Saudi Arabia Health And Medical Insurance Market Size and Share

Saudi Arabia Health And Medical Insurance Market Analysis by Mordor Intelligence
The Saudi Arabia health and medical insurance market is valued at USD 10.03 billion in 2025 and is on track to reach USD 13.74 billion by 2030, advancing at a 6.52% CAGR. Rapid digitization, expansion of mandatory coverage, and Vision 2030’s push to boost private-sector participation in healthcare from 40% to 65% underpin this growth. Mandatory e-claims processing through NPHIES is reducing cash-cycle times, while value-based purchasing via AR-DRG bundles is prompting richer benefit designs. New compulsory cover for dependents of private-sector Saudis immediately enlarges the insured pool by 3.2 million lives. Demand also rises as SMEs proliferate and mobile-first consumers channel 46% of claims through apps. Although GLP-1 obesity drugs and premium-ceiling regulations pressure margins, insurers are countering digital efficiencies and product innovation.
Key Report Takeaways
- By insurance type, group plans led with 74.5% of Saudi Arabia health insurance market share in 2024; individual policies are set to expand at a 15.81% CAGR through 2030.
- By coverage type, inpatient benefits captured 63.3% of the Saudi Arabia health insurance market size in 2024, whereas wellness/telehealth add-ons are projected to post an 18.52% CAGR over 2025-2030.
- By plan tier, silver plans held a 42.2% revenue share in 2024; bronze offerings are forecast to grow at a 14.21% CAGR.
- By insurance model, Takaful commanded 87.3% of the Saudi Arabia health insurance market size in 2024, while conventional insurance is expected to record a 15.33% CAGR by 2030.
- By distribution channel, brokers accounted for 52.1% of the Saudi Arabia health insurance market share in 2024; digital aggregators & InsurTech platforms will advance at a 25.12% CAGR to 2030.
- By end user, large corporates generated 56.4% of premiums in 2024; SMEs are positioned for 18.62% CAGR growth.
Saudi Arabia Health And Medical Insurance Market Trends and Insights
Drivers Impact Analysis
Driver | (~) % Impact on CAGR Forecast | Geographic Relevance | Impact Timeline |
---|---|---|---|
NPHIES real-time e-claims mandate | +1.2% | National; early gains in Central, Western, Eastern | Short term (≤ 2 years) |
CHI AR-DRG value-based purchasing | +0.9% | Major urban centers | Medium term (2-4 years) |
Compulsory cover for dependents | +1.5% | Central and Eastern regions | Medium term (2-4 years) |
Vision 2030 SME boom | +0.8% | Central and Western regions | Long term (≥ 4 years) |
Mobile-first claims adoption | +0.7% | Urban areas nationwide | Short term (≤ 2 years) |
Privatization of five health clusters | +0.6% | All five administrative clusters | Long term (≥ 4 years) |
Source: Mordor Intelligence
NPHIES real-time e-claims mandate transforms payment velocity
National Platform for Health and Insurance Exchange Services (NPHIES) has eliminated the previous 30-60 day reimbursement cycle, enabling providers to obtain real-time payment authorizations and significantly reducing their working capital requirements by up to 50%. This advancement streamlines financial operations for healthcare providers, allowing them to focus more on patient care rather than administrative burdens. With integration into the Saudi Billing System, NPHIES now supports 7,947 unified codes, representing a 30% increase over the older lists. This alignment enhances standardization and efficiency across the healthcare billing process. While early adopters report a 25-30% reduction in administrative costs, only 62% of providers are prepared for Diagnosis-Related Group (DRG) coding. This readiness gap has prompted insurers to invest in coding training programs, aiming to equip providers with the necessary skills and ensure the liquidity of their networks remains intact, thereby fostering a more robust and efficient healthcare ecosystem.
CHI value-based purchasing through AR-DRG bundles reshapes benefit design
In collaboration with Australia's Department of Health, the rollout of Australian Refined Diagnosis-Related Groups (AR-DRG) is transitioning reimbursements from a fee-for-service model to bundled payments. This initiative equips actuaries with detailed cost data, enabling more accurate financial planning and resource allocation[1]Ministry of Health, Saudi Arabia, “National Transformation Program Health Initiatives,” moh.gov.sa. Pilot results from King Fahd Central Hospital indicate that DRG costing exceeds traditional averages by 9%, offering deeper insights into pricing strategies and operational efficiencies. Under the Essential Benefit framework of the Council of Health Insurance (CHI), insurers are rolling out tiered preventive care packages. These packages aim to enhance patient outcomes by prioritizing quality over the volume of utilization, marking a significant shift in the healthcare reimbursement landscape.
