Health Insurance in Bahrain: Public vs. Private Coverage

Published on September 29, 2025 and written by Cyril Jarnias

Bahrain, a small island in the heart of the Arabian Gulf, offers a unique healthcare system where both public and private coverage coexist. While the government promotes a universal system accessible to all citizens, many opt for private insurance to benefit from faster services and specialized care.

This duality raises crucial questions about healthcare equity, efficiency, and accessibility. At a time when many countries are reviewing their health policies, Bahrain’s case could offer interesting perspectives on the dynamics between public and private sectors in healthcare.

Overview of Public and Private Healthcare Systems in Bahrain

Healthcare System in Bahrain: Detailed Description of Public and Private Sectors

The Bahraini healthcare system rests on two main pillars: the public sector and the private sector, both regulated by the National Health Regulatory Authority (NHRA) and overseen by the Ministry of Health (MOH).

Organizational Structure

Sector	Supervising Body	Main Facilities	Target Population
Public	Ministry of Health (MOH), NHRA	Salmaniya Medical Complex, KHUH, specialized hospitals, 21 primary health centers, military hospital, psychiatric hospital	Citizens, expatriates
Private	NHRA, MOH (regulation)	3 private hospitals, clinics, polyclinics, specialized centers	Expatriates, citizens

Types of Services Offered

Public Sector:

• Primary care through 21 health centers distributed nationwide
• Specialized hospital services: cardiology, oncology, pediatrics, maternity, orthopedics, emergency care, psychiatry, geriatrics
• Maternal health, pediatric health, mental health, and rehabilitation services
• 24/7 emergency services

Private Sector:

• General practitioner and specialist medical consultations
• Elective surgery, dental care, aesthetic medicine
• Complementary services: physiotherapy, advanced diagnostics, personalized care
• Reduced waiting times, increased comfort, rapid care

Main Differences Between Public and Private Sectors

Criterion	Public Sector	Private Sector
Cost for Residents	Free or low cost for citizens; moderate fees for expatriates	Patient’s responsibility or covered by mandatory insurance for expatriates
Accessibility	Broad geographic coverage; sometimes longer wait times	Short delays, rapid services, often in urban areas
Perceived Quality	High standards, modern equipment; occasional overcrowding	Modern infrastructure, more personalized experience
Population Served	Primarily citizens, but also expatriates	Expatriates, citizens seeking comfort or speed
Health Insurance	National coverage for citizens	Mandatory insurance through employers for expatriates

Government Role

• Funding: The public sector is primarily funded by the national budget, allowing free or nearly free care for Bahrainis.
• Regulation: The NHRA oversees quality, safety, and accreditation of facilities and practitioners, both public and private.
• Coordination: Policies to ensure integration and continuity of care between sectors.

Relevant Statistics

• Public Facilities: approximately 21 primary health centers, 1 major medical complex (SMC), 1 university hospital (KHUH), 1 military hospital, 1 psychiatric hospital, 4 maternity hospitals.
• Private Facilities: 3 major private hospitals, numerous clinics, polyclinics, and specialized centers.

Access to Care and Cost

• Citizens: free or very low-cost access in the public sector.
• Expatriates: mandatory private health insurance (covered by employer); patient-responsible fees in private sector or moderate in public sector.

Testimonials and Case Studies

Some expatriates report preferring the private sector due to faster care, even though costs are higher. Citizens appreciate the free and quality public care but sometimes complain about wait times, especially for specialized care.

Example: an expatriate family, covered by employer insurance, consistently chooses private care for quick pediatric consultations, while a Bahraini citizen prefers SMC for maternity, benefiting from free and comprehensive support.

Quality and Satisfaction Comparison

Aspect	Public Sector	Private Sector
Quality of Care	Good, sometimes overcrowded	Excellent, more individualized
User Satisfaction	Generally high, criticism about wait times	Very high, higher cost
Challenges	Patient flow management, modernization, delays	Financial accessibility, service segmentation
Improvement Opportunities	Digitalization, demand management, service integration	Better collaboration with public sector, cost regulation

Challenges and Opportunities

• Public Sector: need to modernize infrastructure, reduce wait times, strengthen coordination with private sector.
• Private Sector: ensure accessibility for all, avoid excessive service segmentation, strengthen price regulation.

The healthcare system in Bahrain offers comprehensive and quality coverage but faces challenges in demand management and accessibility for certain groups. The complementarity of both sectors, under strong government regulation, represents an asset for the population.

