not receive your Dental ID Card in the mail, please review your
Personal Information in your UHCSR My Account to verify the information
we have in our system. If we don’t have your U. S. mailing address, be sure
to update it in the SACM Database, through the Ministry of Higher Education
student portal/Safeer as soon as possible. You will not be able to access
your Dental ID Card online until we have a U.S. mailing address on fi le.

Once your U.S. Mailing address is updated within our system, your Dental ID
Card will automatically be mailed to you at your U.S. address.

Upon receipt of your Dental ID Card, please go to www.myuhc.com and
register so that you can access your Dental benefi ts, locate a dentist, request
a replacement or print a temporary Dental ID Card. You may also access this
link within UHCSR My Account on the ID Card and Dental Plan pages.

How to Find a Dental Health Care Provider
Your plan includes in-network Dental administered through UHC Dental. You will need to select an In-Network
Dental provider to ensure that your dental claims are paid with no cost to you.

1. Go to www.uhcsr.com/SACM
2. In the Search for a Provider section, select the Dental – National Options PPO link
3. Select Location, Dentist Name or Practice Name to begin your search
4. Complete your search criteria and click Search
5. The Search results will indicate the provider’s address, phone number and other details
6. You may also print, email or export your search results

You may also search for dental providers through your UHCSR My Account or at www.myuhc.com. Note: you will
need your dental ID card to register at www.myuhc.com.

How to reach UHC for Dental Information
Our live Customer Service Representatives can be reached Monday through Friday from 7am-10pm Central
Standard Time.

Customer Service 1-877-881-8825

Website www.myuhc.com

17

Account
Information

Log into
www.myuhcvision.com to
access your ID card, claims
information and other helpful
information.

Welcome to UHC Vision
UnitedHealthcare has been trusted for more than 50 years to deliver affordable, innovative vision care
solutions through experienced, customer-focused people and the nation’s most accessible, diversifi ed
vision care network.

In-network, covered-in-full benefi ts (up to the plan allowance and after applicable copay) include a com-
prehensive exam, eye glasses with standard single vision, lined bifocal, lined trifocal, or lenticular lenses,
standard scratch-resistant coating* and the frame, or contact lenses in lieu of eyeglasses.

Your vision plan includes:

Benefi t Frequency
Comprehensive Exam(s) Once per calendar year
Spectacle Lenses Once per two calendar years
Frames Once per two calendar years
Contact Lenses in Lieu of Eyeglasses Once per two calendar years

In-Network Services
Copays
Exams $0
Materials $0
Vision Care Supplies
100% up to $200 maximum to be used towards the purchase of eye
glass lenses, frames, and contact lenses every two calendar years

Discounts
Laser Vision – UnitedHealthcare has partnered with the Laser Vision
Network of America (LVNA) to provide our members with access to
discounted laser vision correc on providers. Members receive 15% off
usual and customary pricing or 5% off promo onal pricing at more than
550 network provider loca ons and even greater discounts through set
pricing at LasikPlus loca ons. For more informa on, call 1-888-563-4497
or visit us at www.uhclasik.com.
Addi onal Material – At a par cipa ng network provider you will re-
ceive up to a 20% discount on an addi onal pair of eyeglasses or contact
lenses. This program is available a er your vision benefi ts have been
exhausted. Please note that this discount shall not be considered insur-
ance, and that UnitedHealthcare shall neither pay nor reimburse the
provider or member for any funds owed or spent. Addi onal materials
do not have to be purchased at the me of ini al material purchase.
Hearing Aids – As a UnitedHealthcare plan member, you can save on
high-quality hearing aids when you buy them from hi HealthInnova-
ons™. To fi nd out more go to hiHealthInnova ons.com. When placing

your order use promo code myVision to get the special price discount.

*On all orders processed through a company owned and contracted Lab network.

Did you
know?

When SACM
members receive
vision services from a network
provider, the provider submits
the claim and is paid directly
by UHC.

18

ID Card for Vision Benefi ts

In order to take advantage of these vision benefi ts, simply show your medical ID card to your vision provider. No
separate vision ID card is necessary.

How to Find a Vision Care Provider
Your plan includes in-network vision care administered through UHC. You will need to select an In-Network vision
care provider to ensure that your vision claims are paid with no cost to you.

1. Go to www.myuhcvision.com

2. The provider link is on the left side of the page, at the bottom

 You do not need to register to fi nd a provider

3. Complete your search criteria and click Search

4. The Search results will indicate the provider’s address, phone number and other details

How to reach UHC for Vision Information
Our live Customer Service Representatives can be reached Monday through Friday from 7am-10pm Central
Standard Time.

Customer Service 1-866-808-8461

Website www.myuhcvision.com

19

HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

Country Facts and Current Health System
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

Crude Birth Rate / 1000 population 24.9
Rate of natural Increase 2.32 %
Population under five years 11.6 %
Population under 15 years 32.9 %
Population 15-64 years 64.4 %
Population over 65 years 2.8 %
Total fertility rate 3.22
Life expectancy at birth 73.1 years ( M 72.1 F 74.1)
Demographic Indicators:
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Main Health Providers
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA
Health Facilities

*

Health Care Financing
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

Health Care Financing:
Public sector workers provided by the government
Private sector workers sponsored in full by the employers
Total Expenditure on Health 2007 US $ 13.4 B

Ministry of Health 6% of GDP ( US $ 6.7 B)

MOH Expenditure per capita $ 257

Out of Pocket
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Objectives of Health Care Policy and Health Sector Reform
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

Objectives of Health Care Policy
The national health law (article 2) issued in 2003 aims for:
Provision of a comprehensive health care for all residents.
Health care provision is to be in an equitable method
Health care provision is to be in an easy and accessible way
This law aims for organizing health care delivery
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Health Reform Elements:
To Change the Role of MOH to be Responsible for:
Primary Health Care
Preventive and Public Health medicine
Standardization
Supervision and health system Support .

