The Health Insurance Council has set 6 criteria and regulations for dispensing medical devices to health insurance beneficiaries, including the requirement of a medical condition necessitating device use, availability of medical justification, dispensing through licensed healthcare providers, along with organizing the replacement mechanism to ensure devices reach those entitled according to medical need and approved regulations, and enhancing healthcare quality and sustainability of services provided to the insured.

Healthcare Services

The Council explained that dispensing medical devices is limited to cases that necessitate their use based on medical diagnosis, such as heart diseases, high blood pressure, diabetes, and respiratory diseases, with the need for a medical justification proving the need for the device during the validity period of the health insurance policy.

It pointed out that devices are dispensed through healthcare providers licensed by the Saudi Food and Drug Authority, and according to approved and reasonable prices, ensuring device quality and safe use.

Optimal Use

The Council stated that the medical device is dispensed once during the validity period of the mandatory health insurance policy, while a replacement device can be dispensed after the expiration of the current device's lifespan, according to medical evaluation and relevant regulations.

It added that the concerned entity may request the return of the old device upon replacement, as part of organizing dispensing and replacement operations, and ensuring optimal use of medical devices.

The Council affirmed that these regulations are part of its efforts to enhance beneficiaries’ rights, organize the mechanism for dispensing medical devices to achieve fairness in accessing the service, and improve the efficiency of healthcare provided to health insurance beneficiaries.

Controls for Dispensing Medical Devices

01. A medical condition requiring device use (e.g., heart disease, diabetes, hypertension, respiratory diseases).

02. Availability of medical justification during the health insurance policy validity period.

03. Dispensing devices through licensed healthcare providers.

04. Device dispensed once during the mandatory health insurance policy validity period.

05. Replacement of device after its lifespan ends when needed.

06. Possibility of returning the old device by the concerned entity upon replacement.