Announce Health Insurance Council It recently announced its share of drug and therapeutic costs, which includes a variety of categories such as generics, OTCs, and innovative therapies.
New decisions about the insurance bearing percentage of drug prices for all types of insurance in the Kingdom
This came through a statement published by the Council on its official account on the “X” platform, where it stressed the importance of this matter in providing health services to beneficiaries.
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Specific tolerance ratios
The Council explained that the tolerance rate in cases of generic medicines, non-prescription medicines and innovative treatment, when a generic alternative is not available, reaches 20%.
The Council also specified that the maximum beneficiary participation in the payment is 30 Saudi riyals.
These percentages aim to improve access to necessary medicines and reduce the financial burdens on citizens.
Details of the innovative treatment
As for innovative treatment in cases of a generic alternative, the Council indicated that the deductible rate in this case ranges between 0-50% of the price of the innovative treatment.
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It specifies the maximum financial participation between the employer and the concerned party, allowing more flexibility in dealing with treatment costs.
The Council responded to followers’ inquiries
This announcement came as part of the Council’s response to an observer’s inquiry, who asked how the percentages are calculated in the event that there are innovative medicines and generic medicines whose value exceeds the maximum tolerance.
The Council has clarified that in such cases, the withholding percentage will be calculated according to the maximum limit for each type of medicine, which ensures fairness in the financial distribution.
The role of the Health Insurance Council
It is worth noting that the Health Insurance Council is a regulatory body that aims to enhance the quality and efficiency of health services provided to health insurance beneficiaries.
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The Council seeks to achieve the best standards in health care, which contributes to improving community health and enhancing the level of health services provided.
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