To Establish The National Organization of Hospitals

To Establish The National Health Fund
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Health Reform and Health Insurance
Co-operative Health Insurance for non-Saudis
and
Saudis in Private Sector
Staging of Health Insurance:
National Health Insurance System for Saudis
And
Non-Saudis in the Governmental Sector
Other Groups e.g. Religious visitors
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Types of Insurance In Saudi market
Property and casualty 34%
Aviation

Marine

Medical Malpractice

Car 34%

Health 32%
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Council of Co-operative Health insurance Financing:
1% of all policies
Provider accreditation fee
Insurance company accreditation fee

Refundable governmental annual loan
Investment revenues
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Health Insurance Governance Principals:
Transparency and Predictability

Accountability

Participation

Efficiency and effectiveness
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Eligibility for health care Facilities
The governmental health services
Saudi Nationals & Families
Non-Saudis working for the governmental agencies.
The Private Health care Providers:
Nationals and non-nationals in the private sector are to be
using the health insurance system

Cooperative Health Insurance Law Issued By a Royal
Decree NO: M /10 DATED : August 1999
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Quality of Health Care Services
At The National Level:
National Health Council
National Center for Quality and Accreditation
Saudi Commission for Health Specialties

At The Regional Level:
GCC Center for Evidence Based Medicine
Standardized Employee Health Evaluation
Health Quality Initiatives
Collective Non Communicable Disease Approach

HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Scope Of Health Care Benefits
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Scope Of Health Care Benefits:
For Nationals all levels of care are provided with no upper limits and funded by the government ز

For ًworker in the private sector ( both nationals and non-nationals) are provides through the private health insurance system with maximum coverage of the health insurance policy (US $ 67,000 /policy/year) granted by the employer.
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Health care Funding and Subsidy
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Health care Funding and Subsidy:
For nationals Health care is completely funded by the government

For private sector workers health care is covered by employers

For religious visitors health care is paid for by the governments

For business and tourist visitors health care will be insured
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

Health insurance regulation in Saudi arabia

 Beneficiaries: المستفيدون

​Article (2): Health Insurance is subject to the following categories:
1- all non-Saudi workers in the non-government sector.
2- all persons who do not work in non-government sector, residing in the Kingdom.
3- family members who are dependents of persons described in specific paragraphs (1) and (2) of this Article obtaining a residence permit in the Kingdom.
المادة (2): تخضع للضمان الصحي الفئات التالية:
1- جميع الأشخاص غير السعوديين العاملين في غير القطاع الحكومي.
2- جميع الأشخاص الذين لا يعملون في غير القطاع الحكومي، المقيمين في المملكة.
3- أفراد الأسرة الذين يعولهم الأشخاص المحددة صفتهم في الفقرتين (1) و(2) من هذه المادة الحاصلون على رخصة إقامة في المملكة.

4-all Saudis working in the corporate sector and private institutions and individuals work contracts concluded with them or what benefit the work and methods of installation, regardless of the form of pay that they earn (*)
5- family members of the Saudi referred to in paragraph (4) of this Article as determined by the Cooperative Health Insurance Council (*
4- جميع السعوديين العاملين في قطاع الشركات والمؤسسات الخاصه والأفراد المبرمه معهم عقود عمل أو ما يفيد بالعمل وطرق تثبيته بصرف النظر عن شكل الأجر الذي يتقاضونه(*)
5- أفراد أسر السعوديين المشار إليهم في الفقره (4) من هذه الماده بحسب ما يحدده مجلس الضمان الصحي التعاوني 

Article (3): excluded from health insurance provided for in Article (2) of this Regulation:
1- all employees of non-Saudi workers in the organs and institutions of government and does not provide the necessary employment contract to provide service access to health insurance coverage in accordance with the approved security documents.
المادة (3): يُستثنى من الضمان الصحي المنصوص عليه في المادة (2) من هذه اللائحة:
1- جميع الموظفين من غير السعوديين العاملين لدى أجهزة ومؤسسات حكوميه ويلزم من لا ينص عقد عمله على توفير الخدمة الصحية بالحصول على تغطية تأمينية وفقاً لوثائق الضمان المعتمدة.

2- family members who are dependents of staff members set described in paragraph (1) of this Article. It must be the range of treatment described in the paragraph above, at least in conformity with the provisions of Article (7) of the system and consistent with the level of quality set forth in Chapter IX of these Regulations.
2- أفراد الأسرة الذين يعولهم الموظفون المحـــددة صفتهم فـي الفقرة (1) من هذه المادة. ويجب أن يكون نطاق العلاج الموضح في الفقرة أعلاه مطابقـاً على الأقل لأحكام المادة (7) من النظام ومتفقاً مع مستوى الجودة الوارد في الفصل التاسع من هذه اللائحة.

 insurance coverage of the system
Article (4):
A) The employer shall conclude a health insurance policy with an insurance company covering workers in the Kingdom under his sponsorship, or any new employees under his sponsorship, as well as the rest of his employees subject to this system.
مادة (4):
أ‌)  يلتزم صاحب العمل بإبرام وثيقة تأمين صحي مع إحدى شركات التأمين تغطي العاملين تحت كفالته بالمملكة أو أي عاملين جدد تحت كفالته وكذلك بقية العاملين لديه الخاضعين لهذا النظام.

