Your complete guide to mandatory health insurance in Dubai

The mandatory health insurance in Dubai which had to be availed by 31st of December, 2019, was started to be brought into effect by the 1st of January. 2020. This initiative taken by Dubai Health Authority (DHA) took place under the system of ISAHD (Insurance System for Advancing Healthcare in Dubai), which, in Arabic, means ‘bringing happiness’.

ISAHD ensures sustainable health care availability for not only the citizens of UAE but also for the visitors and temporary residents. The Essential Benefits Plan (EBP) was initiated in 2014, whereas the final phase was completed on the 30th of June, 2016. Under this plan, the employees belonging to the lower salary band and dependents were ensured to avail healthcare facilities in sustainable methods via health insurance in Dubai.

In the final phase of the planned EBP, it stands mandatory for employers with less than one hundred employees, domestic help, as well as dependents. To ensure that every stratum of the society can avail of quality healthcare, whether they are children, lower-income mass, domestic help workers, or non-working residents.

Residence visas will not be issued in the absence of medical insurance.

Who do you need to get EBP for?

  • For uninsured employees, house helps, children and other dependents. If your dependents are insured by your employer, there is no need to avail additional insurance under EBP.
  • If you have already insured them under a higher insurance coverage plan, there is no need to avail EBP.

The premium packages of EBP ranges from Dh650 to Dh725 per year for employees. The prices, as evident, are extremely affordable for every income group to avail.

In the case of dependents’ insurance package

  • Elderly dependants including parents – Starting from Dh2,500
  • For non-working and married women age ranging from 18 to 45 years – Starting from Dh1,600
  • For general and non-working group, age ranging from 0 to 65 years – Starting from Dh650

In the case of domestic help, the general policies start at Dh650 per annum. The employees must be aware of their rights.

  • -The EBP policy benefits that must be provided by the employers
  • Deducting the amount of EBP from the employees’ salary is illegal on the part of the employer
  • For the employees working for less than Dh4001 must avail a plan from one of the nine PIs and the cover levels must at least be up to the minimum guideline provided by Dubai Health Authority (DHA)

The Medical Coverage

EBP covers annual health cover up to DH1,50,000 for all the claims. The basic facilities that can be availed are as followed:

  • Non-emergency medical treatments and in-patient treatments, including surgeries, diagnosis, and tests, 20 percent of expenses will be bored by the insurer. The expenses cannot be more than Dh 500 per encounter or more than Dh1000 per year.
  • Out-patient treatments including tests and diagnosis, 20 percent of the expenses will be bored by the insurer.
  • Physiotherapy sessions will be covered not more than six times in a year, in addition to lab tests and radiology tests, 20 percent of the expenses to be bored by the insurer.
  • Medicines are covered up to Dh1500 per person, 30 percent of the amount payable by the insurer.
  • Ambulance and healthcare can be availed during emergencies.

The maternity benefits

  • Antenatal blood tests, 3 ultrasounds, and 8 pre-delivery visits to a gynecologist. 10 percent of the expenses payable by the insurer.
  • Dh7,000 for normal delivery and Dh10,000 for emergency Caesarean delivery will be covered. 10 percent of the expenses payable by the insurer.
  • The newborn child will be covered under the mother’s insurance for 30 days after birth for neonatal tests, screening, and other medical requirements.

For chronic and pre-existing medical conditions, a declaration must be provided to the insurance company, after which the company will wait for six months before the coverage period begin. Any health emergency before the waiting period will be dealt with according to the company’s policies of insurance. All the claims will be met according to the policy guidelines.

Insurance companies that are participating in EBP by DHA

It is very important to choose the correct insurer. Out of 45 insurers with permits, only 9 of the health insurance companies are for mandatory EBP health schemes issued by Dubai Health Association.

  • Axa Insurance
  • Dar Al Takaful
  • Oman Insurance Company
  • Orient Insurance Company
  • MetLife Alico
  • National Health Insurance Company (Daman)
  • National Life and General Insurance Company (Saoc)
  • Ras Al Khaimah National Insurance Company
  • Takaful Emarat

Mr. Damodhar Mata, an independent financial advisor based in Dubai, issued a remark to Gulf News, stating, “You can choose to take an enhanced plan which will cover you in countries outside UAE but the premiums for these can go up to Dh15,000 per annum taking away the benefits of the EBP plan. Even if insurers agree to cover medical expenses outside the UAE, it will be largely emergency-based treatment and not elective”.

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