Health Insurance

Health insurance or medical insurance is basically a contract between the insurer and the insured, wherein the policyholder pays for the medical as well as surgical expenses. A health insurance plan is indeed the safest and most secured way to give financial coverage to the policyholder’s family.

What is Health Insurance?

A health insurance policy is a type of insurance that provides financial coverage for surgical and medical expenses when the insured is hospitalized.

An apt medical insurance policy covers the policyholder with several benefits like day-care hospitalization and pre as well as post hospitalization. In fact, some of the leading health insurers provide coverage for cashless hospitalization facility at network hospitals during the tenure of the policy. All the medical expenses that are incurred are either paid to the health care provider directly or the health insurance company reimbursed to the policyholder.

Features & Benefits of Health Insurance in the UAE

The different features and benefits of health insurance in Dubai and across the UAE are listed as follows:

• Cashless Treatment: Majority of the health insurance companies in Dubai and throughout the UAE have their collaboration with various hospitals across the country. If the insured admitted to one of those hospitals, he/she can avail the benefit of cashless treatment facility by paying nothing for the medical treatment. The policyholder only requires to provide the policy number and rest of the things will be taken care of by the hospital and the health insurance, However, if the medical expenses go beyond the pre-specified limit by the health insurance cover then the insured will have to settle it directly from the hospital.
• Coverage for Pre & Post Hospitalization: Some of the effective medical insurance policies provide coverage for pre & post hospitalization expenses for a specific number of days before and after a policyholder is hospitalized.
• Medical Check-Up: An apt health insurance plan entitles the policyholder to receive frequent medical check-ups. However, a free medical check-up is offered by a few health insurance companies in UAE, provided the insured have a decent history of No Claim Bonus.
• Transportation Expenses: If the insured get hospitalized, the health insurance policy will cover the expenses incurred on using an ambulance to transport the policyholder from home to the hospital or vice versa. Well, this is an additional benefit and one must opt for it while buying health insurance
• Room Rent: If in case the insured is hospitalized, he/she will have to incur expenses on room rent. Having a medical insurance will ensure that all such expenses are covered to a specific extent.
• No Claim Bonus (NCB): If someone hold a medical insurance plan and don’t make any claim for any sort of treatment during the whole policy year then he/she will be rewarded with No Claim Bonus. It can be provided either as a discount in the cost of premium or as an increment in the sum assured. Well, one can take the benefit of NCB on the renewal of their health insurance
• Third Party Administrators: Most medical insurance companies in the UAE make use of a Third Party Administrator (TPA) to handle certain functions. TPAs play a pivotal role in the health insurance sector. They have their collaboration with health insurance companies in Dubai and across the UAE to manage a wide range of services like enrolment, premium collection, claim settlement, and the like. Health insurance applicants should make sure that in addition to picking the best health insurance they also go for the most reliable and easily-accessible TPA.
• Government Policies: Whether its medical insurance in Dubai or in Abu Dhabi, both of these emirates mandate a certain level of protection for residents. This is applicable for UAE residents and for expatriates alike. For example, the Dubai Health Authority offers a comprehensive health insurance policy (Sadaa) to unprotected residents. Similarly, health insurance in Abu Dhabi is offered to UAE nationals under the name of Thiqa.

Types of Health Insurance in the UAE

Following are the different types of medical insurance plans that one can opt for in order to meet their some specific insurance needs:

Individual Health Insurance Plan

As its name suggests, individual medical insurance plans are offered by health insurance companies in the UAE to a single policyholder. It offers financial coverage against certain illnesses and offering several benefits such as cashless hospitalization, pre and post hospitalization, etc. The entire sum assured is provided to only a single person.

Family Health Insurance Plans

When it comes to medical insurance UAE cost, family health insurance plans are the perfect blend of affordability and wider coverage. Instead of purchasing separate medical insurance policies for each family member, one can opt for the family plans in order to cover the entire family under one single cover. These types of health insurance plans usually restrict the number of policyholders to one spouse and a fixed number of children. Under family medical insurance plans, the sum assured is shared by all the family members that are included in the policy.