B) does not exempt the owners of companies and institutions that have special medical facilities to participate in the cooperative health insurance system, and they get to the insurance coverage set forth in the cooperative health insurance policy at a minimum, through the health insurance companies qualified by the Board.
ب‌)  لا يعفى أصحاب الشركات والمؤسسات التي تملك منشآت طبية خاصة من الاشتراك في نظام الضمان الصحي التعاوني، وعليهم الحصول على التغطية التأمينية المنصوص عليها في وثيقة الضمان الصحي التعاوني كحد أدنى، وذلك عن طريق شركات تأمين صحي مؤهلة من المجلس.

C) does not allow insurance companies qualified by the Board to reject any request to provide cooperative health insurance either directly or indirectly.
ج) لا يسمح لشركات التأمين المؤهلة من المجلس برفض أي طلب لتقديم الضمان الصحي التعاوني سواءً بشكل مباشر أو غير مباشر. 

D) commit the insurer to the insurance company has a staff of institutions and companies that have the medical facilities accredited private contract with the entity concerned to treat the employees of these institutions and companies in the scope of the approved health services provided by the facility.
د) تلتزم شركة التأمين المؤمن لديها على منسوبي المؤسسات والشركات التي تملك منشآت طبية خاصة معتمدة بالتعاقد مع المنشأة المعنية لعلاج منسوبي هذه المؤسسات والشركات في نطاق الخدمات الصحية المعتمدة التي تقدمها هذه المنشأة.

Article (5): the insurance company issued a certificate to the employer (policyholder) whereby the insurance on its employees to be submitted to the competent authority to issue and renewal of residence permits and the Council shall determine the content of the certificate.
المادة (5): تصدر شركة التأمين شهادة إلى صاحب العمل (حامل الوثيقة) تـُفيد بالتأمين على منسوبيه لتقديمها إلى الجهة المختصة بإصدار رخص الإقامة وتجديدها ويحدد المجلس محتوى الشهادة.

Article (6): in the absence of a residence permit to the beneficiary whose name is written off from the cooperative health insurance policy from the date of the final out, and calculated the premium due for the period of insurance in accordance with principles set forth in the document.
المادة (6):  في حالة عدم صدور رخصة الإقامة للمستفيد يتم شطب اسمه من وثيقة الضمان الصحي التعاوني من تاريخ خروجه النهائي، ويحتسب القسط المستحق عن مدة التأمين حسب الأسس المنصوص عليها في الوثيقة.

Article (8): The employer may change the insurance company contracted to provide insurance coverage, that may address this to the insurance company one month before the date of cancellation required and draw pictures of it to the Council, and calculate the re-installment of the insurance on the basis of relative need employer (policy holder) re-insurance cards on the conclusion and cancellation and other insurance policy to provide insurance coverage to begin from the date of the next day to cancel the document.
المادة (8):  يجوز لصاحب العمل أن يغير شركة التأمين المتعاقد معها لتوفير التغطية التأمينية، على أن يوجه خطاباً بذلك إلى شركة التأمين قبل شهر على الأقل من تاريخ الإلغاء المطلوب ويوجه صوره منه إلى المجلس، ويُحسب الجزء المُعاد من القسط التأميني على أساس نسبي ويلزم صاحب العمل (حامل الوثيقة) بإعادة بطاقات التأمين بتاريخ الإلغاء وإبرام وثيقة تأمين أخرى لتوفير التغطية التأمينية بحيث تبدأ من تاريخ اليوم التالي لإلغاء الوثيقة.

Article (13): The employer shall make the insurance coverage to the beneficiary from the date of access and delivery to the UK insurance card within a period not exceeding ten working days from the date of arrival.
Article (14): Ending the death of the beneficiary of insurance coverage, or upon the expiration or cancellation of the document or when you leave the final beneficiary of the Kingdom.
المادة (13): يلتزم صاحب العمل بإجراء التغطية التأمينية على المستفيد من تاريخ الوصول إلى المملكة وتسليمه بطاقة التأمين خلال مدة لا تتجاوز عشرة أيام عمل من تاريخ وصوله.
المادة (14):  تنتهي التغطية التأمينية بوفاة المستفيد أو عند انتهاء مدة الوثيقة أو إلغائها أو عند مغادرة المستفيد للمملكة نهائياً.

 Chapter IV: Benefits
Article (15): the beneficiary receives the benefits identified in the document as follows:
15-a- diagnosis and treatment of authorized service providers to be borne by the beneficiary the amount of staff / endurance (if any) specified in the document in the post payment.
المادة (15): يحصل المستفيد على المنافع المحددة في الوثيقة على النحو التالي:
15-أ- التشخيص والعلاج لدى مقدمي الخدمة المعتمدين على أن يتحمل المستفيد مبلغ الاقتطاع / التحمل (إن وجد) المحدد في الوثيقة مشاركة في الدفع.

