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Health insurance, like most insurance, provides protection for your wellbeing. Like car insurance, it is mandatory in the UAE. This ensures that citizens and residents are provided for in case of medical emergencies.
Furthermore, in Dubai especially, employers are expected to provide basic health insurance as part of the employment contract. This basic minimum requirement of health insurance, Essential Benefits Plan (EBP), falls under the Dubai Health Authority. It is also the minimum requirement for resident visa approval, and the sponsor must apply for it for their family members.
Citizens have the choice of applying for private health insurance or national health insurance, SAADA. These are offered by the government of Dubai and are regulated and supervised by the Dubai Health Authority. This option is also available to UAE citizens, working or residing in Dubai.
There are several plans available but the official distinction between them is fairly summed up in two:
As mentioned before this is the minimum amount of health insurance required by the government. Every resident and citizen must have at least the EBP policy. However, this cover is valid for those residents in Dubai earning less than AED 4000 per month. Though EBP is basic healthcare it provides coverage or medical emergencies, in and out-patient consultations, drugs, as well as maternity coverage. It is prudent to note that these coverages come with restrictions and limitations due to the EBP being a basic package.
Unlike EBP or even traditional insurance, SANAD is designed for the dependants of Dubai residents who have no means of income of their own. It is easy to obtain and doesn’t require more than a resident visa as proof of residence and dependancy documents.
Health insurance plans can be acquired for individuals alone. Depending on pre-existing conditions, the nature of work, and additional features added to a policy the premium can be as high and low as the individual requires.
Family plans cover a set number of family members and can be quite budget-friendly depending on how much coverage is demanded. The medical insurance keeps in mind the needs of children and maternity is also covered.
Because health insurance is so closely monitored by the UAE government there are certain criteria that need to be followed by all insurance providers in their policies. These inclusions are as follows:
During, and after some medical procedures, it is imperative that the patient is admitted into the hospital. The cost of staying, including bed and board, are included in medical insurance policies in the UAE. Some private insurance providers even offer bed and board for luxury VIP rooms but this has an impact on the premium.
Ambulances don’t usually get the credit they deserve. They are essentially a mobile hospital with the essentials in primary care. Patients who have speedy access to ambulances have a higher chance of recovery than those who do not. This is why ambulance services are included in the policy.
It has long been established that vaccines keep the entire community safe from debilitating viral diseases. They are a necessity, not a luxury and thus their provision is provided in medical insurance policies in the UAE.
Diseases and medical conditions can’t be treated unless they are diagnosed properly. This is where lab testing comes in. The policies include regular blood tests, MRI scans, X-rays, biopsies, and diagnostic tests. They can be prohibitively expensive if not subsisted with health insurance.
Prescription drugs can also run a high bill, especially for lifelong illnesses such as diabetes and blood pressure. Provisions for them are included in medical insurance policies in the UAE.
Though predominantly inclusive of most medical procedures there are some exclusions to medical insurance policies that are outlined. These are not provided for under insurance but can be gotten by paying for them personally. However, the cost will not be compensated.
Anything deemed unnecessary to the wellbeing, and immediate health of the policyholder will not be covered by the health insurance policy. These can include minor procedures that don't alter the health of an individual as well as new-age procedures such as laser technology.
Similarly, cosmetic procedures are deemed unnecessary. They are not emergency procedures and don't halt life-threatening diseases or accidental injuries. Therefore they are not included in health insurance, because they hardly contribute to better health in policyholders.
Procedures that encourage fat-loss or curb obesity such as gastric banding and laser surgery aren't covered in health insurance. This may seem like a harsh exclusion since obesity is a genuine health concern. But insurance providers argue that regular exercise and a healthy change in lifestyle should supersede the procedures as they are required in very rare circumstances.
Like most health insurance across the globe, the UAE excludes dental and optical care with the option of adding them to the original policy at a higher cost. Very few policies cover basic emergency dental care.
Health insurance policies do not include maternity care, chronic-pain, and pre-existing condition cover at the outset of a policy. They require a waiting period before these covers are included in the policy. Each provider has its own waiting period so be sure to check what it is before signing up.
Any sign of self-harm or attempted suicide will void medical insurance. These instances are not covered by health insurance and are used by the provider to deny all coverage.
Claiming health insurance is a little different from the motor and home insurance. For health insurance, there are two ways to make a claim - within the hospital network, or outside the hospital network. Network hospitals are simply those medical institutions that the insurance provider has a direct link with.
As mentioned above, insurance providers partner with several hospitals, medical institutions, and clinics. This makes the claims process simple and no cash transactions need to be made by the policyholder. They simply have to show their health insurance card to the hospital staff and their claims are handled directly between the insurance company and 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 is required to pay out-of-pocket and submit for reimbursement from their insurance provider. More leg work is required by the policyholder in this claims process because they need to submit medical bills, case history, etc as proof of claim. Similar to within hospital network claims they are limited to the stipulations of the policy.
Residents in the UAE are spoiled for choice. There are private insurance companies, as well as government-sponsored medical plans. So how do you choose the one that is best for you?
The first thing you need to do is jot down what features you want to be covered in your insurance policy. Whether you want single person policy or a family policy, are there any chronic illnesses, any pre-existing conditions? The premiums for all three will vary according to your needs.
Once you know what you want, compare premium rates and quotes from various insurance providers online. You don't want to choose the first option or sales pitch made to you. Do market research and go for the insurance provider that offers the most value for the lowest premium.
Before making any final decisions you should always sus out an insurance companies reputation in the market by reading customer reviews. Not all companies are in the market to assist you with your insurance needs. It is essential you ally yourself with one that is honest in its undertakings.
Furthermore, do check the insurance provider's claim settlement ratio. Some companies have a bad reputation for not entertaining claims at all or taking a long time to process claims against insurance policies. Be sure that the insurance provider you choose is prompt in dealing with claims.
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