VoxxArrive · Saudi Arabia onboarding topic
Medical Fitness Test for Saudi Arabia Work Visas and Iqama: An Employer's Guide
Saudi Arabia requires foreign hires to pass a pre-arrival medical fitness exam in their home country through the Wafid system (widely described in industry sources as the successor branding to the older GAMCA screening process, run by the Gulf Health Council), before a work visa can be stamped and an Iqama issued. The exam screens for HIV, active tuberculosis (chest X-ray), Hepatitis B/C and syphilis among other conditions; a positive result returns a "Medically Unfit" status that blocks the visa. Wafid's own current guidance points to a shorter certificate validity than commonly assumed - roughly 2 months, based on the site's rule that a worker can only rebook after 2 months from an existing report (some secondary sources still describe 90 days) - so employers must sequence the Qiwa employment contract, the separate MOFA Enjaz visa-authorization step, the Wafid booking, and embassy visa stamping within that tighter window. Ongoing Iqama renewal in-Kingdom is instead gated on the worker holding active health insurance meeting Council of Health Insurance (CHI, formerly CCHI) requirements - note that health-insurance sector regulation itself transferred from CHI to the newly created Insurance Authority (IA) effective March 2024 - rather than a fresh medical exam, though we could not confirm the renewal mechanics with a primary Ministry of Interior source this session.
Steps
- Secure Qiwa work visa authorization - Employer creates the employment contract and visa quota/authorization request on MHRSD's Qiwa platform, which issues its own contract/authorization reference. This is a separate step from MOFA's Enjaz platform (see the consular-stamping step below); Qiwa does not itself generate the Enjaz visa reference number, contrary to how this step was previously described.
- Book the Wafid medical exam - The worker registers on wafid.com with passport and visa reference details and is assigned an accredited clinic in their home country for the pre-departure medical.
- Attend the approved clinic - Exam covers a chest X-ray for tuberculosis, blood tests for HIV, Hepatitis B/C and syphilis (VDRL/TPHA), and a general physical; a positive finding for HIV, active TB, active leprosy or Hepatitis B/C returns a "Medically Unfit" result.
- Confirm "Fit" status before stamping - Result turnaround is reported inconsistently: practitioner/clinic guides commonly cite roughly 24-72 hours, but Wafid's own current FAQ (wafid.com/en/faq) states results appear "within 26 days" - plan for the longer, officially stated window rather than the shorter figure. Wafid's own FAQ rule (rebooking is only allowed 2 months after an existing report) points to a certificate validity of roughly 2 months rather than the 90 days often quoted, so visa stamping must happen inside that tighter window or the exam must be repeated.
- Obtain Enjaz visa authorization and consular stamping - The employer/PRO applies through MOFA's separate Enjaz platform (visa.mofa.gov.sa) to obtain the Enjaz visa-authorization reference; the worker then submits the Wafid "Fit" certificate with other required documents to the Saudi embassy/consulate to have the work visa stamped.
- Iqama issuance on arrival - The employer/sponsor processes Iqama issuance through Jawazat/Absher (MOI); the pre-departure Wafid medical clearance underpins this first Iqama, and active health insurance meeting Council of Health Insurance (CHI, formerly CCHI) requirements must also be linked before it is issued. Health-insurance sector regulation itself moved from CHI to the Insurance Authority (IA) in March 2024.
- Iqama renewal - Ongoing (typically annual) renewal runs through Absher and is conditioned on valid health insurance meeting CHI (formerly CCHI) requirements, now regulated via the Insurance Authority (IA) since March 2024; unlike first issuance it does not appear to trigger a new Wafid-style medical exam, though this specific point is not confirmed against a primary MOI source.
