Is it mandatory to have the health insurance for UAE Residence Visa in Dubai and Abu Dhabi?
Health insurance is a mandatory requirement for all the residents without which you will not be able to get a residence visa in Dubai and Abu Dhabi . Other emirates do not have a mandatory requirement for health insurance however it is always advisable to get a good health insurance to avoid any unexpected health related crisis in emergencies and chronic conditions.
The health insurance law helped to make the healthcare accessible to all the blue collar workers in the emirate.
According to the law, the health insurance is supposed to be provided by the sponsor. If you are a working professional, that would mean that your company provides the insurance cover.
Health insurance is mandatory in Dubai, after the Dubai Health Insurance Law that came into effect in January 2014. According the law, the legal liability for every sponsor is to provide an essential benefits plan (EBP) insurance package — fixed between Dh550 and Dh650 – so that workers earning lower wages can also get access to good healthcare.
In case your company only covers you and not your family, you would be required by law to provide health insurance for the dependents on your sponsorship (spouse, parents or children).
Employers and sponsors are responsible for providing health insurance coverage for their employees and usually their families (1 spouse and 3 children under 18 years). If you have more than three children it is sponsors responsibility to get the health insurance coverage.
According to Department of Health, Abu Dhabi, for individuals with monthly salaries under Dh5,000 or under Dh4,000 plus housing allowance, the basic product policy is to be provided.
Enhanced Policy is for all other individuals and often.
Other Emirates Sharjah, Ajman, Ras Al Khaimah, Umm Al Quwain and Fujairah
Health insurance is not mandatory in other emirates. However, most employers provide some level of health coverage. Speak to your employer, as many companies get group plans for employees. If your company does not provide health insurance, you may refer to the below details if you would like to get insurance on your own.
How can I get the health insurance?
Choosing the right healthcare for you and your family can be a crucial decision in times of emergency. In order to get a health insurance you can approach any of the many insurance companies or insurance brokers in the UAE through their website. If you approach a broker, they would provide options from several companies.
“Enter your inquiry online and someone will call you. They ask some basic information like your gender, the type of hospitals you might prefer visiting and you will get a quote online. You can even get the basic health insurance policy online and the policy certificate is generated instantly after all the required information is provided.
There are three types of health insurance Plans:
- Basic Plan
- Comprehensive Plan
- Enhanced Plan
What is Basic Plan and what is covered under Basic Plan?
Basic which is also know as the Essential Benefitsplan which provide fair enough coverage
- Lower premiums, between Dh550-650 a year.
- Limited hospital and clinic network
- Lower annual limit, medicine coverage and maternity coverage
- Mostly covered only in the UAE.
- Some key exclusions – organ transplant, road traffic accident and kidney dialysis.
“Most major conditions including cancer are covered in the basic plan as per the annual limits of the policy,
The annual limit for basic plans is Dh150,000. The cover for medicine is Dh1,500 per year. Maternity cover is Dh 7,000 for a normal delivery and Dh10,000 for a cesarean delivery (C-section).
Please be aware that basic plan has limited network coverage which means that the network of clinics and hospitals covered in the plan is quite small. Even if the clinic or hospital is covered, you would not be able to see a specialist immediately. A General Practitioner’s consultation is necessary for the consultation, treatment and medicines to be covered. So, if you have a specific preference for a doctor or a hospital, find out if they accept the basic health plan coverage. If not, you would need to purchase a higher insurance coverage. The basic plan will cover you mostly in the UAE only. If you are travelling outside the UAE, you may not be covered.
What is a Comprehensive Plan and what is covered under a Comprehensive Plan?
The comprehensive plan, which provides coverage in the UAE as well as other countries that you can choose. The network is bigger and the annual limits are much higher going up to $1m in some cases which will also cover worldwide coverage. Maternity limit and medicine are also higher. With the plan covering most major conditions and being accepted in most hospitals across the country, this provides the resident with a much better healthcare experience.
The premiums can vary from Dh2,000 up to Dh1m, due to certain complex pre-existing conditions.
What is Enhanced Benefits Plan and what is covered under Enhanced Benefit Plan?