Differences Between Health Insurance for Local Residents and Expatriates

Criterion	Local Residents (Bahraini Citizens)	Expatriates in Bahrain
Public Health Coverage	Complete and free/subsidized access to primary, secondary, and tertiary care in public facilities.	Limited access to public system; mandatory enrollment in public fund (SHIFA) but less extensive coverage.
Complementary/Private Insurance	Can purchase private insurance to cover certain specialized care or private sector; often not mandatory.	Often essential, especially for those wanting international coverage or private care. Broader international health insurance options.
Estimated Average Annual Cost (Local Insurance)	Low or none, covered by the state.	Mandatory contribution covered by employer for employees; personal cost for unemployed/self-employed. Private insurance: much higher depending on coverage level chosen.
Access to Partner Healthcare Providers	“National network”: public hospitals and subsidized medical centers; facilitated access.	Private sector preferred; international network recommended via expatriate insurance for better coverage outside Bahrain. Restricted access to public facilities depending on insurance category chosen.

Legal Obligations

• Both groups must contribute to the SHIFA health insurance fund.
• For citizens: contribution is state-funded.
• For employed expatriates: contribution paid by employer.
• Non-employed or self-employed expatriates must pay contributions themselves.

Major Coverage Differences

• Local residents benefit from free/subsidized services with broad access to public infrastructure.
• Expatriates have limited access to these benefits and often rely on private/international insurance that covers more (including care outside the country).

Impact of Public/Private Policies

• Public policy strongly favors citizens with direct state funding and a dense national network.
• Policy toward expatriates encourages use of private sector, generating higher costs and dependence on international insurers.

Main Distinctive Points:

• Local residents are primarily protected via the state-funded public system.
• Expatriates must enroll in SHIFA then supplement their protection via international insurance, essential to guarantee good care levels, especially in private sector or during stays outside the country.
• Overall cost is significantly higher for expatriates while their provider choice largely depends on the type of insurance purchased.

Evaluation of International Health Insurance Options in Bahrain

International Health Insurance Options in Bahrain:

Option	Coverage	Cost	Advantages	Disadvantages	Ideal For
Local Health Insurance	Limited to Bahrain	Relatively low	Easy access, suitable for short stays, simple to purchase	Limited coverage, little access to care abroad, frequent exclusions	Short-term expatriates, low medical risk
First Euro International Insurance	Worldwide, including outside Bahrain	Higher	Comprehensive coverage, access to best hospitals, rapid care, international management	More expensive premium, sometimes longer procedures, exclusions based on age/health	Long-term expatriates, families, high-needs profiles
CFE Complementary Insurance	Complements CFE (Caisse des Français de l’Étranger) coverage	Variable by profile and guarantees	Benefits from CFE + insurer networks, simplified management for French citizens, complementarity	CFE partially reimburses in Bahrain (e.g., 50% hospitalization), sometimes complex procedures	French expatriates, Franco-Bahraini families
Specific Youth Insurance (e.g., Indigo Expat Junior)	Worldwide, adapted to youth, working holidays, students	Moderate	Flexibility, attractive pricing, common guarantees, simple subscription	Lower caps, limited options, age restrictions	Young professionals, students, temporary stays

Concrete Examples of Popular International Insurances in Bahrain:

• MSH International: known for rapid case management, broad coverage, multilingual services.
• Indigo Expat (WeCare, OnePack, Junior): modular plans, adapted to all expatriate profiles, including youth.
• CFE + private complementary: preferred solution for many French citizens, especially with recent coverage zone changes.

Comparison with Local Public and Private Programs:

Criterion	Local Insurance	International Insurance
Coverage	Care in Bahrain, often limited to certain facilities	Care in Bahrain + abroad, access to best global networks
Cost	Lower, but potentially high for major care	Higher, but extensive protection and higher caps
Accessibility	Simple on-site subscription, sometimes required by employer	Online subscription, centralized management, multilingual assistance
Expatriate Adaptation	Poorly adapted to specific needs or mobility	Specifically designed for mobility, international coverage

Potential Tax Implications for Foreign Residents:

• International health insurance premiums are generally not tax-deductible in Bahrain (no personal income tax).
• If tax-resident in another country (e.g., France), subscribing to CFE and complementary insurance may have consequences on worldwide income taxation or tax residency.
• Some home countries require proof of international insurance to avoid double contribution or guarantee continuity of social rights.

Recent Trends and Regulatory Changes:

• Medical inflation: significant rise in healthcare costs in Bahrain, prompting insurers to review prices and caps.
• CFE: Bahrain moved from zone 1 to zone 2 in 2024, reducing reimbursement rate (e.g., hospitalization covered at 50%), making international complementary insurance even more essential.
• Strengthened visa requirements: growing obligation to justify comprehensive health insurance to obtain or renew residence visas.
• Digitalization: evolution of services (teleconsultations, online reimbursement management), rapid adaptation of international insurers to meet connected expatriates’ needs.

Key Takeaways:

• International health insurance remains the most comprehensive and suitable solution for expatriates in Bahrain, despite higher cost than local insurance.
• Youth and students can opt for specific, more economical plans, but with capped guarantees.
• Recent CFE reimbursement changes and rising local care costs encourage choosing robust international coverage.
• It’s crucial to compare offers based on stay duration, family profile, health status, and planned international mobility.