Getting health insurance in Dubai isn’t optional any more. If you’ve been following the news over the last year, you’ll know that health insurance is a mandatory requirement for all Dubai residents now and not having one means you will have to pay a hefty fine of AED 500 per month!
But, with basic health insurance packages under the ‘Essential Benefits Plan’ designed by the Dubai Health Authority (DHA) starting at an annual premium of only AED 550, why would you want to take that chance?
While details of this basic health insurance package are easily available on the websites of the 12 insurers authorized to offer it, we break down the fine print for you.
Co-insurance: Your share of the expenses
Also known as ‘deductible’, think of co-insurance as a pre-decided ratio in which all medical expenses will be split between the insurer and you. That’s an 80:20 split for basic in-patient and out-patient services and treatments. So that means you’ll be paying 20 percent of all expenses related to medical examinations, lab tests, diagnostic services and emergency treatments. However, you will be required to cover 30 percent of the cost of drugs and medicines prescribed by your doctor.
What if you’re admitted into a hospital and end up with a steep bill?
Breathe easy, there’s a provision here that limits the co-insurance payable for in-patient treatments to a maximum of AED 500 per encounter and an aggregate of AED 1,000 per year. So, if and when you exceed that limit, your insurer comes in and covers the cost of the treatment.
Not only that, there’s a 90:10 split for expenses related to maternity services. So if you’re planning to start a family anytime soon, keep in mind that under the Essential Benefits Plan, you will only have to make a 10 percent co-payment for maternity services like basic ante-natal check-ups, ultrasound scans and tests, as well as for in-patient services.
Coverage limit: The maximum that your insurer will pay
If you’re thinking about opting for the Essential Benefits Plan, bear in mind that there are limits on the coverage available under it, as in any other health insurance plan. These are the important ones you need to be aware of:
- The total annual coverage is limited to AED 150,000. That’s all-inclusive and includes your co-insurance share as well.
- The cost of drugs and medicines is covered up to a maximum of AED 1,500 annually.
- Under maternity services, the maximum in-patient coverage is AED 7,000 for normal deliveries and AED 10,000 for C-sections and cases of medical complications.
What else do you need to know?
Here are some other important bits you need to know before you decide whether the Essential Benefits Plan is right for you or not:
- You cannot seek medical treatment from a specialist without consulting a General Practitioner first.
- Geographic coverage is limited to Dubai, and is extended to other emirates only in case of emergency medical treatments.
- For all treatments that are not medical emergencies, you require prior approval from the insurer. Approval is required within 24 hours of emergency in-patient treatments.