Compulsory coverage extension adds 3.2 million lives
Mandatory insurance coverage has been expanded to include dependents of private-sector Saudis, marking the most significant increase in the insured population since 2003. This extension is expected to enhance access to healthcare services for millions, driving growth in the health insurance market. Established players like Bupa Arabia and Tawuniya leverage their extensive networks to swiftly underwrite family policies, ensuring seamless integration of dependents into the system. In contrast, providers in the northern and southern regions, facing density constraints, are channeling their investments into telemedicine to bridge gaps in healthcare accessibility and improve service delivery in underserved areas.
Vision 2030 SME boom drives micro-group insurance innovation
With a target of 1 million active SMEs by 2027, government financing and regulatory incentives are igniting a demand for streamlined, customizable group insurance plans. These plans are designed to cater to the unique needs of small and medium enterprises, offering flexibility and affordability. Digital platforms are easing the enrollment process for companies with 10 to 250 employees by providing user-friendly interfaces and efficient onboarding systems. This accessibility is driving a surge in micro-group premiums as more SMEs recognize the value of such insurance solutions. Additionally, this growing demand is pushing insurers towards consolidation, enabling them to achieve economies of scale and enhance their operational efficiency to better serve this expanding market segment.
Restraints Impact Analysis
Restraint | (~) % Impact on CAGR Forecast | Geographic Relevance | Impact Timeline |
---|---|---|---|
GLP-1 obesity drugs | -0.8% | Highest in major urban centers | Short term (≤ 2 years) |
CHI premium-ceiling circular | -0.5% | Nationwide | Medium term (2-4 years) |
Limited DRG readiness | -0.4% | Smaller facilities across Kingdom | Short term (≤ 2 years) |
Preference for free MoH services | -0.3% | Northern & Southern regions | Long term (≥ 4 years) |
Source: Mordor Intelligence
GLP-1 obesity drugs create USD800 million claims pressure
Monthly costs for Semaglutide and tripeptide treatments range from USD533 to USD1,067 per patient. These treatments, which are gaining popularity for their effectiveness in managing obesity, could lead to an annual claims surge of USD800 million starting in 2025. With adult obesity rates at 35%, the financial burden on insurers is significant. To address this, insurers are implementing measures such as prior authorization to ensure appropriate use and outcome-based reimbursement strategies to link payments to treatment effectiveness, thereby mitigating their financial exposure[2]A. Alghamdi et al., “Economic Burden of Obesity in Saudi Arabia,” advancesintherapy.com. Additionally, the rising demand for these drugs highlights the growing focus on addressing obesity as a critical public health issue, further emphasizing the need for sustainable reimbursement models to balance patient access and cost management.
CHI premium-ceiling circular constrains pricing flexibility
With Circular (#156-2023) imposing caps on annual premium increases, insurers find it increasingly challenging to counteract rising medical inflation. This regulation restricts their ability to adjust pricing in line with escalating healthcare costs. In response, firms are adopting strategies such as tightening their provider networks, increasing deductibles, and exploring alternative revenue streams. These include fee-for-service administration models, wellness programs, and other innovative approaches aimed at diversifying income sources. By implementing these measures, companies strive to maintain operational efficiency, ensure sustainability, and safeguard profit margins amidst these regulatory constraints.
Segment Analysis
By Insurance Type: Individual momentum within group dominance
Group plans lock in 74.5% of the Saudi Arabian health insurance market share due to mandatory employer coverage, yet individual policies deliver the highest 15.81% CAGR. Digital apps such as Daman speed onboarding for freelancers and self-employed customers seeking portable benefits. Recent USD203 million and USD213 million group contracts with Saudi Arabia and the Saudi Electricity Company underscore the volume still anchored in corporate accounts.
Meanwhile, the gig economy workforce amplifies individual uptake, giving carriers room to diversify beyond employer-centric models. The Saudi Arabia health insurance market size for individual plans is projected to accelerate as mobile enrollment and flexible riders capture price-sensitive consumers. Established insurers refine actuarial models to price self-funded risks, leveraging telehealth to minimize claim costs and reinforce insurer-insured engagement, while group carriers continue to differentiate via provider-network breadth and wellness-incentive programs.

