Health insurance protects you and your family from financial hardship caused by unexpected accidents, illnesses, or disabilities. There are various health insurance policies that help you manage expenses during these challenging times.

It is important to note that some health insurance policies are short-term, meaning they cover a specific period. Therefore, you must verify the coverage duration and whether there is a guaranteed option for renewal. Health insurance can be an independent policy or added to a life insurance plan with certain benefits. Depending on the type of health insurance, benefits may vary according to the coverage duration and age.

Through this course, we aim to provide trainees with comprehensive knowledge of health insurance, the procedures involved in its implementation, and the focus will be on how to prepare health insurance programs, manage contract planning for insurance, and calculate premiums. We will also address common issues and mistakes that health insurance departments may face and how to avoid and handle them, including identifying fraudulent activities and how to detect them.

Target Audience:

• All managers responsible for the insurance sector.

• All managers responsible for social insurance.

• All employees in the medical insurance department of insurance companies.

• All employees in the medical insurance department of service providers.

• Employees working in the medical insurance department in all institutions.

Program Objectives:

The program aims to equip participants with new skills and effectively refresh existing capabilities through:

• Introducing participants to different types of medical insurance.

• Familiarizing participants with standards for managing medical insurance in Saudi Arabia.

• Introducing participants to medical service providers and the medical network.

• Teaching participants how to manage issuances and claims.

• Managing the medical insurance file.

• Negotiating medical insurance contract renewals.

• Handling medical insurance correspondence.

• Introducing medical insurance contracts and the various coverage types.

• Managing medical expenses, premiums, and financing.

• Overview

• History of Medical Insurance Development

• Providers of Medical Services

• Expected Benefits and Objectives of This Course

• Insurance Foundations and Terms

• Medical Insurance

• Types of Insurance

• Medical Insurance Procedures

• Medical Insurance Law

• Continuous Medical Insurance

• Types of Medical Insurance Policies

• Types of Insurance

• Medical Insurance Law

• Types of Medical Insurance Policies

• Permanent Medical Insurance Coverage

• Developing Medical Insurance Programs

• Deductibles and Cost Sharing Rates

• Developing Medical Insurance Programs

• Cost of Deductibles and Cost Sharing Rates

• Managing and Planning Insurance Contracts

• Medical Insurance Correspondence

• Issuances and Claims

• Medical Expense Management and Premium and Financing Management

• Self-Funding Health Insurance Funds

• Claims and Calculation Methods

• How to Calculate Medical Insurance Premiums and Key Factors Influencing the Insurer’s Decision (Insurance Company)

• Medical Service Providers

• How to Calculate Medical Insurance Premiums

• Insurance Companies and Insured Individuals

• People Providing Medical Services

• Healthcare Systems

• Personal Accident Policy - Definition, Importance, and Relation to Medical Accidents

• Recent Changes in Insurance Contracts

• Identifying Fraud Methods in Insurance and How to Detect Them

• Medical Insurance Applications