Timeline
Sources conflict on result turnaround: practitioner/clinic guides commonly cite roughly 24-72 hours, but Wafid's own current FAQ (wafid.com/en/faq, fetched directly) states results appear "within 26 days" - employers should plan for the longer, officially stated window rather than assume 24-72 hours. Certificate validity is also inconsistently reported: Wafid's own FAQ language implies roughly 2 months (its rebooking rule only applies 2 months after an existing report), while some secondary/practitioner sources still describe 90 days. To be safe, employers should not let the gap between the medical exam and consular stamping exceed 2 months rather than assuming a full 3-month window.
Cost & fees
The Wafid exam fee is commonly reported in the range of SAR 300-1,200 per worker, varying mainly by the worker's home country/clinic (e.g., roughly SAR 400-700 for EU/US nationals versus SAR 600-1,200 for nationals of India, Pakistan or the Philippines due to added attestation steps); this is on top of separate Qiwa visa-authorization, MOFA Enjaz/visa, and Iqama-issuance fees, and is typically borne by the employer as part of total per-worker visa costs.
Some figures on this page vary by jurisdiction, zone or nationality, or could not be independently confirmed from a public source at time of writing - confirm the current figure with the regulator before relying on it.
Sources
- Wafid - official Gulf Health Council medical screening portal for GCC-bound workers
- Wafid - official FAQ page (confirms Gulf Health Council ownership, states result turnaround "within 26 days," and a 2-month rebooking rule for existing reports) - fetched directly this session
- Saudi Field Epidemiology Training Program - "Health screening of workers in Saudi Arabia" (Saudi Epidemiology Bulletin, Vol. 4/Issue 2, April 1997 - describes the pre-GAMCA/Wafid "Approved Health Clinics" framework; confirmed this session to predate and not mention GAMCA/Wafid, so it is included as historical background only, not as evidence for current Wafid procedures)
- KPMG GMS Flash Alert - Saudi Arabia: Qiwa Introduces Instant Work Visa Caps and Company Eligibility Requirements
- Jobbatical - Saudi Arabia Visa Costs for Enterprises: 2026 Guide
Frequently asked
Does every nationality have to take the Wafid pre-arrival medical exam?
The Wafid system is run by the Gulf Health Council for expatriates from a defined set of labor-sending countries, and reported fees differ noticeably by nationality (lower for EU/US nationals, higher for South/Southeast Asian nationals), which suggests different processing tracks by country - we could not verify an official, complete list of which nationalities are required versus exempt, so employers should confirm the applicable track per hire with their PRO or immigration provider.
What happens if a worker fails the medical exam?
A positive result for HIV, active tuberculosis, active leprosy, or Hepatitis B/C returns a "Medically Unfit" status, which blocks both work-visa stamping and the resulting Iqama issuance for that worker.
How long is the Wafid medical certificate valid, and who pays for it?
Reports vary: Wafid's own FAQ language implies a roughly 2-month validity window (it only allows rebooking 2 months after an existing report), while some secondary/practitioner sources still describe 90 days. To be safe, plan for stamping to happen within 2 months of the exam rather than assuming the longer figure. Cost (roughly SAR 300-1,200 depending on nationality/clinic) is typically paid by the employer as part of overall visa-issuance costs, though which party pays contractually is not itself government-mandated.
Does renewing an Iqama require a new medical exam?
Based on available sources, ongoing Iqama renewal is processed through Absher and is gated on the worker having active health insurance meeting Council of Health Insurance (CHI, formerly CCHI) requirements - health-insurance sector regulation itself moved to the Insurance Authority (IA) in March 2024 - rather than a fresh Wafid-style exam. We could not confirm the renewal mechanics against a primary Ministry of Interior source, so employers should verify current renewal requirements with their PRO rather than assume no medical check ever applies at renewal.
Is Enjaz the same thing as Qiwa?
No. Qiwa (MHRSD) is where the employer creates the employment contract and visa-quota authorization; Enjaz is a separate Ministry of Foreign Affairs platform (visa.mofa.gov.sa) used to obtain the visa-authorization reference and book the embassy appointment for stamping. An earlier version of this guide conflated the two - treat them as sequential steps on different government platforms.