By Coverage Type: Preventive add-ons eclipse inpatient growth
Inpatient benefits represented 63.3% of premiums in 2024, but wellness and telehealth riders exhibit an 18.52% CAGR, reflecting a preventive-care pivot. The Seha Virtual Hospital and Sehhaty app normalize virtual diagnostics for 24 million registered users, driving coverage beyond classic hospital care. Outpatient, maternity, and dental optics maintain mid-single-digit growth as base demand endures.
The Saudi Arabia health insurance market size attached to wellness riders is expanding rapidly as insurers pair app-based coaching with rewards that reduce chronic disease claims. This trend lowers hospital admissions over time, whereas inpatient-centric insurers confront rising specialty-drug costs. Consequently, product design now embeds wellness modules to preserve competitiveness and shore up loss ratios.
By Plan Tier: Cost-minded SMEs propel bronze plans
Silver packages accounted for 42.2% of revenue in 2024, but bronze tiers are rising at 14.21% CAGR. SMEs favor entry-level bronze cover USD133,000 limits for small firms meeting CHI mandates while minimizing payroll costs. Gold and platinum tiers keep their niche among high-income Saudis and multinationals needing premium networks and overseas benefits. The Essential Benefit Package allows large companies to opt for bronze plans with USD 267,000 limits, whereas higher tiers offer added services.
In the Saudi Arabian health insurance market, insurers are finding that while bronze growth offers them scale, the accompanying thinner margins push them towards digital onboarding and automated claims for profitability. The adoption of digital solutions helps streamline operations, reduce costs, and improve customer experience, which is critical in maintaining competitiveness. As SMEs evolve, their upgrade potential fosters a balanced plan mix, positioning insurers to cross-sell premium tiers as economic conditions brighten. This upgrade potential also allows insurers to diversify their portfolio and reduce dependency on lower-margin plans. Consequently, leveraging technology and targeting SME growth are key strategies for insurers to sustain long-term growth in this market.

Note: Segment shares of all individual segments available upon report purchase
By Insurance Model: Conventional grows inside a Takaful stronghold
Takaful, with its Sharia-compliant appeal, commands an 87.3% market share, reflecting its strong cultural alignment in Saudi Arabia. However, conventional insurance's 15.33% CAGR highlights the growing demand among expatriates seeking tailored solutions. International insurers are developing products that adhere to global benefit standards, catering to this emerging demographic. Meanwhile, Takaful firms focus on cooperative surplus distribution, and some carriers leverage dual licensing to operate both models, mitigating risks from demographic shifts.
As multinationals and foreign workers pursue smooth cross-border coverage, the market for conventional health insurance in Saudi Arabia is expanding significantly. This growth is driven by the increasing need for seamless and globally aligned insurance solutions. In response, Takaful leaders are integrating digital service layers to enhance member engagement and sustain their competitive edge. These efforts aim to preserve cultural relevance while offering convenience comparable to conventional insurance options.
By Distribution Channel: Digital aggregators narrow the broker gap
In 2024, brokers accounted for 52.1% of total premiums, but InsurTech platforms are surging with a 25.12% CAGR. The widespread use of smartphones and swift e-KYC authentication are making purchases easier, particularly for individuals and SMEs. To protect their market share, established intermediaries are utilizing white-label apps, merging advisory insights with user-friendly self-service features. This strategic approach allows traditional players to remain competitive in an increasingly digitalized insurance landscape.
As digital channels gain traction, the Saudi Arabian health insurance market is evolving. Insurers are now turning to API-driven quotation engines and automated underwriting to meet changing consumer expectations. Those who shy away from digital distribution may find themselves confined to stagnant niches as savvy, price-aware consumers increasingly sidestep traditional sales methods. The shift toward digitalization is reshaping the competitive dynamics, compelling carriers to innovate or risk losing relevance.

Note: Segment shares of all individual segments available upon report purchase
By End User: SME emergence anchors future expansion
In 2024, large corporates dominated the scene, accounting for 56.4% of the premium. However, driven by Vision 2030's push for entrepreneurship, SME policies are on track to see an impressive 18.62% CAGR. The government is actively supporting this growth by offering fee-exemption incentives for insurer mergers, which enhance the service capacity for SMEs. Additionally, venture capital funds are broadening the healthcare landscape, leading to a surge in demand for customized insurance solutions tailored to specific needs.
