Health Insurance Dubai

Health Insurance is mandatory for all Dubai residents and nationals. While all UAE nationals are covered under government insurance programs like Enaya and Sa’ada, expatriates with a valid Dubai residency can avail health insurance services from any of the registered insurance companies in Dubai. It is the legal liability of every sponsor to provide health insurance cover. This means that if you are sponsored by your employer, your health insurance plan will be taken care of by the employer.

What is the Essential Benefits Plan (EBP)?

The Dubai Health Authority has created the Essential Benefits Plan (EBP) essentially for employees that earn a monthly salary of AED 4,000 or less. This plan is the cheapest plan available in Dubai and has a fixed cost of AED 550 or AED 650 per year. Only ten participating insurers can provide EBPs. This is done because the DHA wanted to ensure that the most vulnerable workers are protected and such insurers are restricted in the amount of profit they make. The benefits are the same no matter which provider you choose. The alternative form of this basic health insurance plan is the Enhanced Basic Plan that provides the minimum level of benefits permitted by the DHA in addition to a very limited medical network.

The plan doesn’t come with the most comprehensive coverage, but it means worker are protected in the case of a medical emergency. It also covers maternity, medical tests, referrals and medication.

The UAE health insurance third-party administrator (HITPA) market grew significantly in the wake of the mandatory health insurance law that was applied in Dubai. Both private and public sector providers and payers are significantly involved in conducting business with third-party administrators. The mandatory health insurance schemes, in both the Emirates of Abu Dhabi (much earlier in the last decade itself) and Dubai, have been considered as fully rolled out, in 2017. These two emirates make up the majority of the UAE population, which like other GCC (Gulf Co-Operation Council) regions have a large expatriate population. There are currently over 20 third-party administrators actively operating in the UAE market, and some of these are leaders from the region – such as NAS, Neuron and Nextcare, and various other players.

What is covered by the EBP?

The EBP covers most common inpatient and outpatient treatments such as tests (including lab test radiology), surgeries and diagnostic procedures, physiotherapy sessions (maximum six per year). However, insured members are expected to pay up to 20% of the costs provided it does not exceed AED 500 for a session or AED 1,000 a year. Under the EBP 70% of the costs of prescribed medicines are paid by the insurer (up to AED 1500 per person).  The plan also covers preventive medicine or immunisation procedures for newborns and children, and emergency health care and ambulance service.

Pregnant women’s health in Dubai is also covered by the EBP. It includes blood tests, three ultrasounds and 8 visits to a doctor during pregnancy, natural delivery and emergency Caesarean. Insured members are expected to pay 10% of the costs. New-born children are protected by the mother’s insurance for the first 30 for neo-natal tests, screening, and other tests.

You must notify your insurance company of your pre-existing or chronic conditions when you apply for a cover. After a six-month waiting period, your pre-existing conditions will be covered by the EBP. During the 6 months, any emergency related to the conditions will be covered like all other claims under the scheme.

What’s New?

Mental health and alternative medicine treatments such as Ayurveda and Homoeopathy will now be covered under the basic health insurance plan in Dubai, according to the Dubai Health Authority (DHA). In its latest circular dated July 7, the DHA stated that it has issued new mandates and requirements to be included in the essential benefit plan in Dubai. According to the revised plan, basic health cover will now include mental health and psychiatry, Ayurveda and Homeopathy which were so far not covered in the basic health insurance cover — essential benefit plan — which is availed of by low-income workers with salary of up to AED 4,000. The revised scheme is expected to come into effect two months from the circular date.

As per the revision, psychiatry and mental health inpatient, outpatient and emergency coverage will be up to AED 10,000 per annum, with 20% co-payment to be paid by the insured per visit for outpatient services. Alternative medicine cover for Homeopathy and Ayurveda is up to AED 2,500 yearly, with 20% co-insurance payable by the insured for outpatient consultations per visit.

The announcement has been welcomed as a progressive and much needed step by healthcare professionals, insurance companies, and mental health activists alike, for giving low-income workers access to the facilities that were previously limited to high-end health insurance plans.

Globally, corporates and businesses now include mental health programmes and wellness programmes as part of their employee engagement, and employee care packages. From loss in productivity, to absenteeism and low talent retention rates, businesses have huge stakes in ensuring their employees have access to quality mental health services, and alternative therapies. A person’s mental well-being is just as important as their physical health and that is why an Employee Assistance Program (EAP) is available through our partnership with Lifeworks, a world-leading EAP, to all members insured through the HanseMerkur Health Insurance Plans, globally, 24 hours a day, to help deal with a wide range of issues related to Family, Health, Life, Money and Work. Through this EAP service, all members have access to counselling sessions with certified counsellors across the globe irrespective of these mandates being available in your region.

The DHA’s announcement, revising basic health insurance plans, is being seen as a boost for such initiatives in Dubai. All HanseMerkur GlobalCare plans exceed UAE’s requirements and standards of a Basic Health Plan and have teamed up with some of the best Third-Party Administrators (TPAs) in the world when it comes to offering a truly global service for our members. In some parts of the world like the GCC where HanseMerkur has a regional office and a large portfolio of insured member we have also entered into further agreements with local TPAs, Neuron, NAS and NextCare, who are regional specialists. Our goal is to take the best care of our members, keeping you happy, healthy and free from unnecessary hassle and stress.

Please contact a HanseMerkur representative for more information on our products and services.