15-b- the sums of the costs of medical treatment is necessary and urgent in the case of tolerance to these costs directly, provided that the inability of the insurance company to make that service available promptly available to the beneficiary or reject the insurance company providing the service to him unjustly, and have reimbursement to those who bear the expenses of treatment by the limits set forth in the document and to the extent paid by the company to a provider with a similar level.
15-ب- المبالغ المالية لتكاليف العلاج الطبي الضروري والطارئ في حالة تحمله لهذه التكاليف مباشرة، بشرط عدم تمكن شركة التأمين من جعل تلك الخدمة متوفرة بصورة عاجلة في متناول المستفيد أو رفض شركة التأمين توفير الخدمة له بغير وجه حق، ويكون رد التكاليف لمن تحمل نفقات العلاج حسب الحدود المنصوص عليها في الوثيقة وفي الحدود التي تدفعها الشركة لمقدم خدمات ذات مستوى مماثل.

Article (16): the right to begin to claim benefits from the beginning of insurance coverage
المادة (16): يبدأ الحق في المطالبة بالمنافع اعتباراً من بداية التغطية التأمينية

Article (18): end the right to take advantage of the benefits End-insurance coverage in accordance with the provisions of Article (14) of this regulation, including cases of insurance outstanding, and be the decisive factor in the service obligation on the part of the insurance company is the date to take advantage of the service provider by the beneficiary.
 
المادة (18): ينتهي الحق في الاستفادة من المنافع بإنتهاء التغطية التأمينية وفقاً لأحكام المادة (14) من هذه اللائحة، ويشمل ذلك حالات التأمين التي لم يبت فيها، ويكون العامل الحاسم في إلتزام الخدمة من جانب شركة التأمين هو تاريخ الاستفادة من مقدم الخدمات من قبل المستفيد.

Article (19): the benefits of insurance cover immunizations and vaccines for children up to school age according to decisions of the Ministry of Health, and conditions that need to isolate the hospital and to be conducted by providing contracted service provider.
المادة (19): تـُغطي منافع التأمين التطعيمات واللقاحات الأساسية للأطفال حتى سن الالتحاق بالمدرسة حسب قرارات وزارة الصحة، والحالات المرضية التي تحتاج إلى عزل بالمستشفى والتي يتعين أن يقوم بتقديمها مقدم خدمات متعاقد معه.

Article (21): include insurance coverage expense of accommodation and catering facilities in hospitals and one escort to the beneficiary mother to her child until the age of twelve or where required by medical necessity at the discretion of the treating physician.
المادة (21): تشمل التغطية التأمينية نفقة الإقامة والإعاشة في المستشفيات لمُرافق واحد للمستفيد كمُرافقة الأم لطفلها حتى سن الثانية عشرة أو حيثما تقتضي ذلك الضرورة الطبية حسب تقدير الطبيب المعالج.

Article (26): the beneficiaries are not entitled to claim benefits under the policy only if the benefits of the basic coverage provided for in the document, or additional coverage, which was acquired by and in accordance
Article VIII of the cooperative health insurance system.

المادة (26): لا يحق للمستفيدين المطالبة بمنافع بموجب الوثيقة إلا إذا  كانت هذه المنافع من التغطيات الأساسية المنصوص عليها في الوثيقة، أو في التغطيات الإضافية التي تم حصولهم عليها وفقاً 
للمادة الثامنة من نظام الضمان  الصحي التعاوني.

Chapter 5: ensuring the quality of services provided
rticle (98): the right of the Council to make sure to check out the requirements and standards to be met by the providers of health services according to the standards of the Central Council for the adoption of health facilities.
المادة (98): يحق للمجلس التأكد من تحقق الاشتراطات والمعايير الواجب توافرها لدى مقدمي الخدمات الصحية وفق معايير المجلس المركزي لاعتماد المنشآت الصحية.

Article (99) covers the Council’s procedures concerning the maintenance of quality, as a minimum:
1- standards for medical examination rooms to accredited service providers.
2- the regular inspection of hospitals, clinics and dispensaries in the approved location without prior notice by the staff of the Council or appointed by a qualified outside the Council.
3- evaluation of contracts for health services in terms of its commitment to maintaining quality controls.
المادة (99): تغطي إجراءات المجلس المتعلقة بالمحافظة على الجودة النوعية كما يلي كحد أدنى:
1- المعايير الخاصة بغرف الكشف الطبي لمقدمي الخدمات المعتمدين.
2- التفتيش المنتظم على المستشفيات والعيادات والمستوصفات المعتمدة في مواقعها ودون إنذار مسبق من قبل موظفي المجلس أو من يعينهم من المؤهلين من خارج المجلس.
3- تقييم عقود الخدمات الصحية من حيث تعهدها بالمحافظة على ضوابط الجودة   النوعية.

Article (100): is committed to health service providers accredited by the Council to carry out every three years to submit a report to the Council shows the extent of their commitment to the requirements of quality according to standards approved by the Health Services Council in the Kingdom of Saudi Arabia, and in the event of breach of this condition are entitled to cancel the accreditation council.
المادة (100): يلتزم مقدمو الخدمات الصحية المعتمدين من قبل المجلس بالقيام كل ثلاث سنوات بتقديم تقرير للمجلس يوضح مدى التزامهم بمتطلبات الجودة النوعية وفق المعايير المقرة من مجلس الخدمات الصحية في المملكة العربية السعودية، وفي حال إخلالهم بهذا الشرط فيحق للمجلس إلغاء الاعتماد.