As SMEs continue to grow, their stake in Saudi Arabia's health insurance market is expanding. This shift is prompting insurers to develop flexible plans featuring installment-based premiums and the convenience of online enrollment. While large corporates still play a crucial role in sealing mega-contracts, their dominance is gradually being balanced. The ongoing trend of macro-diversification is steering incremental growth towards SMEs, expatriates, and self-employed nationals, reshaping the market dynamics.
Geography Analysis
Central (Riyadh) captured 37.4% of premiums in 2024, supported by dense employer bases and the Kingdom’s largest private-hospital footprint. Efficiency gains from the Riyadh First Health Cluster, which saved USD3.8 million and lifted patient satisfaction to 73.2%, reinforce demand for integrated insurance solutions[3]M. Alafeef et al., “Cluster-Based Healthcare Efficiency in Riyadh,” dovepress.com. Digital infrastructure and policy-setting proximity keep the Central region at the forefront of pilot programs, cementing its lead in the Saudi Arabian health insurance market.
Western (Makkah-Medina) posts the fastest 15.91% CAGR through 2030. Pilgrimage healthcare, port-city expansion, and the NEOM megaproject widen the risk base and spur insurer-provider partnerships. New medical cities and public-private ventures expand network capacity, while visitor insurance for Hajj and Umrah extends product lines year-round.
Eastern Province, anchored by energy-sector employers, remains a sizable contributor, whereas Northern and Southern regions lag due to lower population density and reliance on free Ministry of Health services. Primary-care center ratios declined to 0.62 per 10,000 residents in 2021, prompting insurers to employ telemedicine and mobile clinics to penetrate these areas. Geographic diversification strategies increasingly hinge on digital health to bridge infrastructure gaps and push overall Saudi Arabia health insurance market penetration beyond urban strongholds.
Competitive Landscape
Bupa Arabia, Tawuniya, MedGulf, Al Rajhi Takaful, and SAICO are the top five players, commanding over half of the market's premiums, signaling a moderate concentration. These industry leaders, leveraging scale advantages in network contracting, compliance, and data analytics, negotiate favorable reimbursements and pilot emerging capitation models. As regional health clusters privatize, competition for risk-sharing contracts intensifies. Simultaneously, InsurTech newcomers harness AI-driven underwriting to attract SMEs and individual clients.
Strategic focuses include vertical integration and technology adoption. Insurers are channeling investments into telehealth platforms, predictive analytics, and wellness ecosystems, aiming to reduce loss ratios and boost customer retention. Collaborations, like GE HealthCare’s radiology enhancement at Dr. Sulaiman Al-Habib Medical Group (HMG), not only improve provider outcomes but also strengthen insurer offerings. However, with regulatory premium ceilings in place, there is a push for cost containment. It drives mergers and operational efficiencies as players strive to safeguard profitability in Saudi Arabia's health insurance landscape.
New entrants are making waves with innovations in digital claims, embedded insurance, and on-demand coverage. In response, established players are enhancing their omnichannel distribution and launching loyalty programs linked to lifestyle applications. As the market shifts towards value-based care and consumer-centric models, the emphasis on technological prowess and sophisticated risk management will be paramount for competitive success.
Saudi Arabia Health And Medical Insurance Industry Leaders
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Bupa Arabia for Cooperative Insurance
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Tawuniya (The Company for Cooperative Insurance)
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MedGulf (Mediterranean & Gulf Cooperative Insurance & Reinsurance)
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Al Rajhi Company for Cooperative Insurance (Al Rajhi Takaful)
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Saudi Arabian Cooperative Insurance Company (SAICO)
- *Disclaimer: Major Players sorted in no particular order

Recent Industry Developments
- February 2025: Tawuniya won a health insurance contract with Saudi Arabian Airlines valued at more than 5% of its 2023 revenue.
- January 2025: MedGulf secured a health insurance deal with Saudi Electricity Company worth USD213 million, equal to over 40% of MedGulf’s 2023 revenue.
- January 2025: Redesign Health and Sanabil Investments launched a healthcare venture studio targeting 20 startups in the Kingdom.
