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Picking the right health insurance is crucial. Here's all you need to know. Image Credit: Gulf News

Dubai: Moving to a new country comes with its own stress and adjustment period. If you are moving to Dubai or Abu Dhabi, the two emirates have made health insurance mandatory for all residents. This means that you will not be able to get a residence visa without having an insurance policy in place. While other emirates do not have a mandatory health insurance policy, it is advisable to get a good health insurance as healthcare costs can mount very quickly during any health-related crisis.

Here is a detailed breakdown of all you need to know to get a health insurance in the UAE:

Is health insurance mandatory?

Based on the emirate you are in, health insurance is either mandatory or optional. However, even in the Emirates where health insurance is optional, it is advisable to get yourself covered as healthcare costs can become a significant financial burden in emergencies or chronic conditions.

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It is advisable to get yourself covered as healthcare costs can become a significant financial burden. Image Credit: Gulf News

Abu Dhabi

Employers and sponsors are responsible for providing health insurance coverage for their employees and usually their families (1 spouse and 3 children under 18 years).

According to Department of Health, Abu Dhabi, for individuals with monthly salaries under Dh50,00 or under Dh4,000 plus housing allowance, the basic product policy is to be provided.

Enhanced Policy is for all other individuals and often.

If you have more than three children who you want to get coverage for or want to get a better coverage than the one provided by your employer, you can follow the steps listed later on how to get health insurance.

Dubai

Health insurance in mandatory in Dubai, after the Dubai Health Insurance Law that came into effect in January 2014. According the law, the legal liability for every sponsor is to provide an essential benefits plan (EBP) insurance package — fixed between Dh550 and Dh650 – so that workers earning lower wages can also get access to good healthcare.

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The law has helped make healthcare accessible to blue collar workers in the emirate.

According to the law, the health insurance is supposed to be provided by the sponsor. If you are a working professional, that would mean that your company provides the insurance cover. In case your company only covers you and not your family, you would be required by law to provide health insurance for the dependents on your sponsorship (spouse, parents or children).

Other emirates

Sharjah, Ajman, Ras Al Khaimah, Umm Al Quwain and Fujairah do not have mandatory health insurance. However, most employers provide some level of health coverage. Speak to your employer, as many companies get group plans for employees. If your company does not provide health insurance, follow the steps below to get one.

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Where should you go?

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Insurance market has become heavily digital. Image Credit: Gulf News

Just go online! In order to get a health insurance you can approach any of the many insurance companies or insurance brokers in the UAE through their website. UAE Insurance Authority’s 2017 annual report stated that there are 62 insurance companies and 160 brokers, so there is no lack of options in the country. If you approach a broker, they would provide options from several companies. According to Avinash Babur, Chief Executive Officer of InsuranceMarket.ae, which runs the website InsuranceMarket.ae, the insurance market has become heavily digital.

“Enter your inquiry online and someone will call you. They ask some basic information like your gender, the type of hospitals you might prefer visiting and you will get a quote online. It is a very online driven market,” Babur told Gulf News.

'Buying health insurance is even easier now for the end user. A Basic Health Insurance policy can in fact be bought online and the Policy Certificate is generated instantly after all the required information is provided.'

- Avinash Babur, CEO of InsuranceMarket.ae

What are my options?

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The Essential Benefits plan is supposed to provide a fair enough coverage. Image Credit: Gulf News

1. Basic plan

  • Lower premiums, between Dh550-650 a year.
  • Limited hospital and clinic network
  • Lower annual limit, medicine coverage and maternity coverage
  • Mostly covered only in the UAE.
  • Some key exclusions - organ transplant, road traffic accident and kidney dialysis.

The first, most basic plan, known in Dubai as the Essential Benefits plan, is supposed to provide a fair enough coverage.

"Most major conditions including cancer are covered in the basic plan as per the annual limits of the policy," Babur said.

The annual limit for basic plans is Dh150,000. The cover for medicine is Dh1,500 per year. Maternity cover is Dh 7,000 for a normal delivery and Dh10,000 for a cesarean delivery (C-section).

However, the basic plan also has limited network coverage, which means that the network of clinics and hospitals covered in the plan is quite small. Even if the clinic or hospital is covered, you would not be able to see a specialist immediately. A General Practitioner’s consultation is necessary for the consultation, treatment and medicines to be covered. So, if you have a specific preference for a doctor or a hospital, find out if they accept the basic health plan coverage. If not, you would need to purchase a higher insurance coverage.

“Some key exclusions in EBP are cases of organ transplant, road traffic accident and kidney dialysis. Additionally, the basic plan will cover you mostly in the UAE only. If you are travelling outside the UAE, you may not be covered,” Babur said.

Some key exclusions in the Essential Benefits Plan are cases of organ transplant, road traffic accident and kidney dialysis. Additionally, the basic plan will cover you mostly in the UAE only. If you are travelling outside the UAE, you may not be covered

- Avinash Babur, CEO of InsuranceMarket.ae

2. Comprehensive plan

The next tier of health insurance coverage is the comprehensive plan, which provides coverage in the UAE as well as other countries that you can choose.

Babur said: “This plan is for anybody who is not looking for the basic cover. If somebody has a preference for a specific type of hospital, they have to opt for a comprehensive plan because the network is bigger. Annual limits are much higher, going up to $1m in some cases. It at times will also cover you for worldwide coverage.”

As expected, other sublimits, like for medicine and maternity are also higher. With the plan covering most major conditions and being accepted in most hospitals across the country, this provides the resident with a much better healthcare experience.

The premiums can vary from Dh2,000 up to Dh1m, due to certain complex pre-existing conditions.

3. Enhanced benefits plans

This plan is most suitable for employers, as it is a little flexible and offers reduction on co-payment with an increase in certain annual limits.

My employer provides health insurance. What next?

If your company is offering health insurance, you will get an insurance card, which you should carry with you at all times. Ask your employer for table of benefits and the network list. If you are unhappy with the plan, speak to your employer to find out if they can offer a better plan with you paying an extra amount of money. If not, follow the steps below if you would like to get insurance on your own.

What documents do I need to get my own health insurance?

You will first need to provide basic information like your name, gender and age. If you are applying for a family member or a dependent, you will need to specify your relationship and depending on the type of play you choose, you might also need to fill a health declaration form or medical underwriting form to declare any pre-existing conditions. This is compulsory in the comprehensive plan because the premium depends on your age and previous conditions.

To get a quotation from the company or broker, you will need to provide a copy of the following:

  • Passport
  • Visa
  • Emirates ID

If you are renewing your insurance you will also need a proof of your previous insurance.

How long does it take?

For basic policies, you can expect a turnaround time of one working day, if you have submitted all your documents.

Comprehensive plans can take longer – between three to five working days – as companies may ask you for your previous reports if you have health concerns like diabetes or a heart condition.

Family insurance

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For newborn children, the essential benefits plan covers vaccinations for up to the age of six years. Image Credit: Gulf News

Getting coverage for your family is extremely important and Babur urged residents to buy it well in advance.

“Many customers approach us, for example, after the wife is pregnant, so that they are covered for maternity costs. The insurance company, obviously, charges a higher premium as they know that a claim is going to come in the next few months.”

For newborn children, the essential benefits plan covers vaccinations for up to the age of six years.

In the case of elderly parents, residents can often pay a high premium as the rates increase based on age and health conditions.

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“Over the age of 65, even the essential benefits plan comes up to Dh4,500, which is on the higher side. If you consider a comprehensive plan, it really touches the roof, with premiums from Dh20,000 going up to Dh50,000.”