How does health insurance work?

Different insurance companies will have varying policies on matters such as which hospitals you can be treated at, how much of the medical cost the policy covers and whether they accept direct billing (the insurer pays the medical provider directly, rather than you paying and you insurer reimbursing you).

According to the Dubai Health Insurance Law No. 11 in 2013, it is mandatory for all residents to be covered by a level of health insurance that meets or exceeds minimum benefits stipulated by DHA (Dubai Health Authority). The implementation of this compulsory health insurance scheme was rolled out in three phases, with the last phase scheduled to be implemented by the 31 December 2016.

There are many health insurance providers but it is critical to compare and search for the right insurance policy for you and your family.

[Compare health insurance in the UAE | Compare health insurance in Saudi Arabia]

So what are the things you should consider in a health insurance?

1. List of hospitals covered

Depending on the type of cover you go for, each provider has a specific list of hospitals and clinic that they cover. Generally if you take a ‘local’ cover (geography-wise), the insurance policy will only cover certain list of hospitals, which do not always include the premium private hospitals. A regional plan, on the other hand, will cover all hospitals and clinics. Make sure you have the provider send you the list of which they cover before you sign up. You may like to pay more for international cover – covering medical care in the USA is the most expensive option; Europe, the UK and Canada can be included at a premium but still tend to cost less than US coverage.

2. Deductible

Health insurance providers will give you options of different cost deductibles, and your policy will vary accordingly. A deductible is the amount of the total medical bill that you have to pay – the insurance provider will cover the rest.

3. Maximum claim amount

Not something you normally think to check, but it is important to plan for the future when taking a health insurance policy. Therefore ensure that the maximum claim amount that the insurance provider is offering you covers what you would think you may end up needing. In the worst-case scenario where you use up the full amount, you will need to continue paying out of your own pocket.

4. Pre-existing conditions

When taking out a new policy, your health insurance provider will ask you to disclose any pre-existing conditions. If you do have any, there is a high probability you will be asked to undergo medical check-ups before the provider approves you and you may pay a higher price for cover. Most insurance providers cover pre-existing conditions only after a waiting period which must not exceed six months. Be sure to mention any pre-existing conditions when asking for a quote, to ensure they will be covered and that you do not risk coverage for your pre-existing condition being disqualified or your insurance later being cancelled altogether.

5. Maternity/ pregnancy cover

Various elements of maternity cover were made mandatory in Dubai, following the DHA legislations, as of January 2015. The minimum level of benefits under any health insurance plan must include at least eight outpatient maternity visits along with inpatient maternity covered up to AED 7,000 for normal delivery and AED 10,000 for complications in childbirth. While there is a 10% coinsurance payable by the insured, there is no longer a waiting period.

[Related: Maternity cover: Questions to ask | How much is your baby costing you?]

6. Ambulance cover

Calling out an ambulance is not always covered – check when you’re getting quotes.

7. Dental care, alternate medicines, optician, eyeware

There are always additional elements to consider when taking a health insurance policy, such as dental care cover. If you wanted alternate medicine such as acupuncture or osteopathy, is that covered? Check when getting quotes.

8. Covering your maid

Don’t forget your maid needs health insurance too. You need to consider whether to go for basic cover or get your maid her own plan – it’s a massive saving in the long term if it means uninterrupted childcare. There are even some dedicated maid insurance polices.

[Related: Why it is wise to insure your maid in the UAE | Why it is wise to insure your maid in Saudi Arabia]

9. Senior health insurance

Getting senior health insurance for the over-50s – yourself or your parents – can be costly. Sixty-five is a common cut-off age and pre-existing medical conditions matter more than ever. Pick the right senior health insurance plan from the start: changing service providers later on will cost you more.It’s well worth shopping around and, if you have moved your parents here from overseas, it may be worth leaving them on an international plan – check the costs.

[Related: Senior health insurance]

10. Umrah and Hajj

Check whether your health insurance covers you for Umrah and Hajj, and check what vaccines you will need and whether those are covered too. If traveling from the UAE for Umrah, you may want to get travel insurance for your journey.

[Related: Isahd: What does the health insurance law mean for us financially?]