what does basic insurance provide?

Unlike the UK and Australia, the UAE does not have a national health service. However, there are a variety of quality clinics and hospitals, and most of the costs of patient care are covered by insurance.

Employers in Abu Dhabi and Dubai are required by law to provide at least a basic level of health insurance under mandatory benefit plans to workers earning less than 4,000 dirhams ($1,089) per month.

Anyone earning more could benefit from a wider range of health insurance plans offered by their employers, providing access to more hospitals and services such as dental and optics insurance. increase.

Abu Dhabi’s basic compensation entitles workers to 250,000 dirhams of care, but pharmacy costs are limited to 1,500 dirhams per year.

In Dubai, the annual limit provided for basic care is 150,000 dirhams and the pharmacy limit is 1,500 dirhams.

Dr Kalyan Gudavali, director of health insurance and services at Burger Holdings, said the UAE has an effective interconnected healthcare system that provides professional care to all residents.

“The master plan covers inpatient and outpatient benefits,” said Dr Gudavali.

“Depending on the condition, coverage has a cap on benefits, but it also includes maternity care and cancer treatment.

“Coverage is data-driven, and 90% of people don’t need plan caps.

“According to standards set by the government, most health conditions are covered by basic insurance, which is open to anyone with an income of less than 4,000 dirhams.

“People earning more than that should have more expensive health insurance.”

Co-insurance is paid by the insured and typically accounts for 20 percent of basic hospital care.

Where a patient must visit a hospital for treatment, such treatment is limited to Dirhams 500 per visit under the basic plan, with an annual cap of Dirhams 1,000.

The insured must pay for costs in excess of these limits and may extend coverage for additional fees paid to private medical insurance companies.

What is not covered by the basic health insurance plan?

For workers earning less than AED 4,000 covered by the Basic Benefits Plan, not all health needs are covered.

Routine dental and eye exams are not covered by basic health insurance, but emergency eye care and dentistry are covered.

Not all mental illnesses and dementias are covered by UAE insurance plans, but pre-existing illnesses, with the exception of allergies, can be treated with basic insurance.

“People who maintain health insurance while living in the United Arab Emirates should also be covered for pre-existing conditions, as continuity of coverage is required,” Dr Gudhavari said.

“If someone lives here for 10 years and keeps renewing, all insurance companies have to cover your health because you have existing insurance.

“Those who leave their jobs will have their visas revoked within 30 days, during which time they will be covered until they leave the country or find another job.

“If someone is moving here for the first time, the corporate plan covers all existing conditions. I have.”

Will my family be covered?

In Abu Dhabi, employers must cover health insurance for their employees and their dependents (up to three children), while in Dubai, by law, they are required to provide health insurance only to their employees.

In that case, the sponsor must purchase additional health insurance to cover the costs of dependents.

What if the care I need exceeds my coverage?

Government and private hospitals can provide a range of treatments, and in Dubai the Basma Patient Assistance Program further provides additional cancer and hepatitis treatments for low-income workers.

Eligible expatriates in Dubai with EBP entitlement are entitled to unlimited coverage for three types of cancer treatment under the Basma scheme.

The Dubai Health Authority initiative is the first to fully cover breast, colon and cervical examinations and treatments for all Dubai residents.

Existing and new Emirati residents diagnosed with cancer prior to entry are eligible for registration after one year of residence.

Outside of Dubai, charities such as Friends of Cancer Patients and Lafuma Cancer Care Association often intervene to help patients who cannot afford treatment.

Private hospitals often run free diagnostic and screening campaigns for low-income workers, and may offer free dental and eye exams for those who can’t afford treatment.

For more information on cancer care Basma offers in Dubai, please contact 800-SALAMA.

What are the rules if you live outside Abu Dhabi and Dubai?

Health insurance is not yet compulsory for workers employed in the Northern Emirates, but that could change.

“What has happened recently in the Northern Emirates is that the Ministry of Health is creating a new claims portal for insured persons treated there,” Dr Gudhavari said.

“All claims received by medical facilities from patients with a Northern Emirates visa are uploaded into the national system.

“Anyone can get insurance by paying a portal fee of 38 dirhams per member.

“This applies to all patients with health insurance in Ajman, Sharjah, Umm Al Quwain, Fujairah and Ras Al Khaimah, so we expect it to become mandatory soon.”

Updated: Aug 5, 2023, 6:56 AM