Dubai: The recent roll-out of the first phase of mandatory insurance in Dubai has led to some confusion about dependent coverage, minimum cost of insurance, visa renewal deadlines and potential use.
Dr Haidar Saeed Al Yousuf, Director of Health Funding at the Dubai Health Authority, cleared the air in an exclusive interview with XPRESS. Excerpts:
Is the basic insurance package announced for those earning under Dh4,000 applicable to dependent non-employed/non-earning individuals like housewives and children where companies do not cover the family?
No, the basic benefit package announced in the first phase, that will have a premium of Dh500-Dh700 is applicable only for those employees earning less than Dh4,000. Dependents do not fall under this category.
This basic package has been designed to ensure healthcare access for low-income workers. It is a volume product with low margins and has been planned as a group-buying exercise.
Dependents have until 2016 to get insured.
While we strongly encourage employers to cover their employee’s dependents, it is not mandatory. Therefore, if the employer does not cover the employees’ dependents, their sponsor (ie the employee) will have to cover them. In either case, they may get insurance at the moment, or wait until mid-2016.
Insurance companies are coming up with basic packages for dependents by the year-end. They will be on similar lines in terms of structure and cost as the basic benefit package. Premiums will be under Dh1,000. The packages will ensure basic benefits like access to general physicians, referral to specialists, surgeries, lab services, emergency services and maternity care.
Residents claim insurance hotlines are quoting unaffordable premiums on individual plans for dependents…
These representatives are speaking from historical evidence and not future perspective. There is a massive difference between the two. The issue has been addressed at the top level and we have advised insurance companies to work on their communication. In the earlier non-mandatory system, only those requiring immediate care went for cover, so the pool was smaller and the risk higher. But as we move towards 2016, the pool will become larger and eventually comprise the entire population. So prices will drop. The insurance market is undergoing dramatic changes. Give it time to settle.
With mandatory cover being linked to the visa, what happens if a dependent without insurance wants to renew or get a new visa this year or the next?
These changes will be effected only after the 2016 deadline.
Will insurance policies continue to be issued annually or will they be in keeping with the two year visa validity?
Some insurance companies are working on two-year policies and we are encouraging that.
Why is Dubai not making it binding on employers to cover an employee’s family?
The law in Abu Dhabi, Qatar and Saudi Arabia provides such a mandate. But Dubai is different. We are only urging employers to cover their employees’ families. The reason is that we have over 135,000 small and medium enterprises (SMEs) with an average employee strength of 9.1. The minute we impose the dependent coverage on employers, they will start choosing only singles. That will change Dubai’s social and demographic profile. We want a stable community where people can live with their families.
What is the coverage for dependent parents?
No one can be denied insurance in Dubai. Companies will come up with packages for them once the whole population is covered. The premiums will be higher in line with their risk profile, but not as high as they are today.
How will you ensure the costs are affordable?
By year-end, DHA will regulate prices, both at the level of the healthcare provider and insurance company. They will have to price their services, products and premiums within set parameters.
What steps are you taking to prevent abuse?
We want care to be available to everyone — poor and rich, young and old. But we have inbuilt checks and balances to ensure that no one abuses or piggybacks on the system.
What about policy abuse?
Insurance complaints, until recently, were lost causes and people would go to the court. But today, DHA resolves these issues in a flash. Over 35 per cent of the complaints we received in the last one year were because of misunderstood contracts.
Some policies are vague and grey. But policies of all insurance companies will soon be unified, down to their wording and font size. They will be rewritten in a way clearly understood by everyone.
What is your message to the public and insurance firms?
For those who already have a policy, please understand your rights and obligations.
For those yet to pick up a policy, please give the insurance industry time to mature. Changes will unfold in the next few months and will be fully effective by 2016. As for insurance companies, please work on your communication channels and provide the right information.
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