Senior Citizen Health Insurance Plans

Such type of health insurance plans are specifically designed for anyone who is 60 years old & above. Senior citizen medical insurance plan typically come with discounted premium cost. Although only a few health insurance companies in UAE offer such type of plans, they might ask for a medical check-up before selling out the plan. In addition to this, such policies may slightly higher in comparison of the health plans for young individuals because senior citizens are more prone to illnesses and health diseases.

Group/Employee Health Insurance Plans

These types of health insurance plans are typically provided by employers. Plus, they are created to include & exclude employees as they join & leave the organization. Group health insurance plans are usually low in premium because of the low risks involved.

Plans by Nationality

Usually seen in government medical insurance companies in Dubai and other emirates, certain health insurance providers offer slightly better benefits to UAE nationals. This type of medical insurance plan carries different benefits for expatriates and different for UAE nationals.

When it is important to opt for a health insurance in Dubai, with plenty of options available in the marketplace, choosing the best plans can be a daunting task. That is why, comparing the top medical insurance plans in UAE is essential.

In this regard, given below are the best health insurance providers in the UAE:

(Updated: February 2020. Information is subject to change as per the medical insurance provider’s discretion.)

Health Insurance Inclusions                                                                  

Health insurance policies in the UAE strictly adhere to an inclusions list, which sets forth the exact extent of medical cover that a policyholder is eligible for. While inclusions vary from one health insurance Company in Dubai to the next, the services listed below can be found even in the cheapest health insurance in Dubai:

• Pre-existing diseases and health illnesses
• Pre & post hospitalization
• In-patient hospitalization costs
• Ambulance fees
• Health check-ups
• Day care procedures
• Hospital room cost
• Vaccinations & inoculations
• Newborn or maternity
• Medication

Health Insurance Exclusions

An exclusions list is a collection of the various medical services and treatments that are not offered as part of a health insurance plan in the UAE. Following are some of the most common medical insurance exclusions:

Unnecessary Operations

Simply put, most medical insurance in the UAE will not cover the costs of medical treatments unless they are crucial to the policyholder’s health and wellbeing.

Cosmetic Treatments

It is nearly impossible to find medical insurance companies in Dubai or anywhere in the UAE that offer a health insurance policy with cover for cosmetic treatments.

Obesity

Medical treatments for obesity usually find themselves well outside the scope of cover for health insurance in the UAE.

Dental & Optical Care

When it comes to dental or optical care, even the very best medical insurance in Dubai barely scratches the surface. While some health insurance companies in the UAE do offer emergency dental cover, routine checks and more comprehensive protection can usually only be availed of by paying an additional premium.

Waiting Periods

Certain health insurance plan benefits only come into effect after the customer has been a policyholder for a fixed period of time. This is known as the policy’s waiting period. The most common examples of health insurance services that have a waiting period include maternity cover, cover for pre-existing conditions, cover for chronic conditions and so on.

Voided Policies

Health insurance companies in the UAE reserve the right to terminate a medical insurance plan at any time. Medical insurance policies are usually voided as a direct result of the policyholder’s actions. Examples of activities that may void a health insurance plan include illegal activities (such as gambling), not paying the medical insurance premium on time, self-harm or suicide and more.

The Health Insurance Claims Process

One may have repeatedly come across the term ‘network hospitals’ when going through the various plans offered by the top health insurance companies in the UAE. This network of hospitals plays a crucial role in how claims are processed. There are two major ways that members of a health insurance policy can make health insurance claims:

Within the Hospital Network

Medical insurance companies in UAE usually ties- up with numerous hospitals and clinics. These partnered medical establishments let the policyholder avail of their health insurance plan benefits without making any payment out of pocket (as long as they are within the stipulated policy limit).

Outside the Hospital Network

Unlike the previous type of claim, policyholders will be required to pay for any medical treatment that is availed of outside a health insurance policy’s network of hospitals. However, this amount can be reimbursed by presenting the health insurance provider with treatment details, original bills and other document proofs as requested. Note that the reimbursement amount is subject to medical insurance policy eligibility and to the limits that have been set forth by the insurance provider.