Chapter6 : the practice of the health insurance
Article (39): The practice of the health insurance cooperative insurance companies authorized to carry on insurance business in the Kingdom under the Cooperative Insurance Companies Control and its implementing regulations.
المادة(39): تتولى ممارسة أعمال الضمان الصحي شركات التأمين التعاوني المصرح لها بمزاولة أعمال التأمين في المملكة بموجب نظام مراقبة شركات التأمين التعاوني ولائحته التنفيذية.

Article (43) is committed to the insurance company to provide the following documents within the application for qualification:
1- Name and address of the company.
2- the statute or the Articles.
3- the names of the Chairman and members of the Board and Managing Director and executive management.
4- the annual accounts audited by a chartered accountant for the three years preceding the filing of the application (for existing companies).
المادة(43): تلتزم شركة التأمين بتقديم المستندات التالية ضمن طلبها للحصول على التأهيل:
1- اسم وعنوان الشركة.
2- النظام الأساسي أو عقد التأسيس.
3- أسماء رئيس وأعضاء مجلس الإدارة والعضو المنتدب والإدارة التنفيذية.
4- الحسابات السنوية المدققة من قبل محاسب قانوني للسنوات الثلاث السابقة لتقديم الطلب (للشركات القائمة).

Article (52): The Council’s adoption of health care providers (government / non-governmental organizations) in the range of the following conditions:
1- be a health care facility in the private sector has been licensed by the Ministry of Health.
2- that the organizers of the individuals providing health care has been registered by the Saudi Commission for Health Specialties.
3- that the health care facility (government / non-government) updating 4- procedures for maintaining the quality and in accordance with the decisions and instructions issued by the Central Council for the adoption of health facilities
المادة(52): يقوم المجلس باعتماد مقدمي خدمات الرعاية الصحية (الحكومية / غير الحكومية) في حدود الشروط التالية:
1- أن يكون مرفق الرعاية الصحية في القطاع الخاص قد تم ترخيصه من وزارة الصحة.
2- أن يكون الأفراد القائمون على توفير الرعاية الصحية قد تم تسجيلهم من الهيئة السعودية للتخصصات الصحية.
3- أن يكون مرفق الرعاية الصحية (الحكومي/غير الحكومي) مستوفياً الإجراءات المتعلقة بالمحافظة على الجودة 4- النوعية وفقاً للقرارات والتعليمات الصادرة عن المجلس المركزي لاعتماد المنشآت الصحية.

Chapter sex:  Chapter X: Sanctions and dispute settlement
 الفصل السادس : الجزاءات وتسوية المنازعات
Article (102): made the complaint from the party concerned in writing to the
Secretariat within ninety days from the date of the dispute that resulted in the subject of the complaint that there were not reasonable circumstances prevented the complaint during this period.

المادة (102): تقدم الشكوى من الطرف المعني كتابة للأمانة العامة خلال تسعين يوما من تاريخ وقوع الخلاف الذي ترتب عليه موضوع الشكوى ما لم تكن هناك ظروف معقوله حالت دون تقديم الشكوى خلال هذه المده.

Article (40): Do not allow insurance companies to commit acts of health insurance only after being qualified by the Council, and limiting the duration of the rehabilitation of three years renewable for similar periods.
 
المادة(40): لا يسمح لشركات التأمين بممارسة أعمال الضمان الصحي إلا بعد تأهيلها من قبل المجلس، ويكون التأهيل مقيدا بمدة ثلاث سنوات قابلة للتجديد لمدد أخرى مماثلة.

Council of
Co-operative
Health

Insurance
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA
CCHI
www.cchi.gov.sa
+ 966 1 487 55 57
Fax 1 487 15 35

*

Resources:

www.cchi.gov.sa (Council of Co-operative Health Insurance)

www.sama.gov.sa (Saudi Arabian Monetary Agency)

www.gosi.gov.sa (General Organization for Social Insurance)

www.moh.gov.sa ( Ministry Of Health)

www.cdsi.gov.sa ( Central Department for Statistics and
Information)
HEALTH SYSTEM AND INSURANCE
IN SAUDI ARABIA

*

nib340505_0515

nib Saudi
Health Cover
Students

Need help?
Call us on 1800 783 685
Mon to Fri: 8am – 8.30pm Sat: 8am – 1pm (AEST)
Go to nib.com.au/saudihealth
nib health funds limited abn 83 000 124 381 Head Office 22 Honeysuckle Drive Newcastle NSW 2300

2 3

nib Saudi Health Cover
Meets the DIBP visa requirements

Provides cover for medical and
hospital treatment if you get sick
or have an accident while you are
studying in Australia

Covers you Australia wide for
emergency ambulance transport

Who can be covered under
nib Saudi Health Cover
Singles – cover for only you.

Couples – covers both you and your
partner if they live with you in Australia
and are listed on your visa.

Families – covers you, your partner
and any dependent children aged under
18 living with you in Australia and listed
on your visa.

Overseas Student
Health Cover (OSHC)

SECTION
01

If you have any questions please call 1800 783 685

As you are aware international students who wish to study in Australia are required
as part of their visa application through the Department of Immigration and Border
Protection (DIBP) to show proof they have purchased relevant health insurance.

The information contained in this product information
brochure is current as at 20 April 2015. This brochure
is a summary of the key features of the nib International
Students Fund Rules Extract and Product Information
and should be read in conjunction with these Fund
Rules available at nib.com.au/saudihealth or by
calling 1800 783 685. Please read this brochure and
keep a copy for your records. Rules and benefits may
change from time to time.

Welcome to nib
We hope you have an exciting and
enjoyable time in Australia.

Taking care of your health is essential
for a happy and successful visit to
a new country.

