For all Dubai residents and nationals, Health Insurance has become a mandatory requirement. Government insurance programs like Enaya and Sa’ada are available for UAE Nationals, ex-patriates can avail health insurance from any of the 46 registered Insurance companies in Dubai. It is also the legal liability of every sponsor to provide health insurance cover for his employees. Here’re some things you should know about your health insurance in Dubai.
Coverage
The basic level is the affordable Essential Basic Package and it comes at the minimum premium. It could include General Physician consultation, dental and maternity cover, and it also provides a maximum insurance limit in case of emergencies. All pre-existing conditions are also covered in the basic package after six months from the first time.
Network
The health insurer contracts an organisation (network provider) to provide services to plan members for specific pre-negotiated rates. The network provider organises a group of clinics, family health physicians, diagnostic centres and pharmacies that are approved under the EBP.
Group v/s individual insurances
Generally, people employed in a company can get a group insurance plan at group discounts. Individual insurances have higher annual premiums depending on the health of the policy holder.
Deductibles
The insurance holder has to pay a certain basic sum personally (deductible) for consultation at the clinic like 10% of the doctor’s consultation fee.
Co Insurance or COINS
It refers to the percentage you have to pay personally towards the total bill Separate limits are set for outpatient and inpatient co insurance. Co Insurance can be availed three times in a year, not exceeding Dh1,000.
Pharmacy limits
Each policy has a limit for the pharmacy expenses beyond which, the expenses incurred will have to be paid from your pocket.
Pre-Approvals
Just to ensure clinics are not over-prescribing expensive diagnostic tests and procedures, many insurance providers prefer that the clinic seeks a prior approval for these tests. But in case of an emergency, immediate treatment is extended.
Pre-existing conditions
Relevant only to a first-time subscriber of a health insurance package! If an individual suffers from any condition like Diabetes, Hypertension, Cancer etc., he or she must disclose this at the start to the insurance company. The condition will not be covered for the first six months after which the insurance will cover it.