Before you start

A confirmed job offer / employment with a Saudi entity (the employer, as your sponsor, arranges and pays for the policy)
Passport and visa details for you and any dependents you are bringing
An Iqama application in progress (or your existing Iqama for renewal) — insurance is checked against it
Absher and the Tawakkalna app set up for government/health identity verification

Step-by-step

1
Employer enrols you (and dependents) in a CHI-compliant policy
Your sponsor must buy you a cooperative health insurance policy from a CHI-licensed insurer (Bupa Arabia, Tawuniya, MedGulf are the largest) that meets at least the minimum Essential Benefit Package. Crucially, every dependent on your Iqama — spouse and children — must be covered too, and that is also the employer's obligation. Confirm with HR the coverage class/tier and the hospital network, because the cheapest compliant plan limits which private hospitals you can use.
Via employerWho: Employer / sponsor (HR), via a CHI-licensed insurerActivated before the Iqama is issued; typically within days of onboardingPaid by the employer for the employee; dependent premiums are sometimes passed to you — confirm with HR
2
Policy is registered and verified electronically against your Iqama
The insurer registers your policy on the CHI / Nphies platform, which links it to your Iqama number. The Passport Directorate (Jawazat) and Ministry of Human Resources check this register automatically — no paper is submitted. If the policy is missing or lapsed, the Iqama issuance or renewal simply will not go through on Absher.
OnlineWho: Insurer + CHI / Jawazat (automatic)Immediate once the insurer activates the policyIncluded in the policy
3
Verify your own coverage and choose your network hospital
Check that your policy is active by entering your Iqama number on the CHI beneficiary service, and view insurance approvals in the Ministry of Health's Sehhaty app under your health profile. Then pick a primary hospital from your network — major private hospitals in Riyadh (Dr Sulaiman Al Habib, Kingdom Hospital, Dallah, Saudi German) have English-speaking doctors. Confirm whether your plan needs a referral/approval for specialists.
Mobile appWho: YouDo this in your first weekFree to check
4
Know the emergency and public-care path
For a medical emergency call the Saudi Red Crescent ambulance on 997 (or the unified 911, live in Riyadh). Emergency rooms must stabilise anyone regardless of insurance or nationality. For non-emergencies, use your insurer's network private hospitals; public Ministry of Health hospitals are geared to Saudi citizens and you generally cannot rely on them for routine care. Keep your Iqama and insurance details (in Sehhaty / your insurer's app) accessible.
In personWho: YouAs neededEmergency stabilisation provided regardless; routine private care covered by your policy

Documents you’ll need

Passport (and copies) for you and each dependent
Iqama (or Iqama application reference) — the policy is keyed to this number
Insurance card / digital policy from your insurer (Bupa, Tawuniya, etc.)
A registered Saudi mobile number for Absher, Tawakkalna and Sehhaty verification

Things most newcomers don’t know

Insurance is the gatekeeper to your Iqama, not just a benefit — no valid policy means no residency permit.

Jawazat and HRSD verify your policy on the CHI register before issuing or renewing the Iqama, so a lapsed policy can freeze your legal status, your dependents' status, school enrolment and even domestic travel.

Source: CHI / Giraffy 2025 guide

Your dependents' cover is the employer's legal duty too, but check it is actually the same class as yours.

Some employers buy the employee a good plan and dependents the bare minimum; a lower-tier dependent plan can lock your family out of the better private hospitals.

Source: Arab News; CHI Essential Benefit Package

Treat the coverage class and hospital network as the real question, not whether you are 'insured'.

All compliant plans cover emergencies and basics, but the cheapest tier restricts which private hospitals accept you and may exclude or cap pre-existing conditions, maternity and dental — verify the network and exclusions with HR before you need care.

Source: CHI tiered Essential Benefit Package

Private is the default for expats; public Ministry of Health hospitals are not your everyday option.

MoH facilities are free for Saudi citizens and your card may not be accepted for routine care — your insurance ties you to private network hospitals, while ERs stabilise anyone in a true emergency.

Source: MoH; Expatica healthcare guide

Common mistakes to avoid

Assuming 'I have insurance' is enough — a bottom-tier compliant plan can still leave you unable to use the hospital you want; check the network and class.
Forgetting dependents: a spouse or child without an active policy on the Iqama can block the family's Iqama renewal.
Letting the policy lapse near renewal — Iqama renewal silently fails on Absher until the insurer reactivates and re-registers the policy with CHI.
Expecting free public-hospital care like citizens get — outside emergencies, expats are routed to (and limited by) their private insurer's network.