At nib, we believe that health cover
should be easy to use, easy to
understand and most of all good value.

Why over 1 million customers trust nib
in Australia and New Zealand

Over 60 years experience
in providing health cover

Dedicated Customer Service Team

Easy mobile claiming

24 hour Online Services

Contents
Overseas Student Health Cover (OSHC) 3

nib Saudi Health Cover 4

nib Online Services 8

Seeking medical treatment 9

nib Saudi Health Cover provides
peace of mind in knowing that you
are covered for those unexpected
health needs.

4 5

SECTION
02nib Saudi Health Cover

If you have any questions please call 1800 783 685

As a valued Saudi Scholarship student the Saudi Arabian Cultural Mission has
chosen comprehensive health insurance for you. nib Saudi Health Cover will help
you pay for medical, hospital treatment plus Extras services (such as dental, optical,
physiotherapy, etc) you may need should you get sick or have an accident while
you are in Australia. The following is an explanation of your Saudi Health Cover.

General Exclusions
Exclusions are services not covered under your health cover. You will not receive
a benefit for the services listed below.

General exclusions applying to all benefits (including dental and optical)

✗ Elective cosmetic surgery (including
gender reassignment and surgery)
only where services are not listed
on the Medicare Benefits Schedule

✗ Organ donor treatment where
services are not listed on the Medicare
Benefits Schedule, unless expressly
provided otherwise

✗ Treatment considered not medically
necessary (e.g. health screening for
visa renewals)

✗ Treatment outside of Australia or
arranged before arriving in Australia

✗ Luxury hospital rooms and other
non-essential items like TV hire,
beauty treatments and phone calls

✗ Items and services delivered by
providers not recognised by nib

✗ Contraception

✗ Allergy testing, unless prescribed
by a physician or other registered
medical practitioner for an illness
covered under the policy

✗ Alopecia, wigs and toupees

✗ Any care, service, equipment
or treatment obtained for testing,
research or experimental purposes

✗ Treatment by physicians or
practitioners who are not licensed
or registered in accordance with
applicable regulatory requirements

✗ Treatment at facilities which are not
licensed or registered in accordance
with applicable regulatory requirements

✗ Medical appointments not kept
or complied with

✗ Any cost or expenses incurred after
the expiry date of the coverage,
except in respect of the claims
accepted by the Service Provider
before the expiry date of the coverage

✗ Claims which contain inaccurate
or false information

✗ Services where a customer is eligible
to receive benefits from a liable
third party (e.g. under Compulsory
Third Party insurance or Worker’s
Compensation insurance)

✗ Any duplication of service
or medical supplies

✗ Any service or medical supplies
received through any relatives
of the Insured

✗ Any service or medical supplies
received free of charge

This product information is intended as a summary only and for further information please visit nib.com.au/saudihealth This product information is intended as a summary only and for further information please visit nib.com.au/saudihealth

Medical services covered
in-hospital

Medical services covered
out-of-hospital

100% of the cost of public and private
hospital accommodation for overnight
and same day stays

Doctor visits

100% of the cost of service for consultations
with a doctor for day-to-day health needs

100% of the cost of operating theatre,
intensive care, ward fees

Specialist services

100% of the cost of specialist services
and treatment to support day-to-day health
needs, usually as requested by
a doctor, such as:

Pathology
Diagnostic Imaging.

100% of the benefit for approved
surgically implanted prosthetic
devices as determined by the
Federal Government

Emergency Ambulance

100% of medically necessary transport
provided by a State and Territory
Ambulance Service

100% of the cost for medical treatment
provided in a hospital includes:

Doctors and Specialists
Pathology and Diagnostic Imaging.

If you are considering bariatric surgery
benefits may be paid at a lower benefit.
Please contact nib for more details

MRIs

MRI scans are only payable by nib if all three
(3) of the following criteria are met:

The MRI must be referred by a registered
specialist medical practitioner and

The MRI must be listed on the Medicare
Benefits Schedule (MBS) and have an
eligible Medicare Item Number and

The MRI must be performed on a
Medicare Eligible MRI Unit by a
Medicare eligible provider.

6 7

If you have any questions please call 1800 783 685

Saudi Health Cover Students Extras Cover

Extras Cover
(additional services covered)

Annual Limit
(maximum amount claimable per person in a calendar year)

General dental

Major dental
(excludes implants unless as a result of an accident)

Orthodontia^
(Lifetime limit $3,500)

Combined dental
annual limit $5,500

*Dental services required as a result of an accident
– 100% (Proof of accident required. Benefits will be

paid from annual limits first.)
^Orthodontia: Only payable if medically necessary

and has a $3,500 lifetime limit.

Optical $300

Physiotherapy

Acupuncture

Chiropractic

Osteopathy

Podiatry

Exercise physiology

Combined annual limit $500
*100% coverage for therapy due to an accident or
surgical procedure (pre-operative & post-operative

care). Includes physiotherapy, chiro, osteo.
Proof will be required before benefits paid.

