Health insurance covers medical and surgical expenses arising from an insured individual's illness. These expenses might be related to the cost of medicines, lab tests, vaccines, doctor consultation fees, or hospitalization.
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Health Insurance plans are usually classified into two:
Health Insurance Plans can be acquired for individuals or a group of individuals. Depending on pre-existing conditions, the nature of work, and additional features added to a policy, the premium can be as high or low as the individual requires.
Family plans cover a set of family members and can be quite budget-friendly depending on how much coverage is demanded. Medical insurance keeps the needs of children, and maternity also covered.
The UAE government closely monitors health insurance; therefore, certain criteria need to be followed by all insurance providers in their policies. These inclusions are as follows:
Though predominantly inclusive of most medical procedures, some exclusions to health insurance policies are outlined. These are not covered under insurance but can be gotten by paying for them. However, the cost will not be compensated.
Claiming health insurance is a fairly simple process. There are two ways to make a claim for health insurance - within or outside the hospital network. Network hospitals are medical institutions to which the insurance provider has direct links.
As mentioned above, insurance providers partner with several hospitals, medical institutions, and clinics. It makes the claims process simple, and the policyholder must make no cash transactions. They have to show their health insurance card to the hospital staff, and their claims are handled directly between the insurance company and the hospital. Of course, these claims are limited to the stipulations of the policy. If procedures are performed that exceed the limit or are not included in the policy, then those will have to be paid by the policyholder out-of-pocket.
The only difference here is that the policyholder must pay out-of-pocket and submit for reimbursement from their insurance provider. The policyholder requires more leg work in this claims process because they need to submit medical bills, case history, etc., as proof of claim. Similar to hospital network claims, they are limited to the policy's stipulations.