The healthcare sector in the UAE is renowned for its state-of-the-art facilities and cutting-edge treatments. With the rising demand for advanced medical care, health insurance providers in the UAE now cover various treatments. Whether you are a resident or an expat, understanding the treatments covered and not covered in your health insurance plan can help you make informed choices about your healthcare needs. In this article, you will learn about the basic inclusions and exclusions in health insurance in the UAE and how to make the most of these benefits.
List of inclusions and exclusions in health insurance in the UAE:
Here are some of the inclusions and exclusions in UAE health insurance:
Treatments covered in UAE Health Insurance:
Let’s look at the common health insurance inclusions in Dubai and the UAE:
Note: Always check with your insurance provider to confirm the treatments covered (inclusion) under your specific health insurance policy. Coverage details may vary depending on the provider, plan and individual circumstances.
| Treatment/service | Description | Significance |
| Pre-existing conditions (if disclosed) | Treatment for conditions disclosed during the application is subject to approval and plan terms. | Offers support for chronic or pre-existing health issues without financial burden. |
| In-patient services | Hospital stays, surgeries, and related care requiring admission. | Covers expenses for extensive medical procedures or recovery in a hospital. |
| Out-patient services | Consultations, diagnostic tests, and treatments that don’t require hospital admission. | Allows flexible access to routine and follow-up care. |
| Mental health services | Therapy, counselling, and medications for mental health conditions. | Addresses psychological well-being, a growing focus in health policies. |
| Chronic disease management | Ongoing care for conditions like diabetes, hypertension, and asthma. | Helps in managing long-term illnesses and preventing complications. |
| Maternity and newborn care | Pre- and post-natal care, delivery, and newborn health services. | Essential for families planning children to ensure proper maternal and infant care. |
| Cancer care | Advanced treatments like chemotherapy, radiotherapy, and palliative care. | Provides coverage for critical illnesses, reducing financial strain. |
| Rehabilitation services | Physiotherapy, occupational therapy, and other post-treatment care prescribed by a physician. | Supports recovery from surgeries, injuries, or serious illnesses. |
| Diagnostic testing | Blood tests, imaging (X-rays, MRIs), and other necessary diagnostics. | Facilitates accurate diagnosis and effective treatment planning. |
| Vision and dental care (if included) | Basic vision correction and preventive dental services, as specified in the policy. | Enhances overall health and well-being. |
| Home healthcare services | Nursing care is provided at home for chronic conditions or post-surgery recovery. | Ensures comfortable recovery in a familiar environment. |
Treatments not covered under UAE Health Insurance:
Let’s look at the common health insurance exclusions in Dubai and the UAE:
Note: Always check with your insurance provider to confirm the treatments are not covered (excluded) under your specific health insurance policy. Coverage details may vary depending on the provider, plan and individual circumstances.
| Exclusion | Description | Notes/examples |
| Birth control and family planning | Contraception, sterilisation, vasectomy, and pregnancy termination (unless medically necessary). | Includes consultations for family planning and discussions about contraception. |
| Complementary therapies | Treatments by complementary therapists, except homoeopaths and Ayurvedic practitioners. | Acupuncture, Chinese medicine, and other alternative therapies are excluded unless specified. |
| Cosmetic treatments | Non-medically necessary surgeries to alter appearance. | Includes abdominoplasty, scar revision, and nasal septum corrections unless medically necessary. |
| Desensitisation and neutralisation | Treatments for allergic conditions unless deemed medically necessary. | Allergy testing and immunotherapy not directly related to a medical condition are excluded. |
| Developmental problems | Treatments for developmental or learning difficulties. | Excludes conditions like dyslexia and related educational support. |
| Experimental or unproven treatments | Treatments or procedures not in standard clinical use or still under clinical trial for safety and efficacy. | Includes experimental surgeries and medications not approved by relevant authorities. |
| Eyesight correction | Vision correction surgeries like LASIK or PRK. | Unless covered under specific plans, routine glasses or contact lenses may also be excluded. |
| Genetic testing | Genetic tests are not deemed medically necessary. | Tests predicting the likelihood of developing conditions like Alzheimer’s are excluded. |
| Substance abuse and reckless behaviour | Treatment arising from hazardous or illegal use of alcohol, drugs, or medicines. | Includes injuries resulting from reckless acts or criminal activities. |
| Infertility treatments | Procedures and treatments to assist reproduction. | Includes IVF, GIFT, ZIFT, artificial insemination, and related costs. |
| Mechanical or animal donor organs | Costs for mechanical or animal donor organs, except temporary use while awaiting transplant. | Stem cell harvesting and storage are also excluded. |
| Obesity treatments | Weight-loss surgeries and related treatments unless explicitly covered under the policy. | Includes slimming programs, drugs, and classes. |
| Health hydros and spas | Treatments in non-hospital facilities like spas, health hydros, or nature cure clinics. | Any treatments not aimed at improving medical conditions. |
| Non-improving conditions | Treatments for conditions where no improvement or recovery is expected. | Includes artificial life maintenance for vegetative states unless due to cancer. |
| Criminal acts | Treatments arising from injuries sustained during illegal acts or criminal activities. | Includes accidents caused by reckless driving or resisting authority. |
| Elective procedures | Non-essential treatments, including certain dental or elective surgeries. | Surgeries like teeth whitening or cosmetic veneers are excluded unless covered under a specific plan. |
How to understand your health coverage in the UAE?
1. Check your policy details
- Review your insurance policy document or portal for covered treatments.
- Ensure you understand terms like co-payment, deductibles, and pre-approvals.
2. Consult your insurance provider
- Reach out to your insurer to clarify whether a specific treatment is covered.
- Example: Many UAE residents use platforms like InsuranceMarket.ae for policy guidance.
3. Seek prior approvals
- Some treatments require prior approval from the insurer before they can be undertaken.
4. Utilise network hospitals
- Opt for hospitals and clinics within your insurance network to avoid extra costs.
What’s the bottom line?
Knowing about inclusions and exclusions in health insurance in the UAE is very important for managing your healthcare effectively. Insurance companies frequently update their plans to include new treatments as medical technology improves, giving you access to advanced services that can make a difference.
If you’re curious about the kinds of health insurance available or wondering how to pick the right one for your needs, why not explore some helpful resources at platforms like InsuranceMarket.ae that break it all down for you?
Understanding your UAE health insurance inclusions and exclusions ensures you can maximise your coverage while avoiding unexpected expenses. Always read your policy documents thoroughly and consult your insurer for clarity.