Pharmaceuticals
(PBS, non-PBS, listed on the ARTG & Mims published)

Unlimited

Speech Therapies

100% cost

Home nursing 100% cost

Occupational therapy 100% cost

Antenatal & postnatal services
(such as classes & lactation)

100% cost

Hearing aids annual limit $12,000
(please contact nib for specific replacement limits)

Artificial aids
100% cost

(please contact nib for specific inclusions,
restrictions and replacements)

Extras Exclusions
Optical exclusions (in addition to the General Exclusions)

✗ Laser eye surgery to correct or improve vision (unless listed on MBS)

✗ Cosmetic contact lenses

✗ Replacement of glasses or lenses due to theft or loss

Dental exclusions (in addition to the General Exclusions)

✗ Any procedure related to the correction of vertical dimensions of the jaw,
except as required as a result of an accident during the policy period

✗ Artificial teeth, or part thereof, except as required as a result of an accident during
the policy period. Artificial teeth mean fabricated teeth made of porcelain or other
synthetic compound as imitation of natural teeth

✗ Replacement of bridges, crowns and dentures, where repair is possible

This product information is intended as a summary only and for further information please visit nib.com.au/saudihealth This product information is intended as a summary only and for further information please visit nib.com.au/saudihealth

8 9

Seeking medical treatment

Apple and the Apple logo are trademarks of
Apple Inc., registered in the U.S. and other
countries. iPhone is a trademark of Apple Inc.

Claim in a snap
with the nib App.

■ Download the free nib App today

■ Upload a photo of your official provider receipt

■ Benefit is paid directly into your bank account

Available for iPhone®, iPad® and Android ™

nib Online Services
Our Online Services makes it easy for you to manage and access your health cover
at anytime and anywhere. To register for nib Online Services visit nib.com.au

Update your contact details, e.g. your Australian address and bank account details

View your health cover and what you are covered for

Submit a claim

View your claims history

Order a replacement customer card

SECTION SECTION
03 04nib Online Services

Healthdirect
Australia
Provides access to health
information and advice over
the phone.

To talk to a registered nurse
call Healthdirect Australia
on 1800 022 222 or visit
healthdirect.gov.au for health
information. Available 24 hours
a day, 7 days a week.

Healthdirect Australia does
not provide a health diagnosis
and does not replace the services
of a doctor or hospital
emergency department.

When to see a doctor or specialist
If it is not an emergency and you are feeling unwell visit your local doctor. In Australia
a doctor is called a GP (or ‘General Practitioner’). A GP can prescribe treatments or
medicines. A GP may refer you to a specialist for further investigations or treatment.

What if it is a medical emergency
In the event that you have a medical emergency for example a life threatening illness
or a serious injury that needs immediate attention, then you should go to the nearest
hospital emergency department. If your condition is serious and you cannot get
yourself to a hospital, call ‘000’ for an ambulance.

This product information is intended as a summary only and for further information please visit nib.com.au/saudihealth This product information is intended as a summary only and for further information please visit nib.com.au/saudihealth

10 11

Saudi Arabia: An Introduction To
Medical Education and
Healthcare

Outline 

• History 
•

Demographics

• King Saud University 
• Saudi Healthcare system 
• Saudi Vision 2030 

Location

Kingdom Of Saudi Arabia

• Saudi Arabia is the birthplace of Islam, and home to Islam’s two 
holiest mosques, in Mecca and Medina.

• Saudi Arabia is the largest Arab state in Western Asia by land area, 
and the second‐largest in the Arab world.  

Demographics

• Area: 2,149,690 sq km
• 13 regions
• Official language: Arabic
• Population: 31,742,308 (2016)
• Capital city: Riyadh
• Currency: Saudi Riyal (= 1.77 dkk)

Traditional customs’ 

History
• The Kingdom of Saudi Arabia was founded by Abdulaziz
Bin Saud in 1932 , after a 30‐year campaign to unify most 
of the Arabian Peninsula. 

• One of his male descendants rules the country today, as 
required by the country’s 1992 Basic Law.

• 1938 ‐ Oil was discovered and production began under 
the US‐controlled Aramco (Arabian American Oil 
Company). 

• Till this day Saudi Arabia is the number 1 country in 
exporting crude oil and has the world’s largest reserve.

Chief geologist. Max Steineke 

• The King’s official title is the Custodian of the Two Holy Mosques. 
• King and Prime Minister Salman bin Abdulaziz Al Saud has been on the throne since 23 January 
2015 (center)

• Crown Prince, Deputy Prime Minister, and Minister of Interior : Mohammed bin Naif bin 
Abdulaziz Al Saud (left)

• Deputy Crown Prince, Second Deputy Prime Minister, and Minster of Defense: Mohammed bin 
Salman bin Abdulaziz Al Saud (right)

Saudi & Denmark 

• The kingdom government system is 
made of legislation, executive, judicial.

• The king combines all functions
• It is an absolute monarchy governed by 
the AlSaud family.

‐ Our foundation of ruling is Quraan & 
Sunnah.

‐ We follow a civil law system

‐ The three pillars:
Saudi Council of Ministers
Regional prince
Consultative Council or Majlis al‐
Shura (150 seats).

Population pyramid
Life expectancy :
total population: 75.3 years
male: 73.2 years
female: 77.4 years (2016 est.)
Obesity ‐ adult prevalence rate:
33.7% (2014)
Diabetes prevalence:
The World Health Organization (WHO) has 
reported that Saudi Arabia ranks the 
second highest in the Middle East, and is 
seventh in the world for the rate of 
diabetes.

What’s Not true about Saudi !

• We don’t have Oil in our backyard 
• We don’t live in tents 
• We don’t ride camels 

Medical Education 
in Saudi Arabia

The College of Medicine in King Saud
University was established as the first
medical college in the Kingdom in 1967.
In 1975, the College opened a department
for female students.
KSU is a public university, and does not
charge tuition fees to Saudi students.
Enrolled students receive a monthly
stipend.

