Insurance

Medical Insurance

1. What is medical insurance and why do I need it?
   Health care in the UAE is very expensive. Unless you are covered by Insurance and have an Insurance card, you may not be admitted in many of the hospitals. There are various kinds of coverage available. So good medical cover not only makes sense, but is a vital factor for a productive and affordable life in the UAE.
   
   
2. Is medical insurance mandatory for all the workers in the UAE?
   As of now, only the Emirate of Abu Dhabi has made it mandatory to cover every employee under the medical insurance. Resident Visa is stamped only after the employer produces the evidence of Insurance cover to the worker.
   
   
3. What are the covers available in Abu Dhabi?
   There are four plans: Abu Dhabi plan, UAE plan, Regional plan and Global plan. The coverage increases from Abu Dhabi plan onwards.
   
   
4. How does the medical insurance works?
   Basically, medical insurance is available in two different ways –
   
   
   • Insurance offered through a group scheme, typically from your employer (or sponsor)
     
     
   • Insurance taken out by you as an individual
     
     
   Both types work in fundamentally the same way, i.e. in return for a monthly premium, you can receive certain types of medical care free of charge. In the case of the group scheme, your employer will normally pay the premium (or a large percentage of it) on your behalf. You will receive a membership card from the insurer, which you take with you whenever you visit a doctor, clinic, hospital or walk-in outpatient centre (often called an “ambulatory centre”).
   
   
5. What are the costs you will have to pay?
   
   Deductibles: The insurer will ask you to pay a certain amount whenever you receive treatment, up to a set limit. Beyond that limit, they pay. This is generally worked out across a full calendar year so typically, you may have to pay the first AED 1,500 of the treatment you receive over a 12-month period.
   
   Copayments: Whereas the deductible is worked out over a full year, the copayment applies to each and every health centre visit. So you might have to pay AED 50 or AED 150 every time you visit the doctor, or for every prescription.
   
   Coinsurance: This applies to larger sums, for instance, an operation. In addition to (or perhaps instead of) the copayment, you may have to pay, for example 20 per cent of the cost of the operation, with the insurer paying the other 80 per cent. There will often be an upper limit on the coinsurance needing to be paid.
   
   If yours is a group scheme, perhaps provided by your employer (the UAE government is committed to making it compulsory for all expatriates to have their healthcare funded by their employers), you need to check with the insurer exactly how these arrangements work, and it is best to do so the moment the cover is in force. This will avoid any unpleasant surprises at the point of care.
   
   If yours is an individual policy, you will need to discuss all of the above, adapting them where possible to your most likely requirements. This may of course involve changes in the rate of premium.
   
   
6. Are all illnesses and medical conditions covered?
   No, absolutely not. Many insurers will automatically exclude pregnancy care, eye care and dentistry, for example (you can extend the policy to include these, for additional premiums). Also, HIV Aids, speech disorders, behavioral problems, hormone replacement therapy, allergies and dialysis are typically excluded, along with reconstructive surgery, physical aids/ appliances and general nursing care. Again, many of these can be included in return for higher premiums on a bespoke policy. It is better to check all these details from the Insurance company before enrolling to the policy.