Health Insurance in Dubai has gone through rapid developments in the recent past.
Thanks to the positive efforts by the Dubai Health Authority, there have been many developments in the Health Insurance proposition. The following is an 11 point checklist to consider; for a person looking to buy health insurance;
1 – Mandatory Health / Medical Insurance for all Residents in Dubai
The Dubai Health Insurance law makes it mandatory for all Nationals and Residents of Dubai (including dependents) to have medical insurance for emergency and curative healthcare needs.
The law also applies to all economic areas of the Emirate of Dubai including Free Zones.
The mandatory health insurance scheme for all Dubai Residents was rolled out in 3 phases.
The last phase of Mandatory health Insurance in Dubai carried a deadline of 30th June 2016, pertaining to companies with less than 100 employees.
Also, spouses, dependents and domestic workers should be covered by June 2016.
It is the responsibility of the employer to provide Medical insurance coverage to their employees. However, it is not mandatory, as per the law, for employers to provide cover for the dependents of their employees.
Hence the employee must provide medical cover for their spouse, children, and dependent parents, otherwise, they may not be able to renew their visa.
2. Payments by employees:
The premiums of the Medical insurance plans have to be borne by the employer. They are not allowed to deduct premiums from employees salary or reduce salary according to the premiums paid for the medical insurance.
Employees are responsible for paying the deductible or coinsurance amounts specified under the terms of the policy as well as any other treatment costs incurred which are not covered by the policy or which are in excess of any policy limits or sub-limits.
3. Type of Coverage:
DHA has specified a minimum level of benefits to be provided by all insurance plans offered in the Emirate of Dubai.
Insurance companies in Dubai offer such benefits under 2 type of plans;
- Essential Benefits Plan (EBP)
- Enhanced products
4. Essential Benefits Plan ( EBP):
For employees earning less than AED 4,000 or below employers and other sponsors must provide health insurance meeting all the minimum requirements set by DHA from a Participating Insurer.
Insurance companies which meet the additional requirements prescribed by DHA are awarded the status of Participating Insurer. Such companies are allowed to sell the Essential Benefits Plan in addition to the regular plans.
DHA will review the premiums of the EBP plan every year, in accordance with the inflation and the number of claims.
5 Check Pre-Existing Conditions:
Under the new DHA regulation, all medical / health insurance plans should cover pre-existing medical conditions up-to AED 150,000, after a waiting period of 6 months.
However, it is mandatory to declare any pre-existing condition when applying for cover. The insurance provider will determine the premium based on the medical history of the insured.
In the case of pre-existing conditions, there is usually a premium loading( Extra Premium charged). In the unfortunate event of will full or ignorant nondisclosure; the claim will be declined by insurance providers, causing unnecessary delays and confusions during treatment.
6. Check Maternity Cover :
Similarly, DHA has also made Maternity Cover mandatory as well.
All Medical Insurance plans have provided a Maternity cover of AED 7000 for normal delivery and AED 10,000 for medically necessary Cesarean delivery.
Ante-natal or out patient treatment is covered subject to 10% co insurance, with a maximum of 8 visits for regular check-ups during the pregnancy.
As per DHA regulation, Investigations like Blood tests, Urinalysis and 3 ultrasound scans are covered.
For enhanced plan, each provider has different levels of cover for maternity. Contact me to understand in detail about different levels of Maternity cover offered by various providers.
7. Check New Born Cover:
All children, whose parents are covered by existing insurance, will be covered for 30 days under the mother’s policy.
Mandatory vaccinations and neo-natal screening must also be covered.
8. Check Hospital Network:
In order to avoid hassles in future, make sure that your preferred clinic or hospital is included within the approved network of the particular plan.
Different providers have different names for the network lists and bear in mind that A gold network with one insurance company may not be the same as the gold network with another insurance company
Analyze the inpatient and out patient network lists in detail. Some plans may cover a particular hospital for inpatient but may not cover for out patient treatment. If you need access to hospitals like Welfare, City Hospital, Canadian hospital, Saudi German Hospital and American hospital, then you may have to opt for a premium plan.
Make sure your preferred list of clinics is on the plan as desired.
9. Understand Co-Insurance and Deductible:
Most plans have a co-insurance and or a deductible. You can play with different options of deductible and co insurance to arrive at the premium suiting your budget and coverage needs.
if you think that you or your family members may have to access health care quite frequently, then you should opt for the plan with lesser co insurance and or deductible, other wise it would be prudent to choose an option with a higher co-insurance and or deductible.
Click here to know more about Co-Insurance and Deductibles.
10. Check For Dental and Optical Benefits:
If you feel the real need for visiting a dentist and optician more than once in a year, then you can consider including optical and dental benefits to your plan.
Please note that each plan will have a certain waiting period for dental coverage. Also, the premiums will increase substantially when you include one or both benefits to your plan.
11. Check the Geographical Area of coverage:
Almost all providers offer medical / health insurance plans with the following options for geographical coverage;
- Within the Emirate of Dubai for elective and outpatient services, and emergencies covered across UAE for Essential Benefits Plan (EBP)
Enhanced plans cover the following areas;
- Local – Within UAE
- Regional – GCC and Indian Subcontinent
- World Wide – Excluding USA and Canada
- Worldwide – Excluding USA
Trust the above-mentioned options would help you decide on a suitable medical insurance plan in Dubai.
The Next Steps…
Drop me an email by clicking here; with the following details, I will send you a detailed quotation on the plan(s) of your interest and help you choose the right type of medical insurance for you and your family.
- Name of the insured(s)
- Please indicate your choice of geography: International, Regional or Local
- Indicate your preferred list of hospitals, and benefits required like Optical and Dental
- Also, indicate your budget if possible
If you have any questions feel free to call me on +97150-2285405.