UAE workers: A guide to the new basic health insurance benefits and exclusions

Dubai: As of January 1, 2025 all private sector employees and domestic workers in the UAE are legally required to have basic health insurance coverage. This significant policy change primarily impacts workers in Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah, and Fujairah.

The Ministry of Human Resources and Emiratisation (MOHRE) announced that mandatory health insurance coverage is now extended to all emirates. This decision, made in collaboration with other government agencies in December 2024, aims to ensure all workers in the UAE have access to basic healthcare.

If want to understand the benefits and exclusions of basic health insurance, here is a breakdown on the new policy and how it impact workers in the UAE.

Employers are responsible for purchasing the new health insurance policy. This is a prerequisite for issuing or renewing residency permits through the DubaiCare Network or any other approved provider. This excludes individuals with valid work permits issued before January 1, 2025. However, insurance must be obtained upon renewal of their residency permits. For detailed breakdown on the new insurance policy click here.

The health insurance plan for employees is known as 'Workers' Health Insurance (WIH)' and can be purchased from the DubaiCare network by Dubai Insurance.

This mandatory health insurance applies specifically to workers in the Northern Emirates (Sharjah, Ajman, Fujairah, Ras Al Khaimah, and Umm Al Quwain). It does not apply to employees in Abu Dhabi and Dubai, where mandatory health insurance has already been in place.

Dependent family members of workers can also be included on the health insurance plan with the same benefits and pricing. Proof of the parent's insurance is mandatory for policies covering children only. A medical application form is required for dependents aged over 64, along with recent medical reports and prescriptions.

To obtain health insurance for dependents, the insured and sponsor must provide copies of their passports with visa pages and Emirates ID.

The basic health insurance plan covers pre-existing chronic diseases without a waiting period.

Inpatient care: 20 per cent co-payment is payable by the insured, up to Dh500 per visit and Dh1,000 per year. The insurance company covers 100 per cent of costs exceeding these limits.

Outpatient care: 25 per cent co-payment is payable by the insured, with a maximum of Dh100 per visit. No co-payment is required for follow-up visits scheduled within seven days of the initial appointment.

Inpatient tests, diagnosis, treatments, and surgeries: Covered for non-urgent medical cases (subject to prior insurer approval) with 20 per cent co-insurance payable by the insured, capped at Dh500 per encounter and Dh1,000 annually. The insurer covers 100 per cent of costs exceeding these caps.

Outpatient examinations, diagnosis, and treatment: 25 per cent co-insurance payable by the insured per visit, up to Dh100. No co-insurance for follow-up visits within seven days for the same illness.

Laboratory tests: Covered with 25 per cent co-insurance.

Physiotherapy: Covered up to a maximum of six sessions (prior insurer approval required).

Drugs and medicines: Covered up to Dh1,500 with 30 per cent co-insurance.

Telehealth services are also included.

For detailed understanding on the policy terms and conditions for the basic health insurance, visit the official website of Workers Health Insurance - www.whi.ae