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WHAT IS MEDICAL/HEALTH INSURANCE

Know Your Insurance

WHAT IS MEDICAL/HEALTH INSURANCE

Know Your Insurance

Published on 31 Dec 2020

Last updated 26 Sep 2024

5 min read

What is Medical Insurance & Why is it a “Must Have”

Medical, or Private Health Insurance to use its alternate title, is a compulsory insurance in the UAE and probably the first Policy that any new expatriate resident will purchase. Given its mandatory status it is widely available through all leading Insurers in the UAE market, and this “competition” makes it reassuringly affordable and easy to arrange. Insurers also offer a variety of options in their product ranges: meaning that consumers can purchase a policy with the benefits that suits their individual needs best.

What is Medical/Health Insurance

Medical Insurance is a type of Personal Insurance policy specifically designed to protect individuals against the costs of their necessarily-incurred medical expenses. These typically include medical consultation and treatment, surgical procedures, prescription medications/drugs and sometimes dental and optical expenses.

Most employers offer Medical Insurance as an employee benefit, covering the cost of the premiums themselves or sometimes a part-funding from the employee: with the level of cover generally variable according to the designation or grade employees of the employee.

Why should I have it?

Perhaps the most important reason to have Medical/Health Insurance is that it is a legal requirement in the UAE! Health Schemes and cover requirements may vary from Emirate to Emirate (particularly Dubai versus Abu Dhabi and Al Ain) but the mandate to have valid insurance is the same across the UAE. In Dubai, all registered employers (including those in Free Zones) are required by law to provide health insurance for their employees. The minimum standard cover stipulated by the DHA (Dubai Health Authority) is commonly known as the Essential Benefits Plan (EBP) and many Insurers offer a product known under this, or a similar, name. The law also extends to sponsors who must provide health coverage for their spouses, dependents (by definition, children) and domestic workers.

Notwithstanding the need to comply with the law, having a Medical Insurance that is suitable for your needs is invaluable for a number of reasons. First, you may have worries about being taken ill during your time as an ex-patriate in the UAE and want to be sure that you’ll get the medication and treatment you need. Medical Insurance can therefore give you peace of mind knowing that if and when you’re taken ill or if you suffer an unfortunate injury, you’re supported by your Insurer’s Medical Network.

Another major consideration is cost. Prescription drugs, physiotherapy, outpatient treatment, consultations with medical specialists and surgical in-patient procedures are all expensive in the UAE and therefore financially out of reach for many. The last thing you need to add to your condition is the stress of how you would pay for the necessary treatment you’re having: therefore, a good Medical Insurance can take care of the cost while you’re being taken care of by the medical experts.

How does it work?

On joining an employer’s scheme; or if you have taken out your own policy; you should receive a “welcome pack” containing a membership card confirming your enrolment details, as well as information on the services you are entitled to and a list of providers where these services can be accessed. These providers are in what is referred to as “the medical Network” and either your insurance company or their appointed administrators (called TPA’s/Third Party Administrators) can confirm the details of the Networks they deal with in Dubai and the other Emirates.

As a general rule, for an expense to be reimbursed or paid direct to the provider, it should first be approved by the Insurer by making a referral to them. This referral should provide full details of the item being claimed for, the cost and the cause/reason (this should be a diagnosis or recommendation by a medical professional). This is a very important term and condition of the Policy and failure to do so can result in the non-payment of claims.

Once accepted, the go-ahead will be given to proceed with the service or medication being claimed for and payment will be made by either a reimbursement or direct billing basis.

So, how can Medical Insurance be arranged and is it easy?

As this is one of the most widely insurances available in the UAE market, it won’t be a surprise to learn that there are many ways of obtaining it! Medical/Health Insurance can be arranged through:

  • Direct salespeople who are representatives of a Brokers or Insurer
  • In person at a Branch Office or any Insurance Broker or Insurer
  • Bancassurance: your bank may offer Medical Insurance to its customers at preferential rates or discounts backed by leading Insurers
  • A Call Centre of an Insurance Broker or Insurer
  • Online through a web portal of an Insurance Company
  • Through an insurance comparison website like InsuranceMarket.ae

Of course, you could try to obtain this insurance yourself but why not simply use our expertise? In partnership with the UAE’s leading Medical Insurers, InsuranceMarket.ae is able to arrange cover from EBP minimum standard cover in Dubai through to the most sophisticated policies covering top-tier hospitals and with large coverage limits. Contact one of our friendly Advisors and let us take the stress out of arranging this most critical of cover. Note that due to the more complicated Scheme parameters in Al Ain and Abu Dhabi, we are unable to arrange Health Insurance for these Emirates at this current time.

author

ABOUT AUTHOR

With over 34 years in the international insurance industry in a variety of senior management roles, and as holder of the Diploma in Insurance from the Chartered Insurance Institute, Rachel surely knows her insurance! With experience in London, continental Europe and the Middle East, Rachel is here to share her knowledge and help you understand more about insurance products in this easy-to-understand series of videos and blogs.

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