- November 2024: Almoosa Health Company filed for a Saudi Exchange IPO to expand its hospital network.
- August 2024: Dallah Healthcare agreed to acquire Al-Salam and Al-Ahsa Medical Services companies to deepen its Eastern Province footprint.
- April 2024: Cigalah Healthcare and Abdi Ibrahim formed Abdi Cigalah Pharma, expected to add USD133 million to the economy within five years.
Saudi Arabia Health And Medical Insurance Market Report Scope
Health insurance implies a form of coverage where policyholders pay regular premiums, and in return, the insurance provider covers their medical and surgical expenses during emergencies.
The health & medical insurance industry in Saudi Arabia is segmented by type of insurance provider, type of customer, type of coverage, product type, demographics, and distribution channel. The type of insurance provider is sub-segmented into public sector insurers, private sector insurers, and standalone health insurance companies. The type of customer is sub-segmented into corporate and non-corporate. The type of coverage is sub-segmented into individual insurance coverage, family insurance coverage, or floater insurance coverage. Product type is sub-segmented into disease-specific insurance and general insurance. Demographics is sub-segmented into minors, adults, and senior citizens, and distribution channel is sub-segmented into direct to customers, brokers, individual agents, corporate agents, online, bancassurance, and other distribution channels. The report offers market size and forecasts for the health & medical insurance industry in Saudi Arabia in value (USD) for all the above segments.
By Insurance Type | Individual Health Insurance |
Group Health Insurance | |
By Coverage Type | Inpatient Cover |
Outpatient Cover | |
Maternity Cover | |
Dental Cover | |
Optical Cover | |
Critical-Illness Riders | |
Wellness/Telehealth Add-ons | |
By Plan Tier | Bronze |
Silver | |
Gold | |
Platinum | |
Employer Self-Funded (ASO) | |
By Insurance Model | Co-operative (Takaful) |
Conventional | |
By Distribution Channel | Insurance Brokers |
Bancassurance | |
Direct Sales Agents | |
Digital Aggregators & InsurTech Platforms | |
Corporate In-house Sales | |
By End-User | SMEs (<250 employees) |
Large Corporates | |
Expatriates | |
Saudi Nationals in Private Sector | |
Government Employees (Supplemental) | |
Self-Employed / Individual Citizens | |
By Region | Central (Riyadh) |
Western (Makkah & Medina) | |
Eastern Province | |
Northern Region | |
Southern Region |
Individual Health Insurance |
Group Health Insurance |
Inpatient Cover |
Outpatient Cover |
Maternity Cover |
Dental Cover |
Optical Cover |
Critical-Illness Riders |
Wellness/Telehealth Add-ons |
Bronze |
Silver |
Gold |
Platinum |
Employer Self-Funded (ASO) |
Co-operative (Takaful) |
Conventional |
Insurance Brokers |
Bancassurance |
Direct Sales Agents |
Digital Aggregators & InsurTech Platforms |
Corporate In-house Sales |
SMEs (<250 employees) |
Large Corporates |
Expatriates |
Saudi Nationals in Private Sector |
Government Employees (Supplemental) |
Self-Employed / Individual Citizens |
Central (Riyadh) |
Western (Makkah & Medina) |
Eastern Province |
Northern Region |
Southern Region |
Key Questions Answered in the Report
What is the current size of the Saudi Arabia health insurance market?
The market stands at USD10.03 billion in 2025 and is projected to hit USD13.74 billion by 2030.
Which segment is growing fastest in Saudi health insurance?
Individual policies show the quickest expansion with a 15.81% CAGR, fueled by freelancers and self-employed nationals.
Why are wellness and telehealth riders gaining popularity?
Mobile-first consumers and government digital health initiatives drive adoption, giving wellness riders an expected 18.52% CAGR.
How does Vision 2030 affect health insurance demand?
Vision 2030’s goal of 1 million active SMEs boosts micro-group policies and prompts insurers to design affordable bronze-tier plans.
What are the biggest cost pressures for insurers?
High-priced GLP-1 obesity drugs, which may add USD 800 million in annual claims, and premium-ceiling regulations both squeeze margins.
Who are the leading insurers in Saudi Arabia?
Bupa Arabia, Tawuniya, MedGulf, Al Rajhi Takaful, and SAICO collectively hold about the majority of the total premium, giving the market a moderate concentration.