This plan is most suitable for employers, as it is a little flexible and offers reduction on co-payment with an increase in certain annual limits.
What are the documents required to get the health insurance? How long does it take?
You will first need to provide to the broker the basic information like your name, gender and age. If you are applying for a family member or a dependent, you will need to specify your relationship and depending on the type of play you choose, you might also need to fill a health declaration form or medical underwriting form to declare any pre-existing conditions. This is compulsory in the comprehensive plan because the premium depends on your age and previous conditions.
In addition you will need to provide the below documents to the broker to process your health insurance:
- Emirates ID
If you are renewing your insurance you will also need a proof of your previous insurance.
For basic policies, you can expect a turnaround time of one working day, if you have submitted all your documents.
Comprehensive plans can take longer – between three to five working days – as companies may ask you for your previous reports if you have health concerns like diabetes or a heart condition.
Note on Family Insurance:
For newborn children, the essential benefits plan covers vaccinations for up to the age of six years.
In the case of elderly parents, residents can often pay a high premium as the rates increase based on age and health conditions.
“Over the age of 65, even the essential benefits plan comes up to Dh4,500, which is on the higher side. If you consider a comprehensive plan, it really touches the roof, with premiums from Dh20,000 going up to Dh50,000.”
What if you are not satisfied with the insurance provided by the company?
It is always the responsibility of the employer and the sponsor to provide the health insurance , however if you are unhappy with the plan speak to your employer to find out if they can offer a better plan with you paying an extra amount of money. If not, you may refer to the below details if you would like to get insurance on your own.
What are the important facts to be considered while choosing health insurance?
Every health insurance package has a range of coverage which refers to the list of health conditions and health care services that will be addressed.
A network is the organisation contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates. The full list of clinics and hospitals that your insurance package gives you access to. This is also known as an in-network provider.
An out-of-network provider is not contracted with the health insurance plan. On your insurance card, the name of the network is mentioned under the subhead Insurance Provider (IP) net.
3. Group v/s individual insurances:
Most people employed in a company can avail of a group insurance which has group discounts. Individual insurances usually are tailor-made and have higher annual premiums depending on the health of the policy holder
These are sums that have to be borne personally by the insurance holder. There is a basic amount an individual has to pay for consultation at the clinic.
5. Co Insurance:
Also abbreviated to the acronym COINS on the health insurance card, which refers to the percentage you have to pay from your pocket towards the total bill.
- Pharmacy limits:
Each policy sets a limit for the expenses you can make at the pharmacy.
The policy holder needs to read the Table of Benefits (ToB) carefully. It also means that in case of a sickness episode which is over and above these number of visits, the policy holder will have to pay from their pocket for the medicines, if he has exhausted the limit.
Despite the limits, many insurance providers prefer that the clinic seeks a prior approval for particularly expensive diagnostic tests and procedures. This is done to make sure clinics are not over-prescribing these tests. Once the pre-approval is in place, there is no chance of the claim being rejected. In case of an emergency of course, the patient can walk into the nearest hospital, where no questions are asked and immediate treatment is extended. All hospitals in Dubai are bound by law to attend to a patient in emergency where the coverage of the insurance card is not an issue.
8. Pre-existing conditions:
This is relevant only to a first-time subscriber of a health insurance package. In case an individual suffers from any condition such as diabetes, hypertension, cancer or any other ailment, he or she must disclose this at the outset to the insurance company.
The condition will not be covered for the first six months after which the insurance will cover it.
In many cases, your insurance might allow for an ‘out of network’ consultation or treatment where you pay the cost of treatment upfront and later file a claim with the bills and get reimbursed. Read the fine print on the ToB to know whether you can go to clinics and hospitals that are not in the network of your policy.
10. Last month coverage:
There are instances when insurance policy holder is denied coverage in the last month – such as medicine coverage in the month of December even though the coverage is up to end of that month. This is illegal according to the UAE law.
“If any pharmacy or clinic is doing that, it was illegal,” says Dr Al Yousuf. “The clinic must provide the insurance cover until the last day of the health coverage and insurance policy holders have a right to register a complaint if there is a violation of this right.”
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