Today, there are 32 medical schools
across the Kingdom.

Medical Curriculum at KSU

P Preparatory Year

1 Basic Sciences (Foundation – Musculoskeletal – Cardiac – Respiratory – Renal)

2 Basic Sciences (CNS – Gastrointestinal – hem/onc – Endocrine – Reproductive)

3 Clinical ( Medicine – Surgery – Radiology – Research)

4 Clinical subspecialties (ENT‐ Ophthamology – Orthopedics – Obs/Gyn – Fam Med – Anesthesia ‐ Psych)
Elective

5 Core rotations (Medicine – Surgery – Pediatrics)
Elective

6 Internship

Courses in professionalism, ethics, health informatics, community medicine, forensic 
medicine, and toxicology are part of the curriculum as well.

Research

Research Centers at the Faculty of Medicine:
1. Faculty of Medicine Research Center. 2- Liver Disease Research Center
3 – Autism Research Center 4- Obesity Research Center.
5- Sleep disorders Center. 6- Prince Nayef bin Abdul Aziz
Center for Research( for all health colleges )

the Faculty was awarded first prize for accumulative research for the past ten
years in 2008 by the prestigious Scopas.

Postgraduate Medical Education

The Saudi Commission for Health Specialties 
(SCFHS) is responsible for supervising and 
evaluating training programs, as well as 
setting controls and standards for the 
practice of health professions.

This includes developing, approving and 
supervising professional health‐related 
programs, and developing sustained medical 
education programs for health‐related 
disciplines. 

Healthcare systems in Saudi Arabia

• The Saudi government provides its citizens with free public healthcare.
• The Ministry of Health is responsible for overseeing the health care system in

Saudi Arabia.

• Currently, MOH is the largest provider of health care services in Saudi Arabia,
with a total of 244 hospitals (33,277 beds) and 2037 primary health care centers.

• Many other branches of the government operate hospitals independent of MOH,
but still depend on MOH in a regulatory and advisory role.

• Private healthcare contributes as well.

Healthcare systems in Saudi Arabia

Other Government Providers:

• Ministry of Defense
• Ministry of Interior
• National Guard
• Ministry of Education (University 
hospitals)

• Specialist hospitals (KFSHRC, 
KKESH)

Distribution of hospital beds in Saudi 
hospitals

Private Healthcare in Saudi Arabia 

• Funding health care services is a
central challenge faced by the
MOH.

• The Council for Cooperative
Health Insurance was established
by the government in 1999.

• Its main role is to introduce,
regulate and supervise a health
insurance strategy for the Saudi
health care market.

Saudi Arabia’s 

Vision 2030

Saudi Arabia has launched an ambitious reform program with Vision
2030, a long‐term strategy to bolster the country’s fiscal position and
diversify its economy in a world of low oil prices. The strategy provides
international firms with the opportunity to invest in the country,
particularly in its non‐oil sectors.

Capacity:
Beds: 1200
Operatig rooms: 32
Procedures: 600 Procedures
Outpatient visits: 6600 patients/per
month

Economy
Total budget:
from the ministry of higher education
(444.5 Billion SR)

KKUH has several specialized
departments like:

Medical Education
Anatomy
Anesthesia
Cardiac Sciences
Dermatology
Emergency Medicine
ENT
Family & CommunityMedicine
Medicine
OBS‐Gynecology

Ophthalmology
Orthopedics
Pathology
Pediatrics
Pharmacology
Psychiatry
Physiology
Radiology
Surgery
Critical Care

• http://rahah.org
https://youtu.be/PHZvgIl2bZo

Saudi Arabia’s Vision 2030
Saudi Arabia has launched an ambitious reform program with Vision
2030, a long‐term strategy to bolster the country’s fiscal position and
diversify its economy in a world of low oil prices. The strategy provides
international firms with the opportunity to invest in the country,
particularly in its non‐oil sectors.

Vision 2030

• The drop in global crude prices since 2015 has had a significant impact on oil 
exporters in the Gulf Cooperation Council (“GCC”), the majority of whom are 
heavily reliant on the revenue those exports generate

• Saudi Arabia has been particularly hit by the new oil price. The country ran a 
budget deficit of USD 98 billion in 2015, equivalent to around 16 percent of its 
GDP, and USD 79 billion in 2016

• The fiscal pressures resulting from the drop in oil price have brought with it 
increased scrutiny of the region’s economic models, built around very low taxes, 
heavy subsidies and sprawling public sectors

Initial Reforms 

• Healthcare: The government has earmarked USD 11 billion for 
investment opportunities in the sector by 2020, including 
opportunities in tertiary and secondary care, procurement and 
manufacture of medical devices, education and insurance.

• Transportation: In 2015, the Ministry of Transport set a 10‐year 
expansion plan of its public transportation services, earmarking USD 
90 billion for new metro lines and bus routes in Riyadh, Jeddah, 
Mekkah and Medina. 

Initial Reforms

• Tourism: Historically restricted to religious tourism, Saudi Arabia is 
looking to attract 1.5 million leisure tourists by 2020 through the 
easing visa restrictions and investment in hospitality projects. 
International companies such as the Rezidor Group and Accor have 
announced plans to open dozens of new hotels in the next five years

• Wastewater and desalination: As the government looks to increase 
its annual production of water to meet growing demand, it has 
allocated USD 60 billion for the development of wastewater and 
desalination plants.