Medical Insurance

individual-medical-insurance-bannerIn today’s world, medical costs are on the rise and absence of a right medical plan could have a devastating effect on your finances. Having the right medical insurance is key for your wellbeing.

Medical Insurance is an agreement whereby an insurance company agrees to undertake a guarantee of compensation for medical expenses in case the insured falls ill or meets with an accident which leads to hospitalization of the insured. Generally, insurance companies have tie-ups with the leading hospitals so as to provide cashless treatment to the insured. In case the insurance company has no tie-ups with the hospital, they reimburse the cost of expenses incurred by the insured.

Importance of Health Insurance

Buying a health insurance policy for yourself and your family is important because medical care is expensive, especially in the private sector. Hospitalization can burn a hole in your pocket and derail your finances. It will become even more tough, if the person who is the breadwinner, is now in a hospital bed. All this can be avoided by just paying a small annual premium which would lessen your stress in case of medical emergencies.

A good health insurance policy would usually cover expenses made towards doctor consultation fees, costs towards medical tests, ambulance charges, hospitalization costs and even post-hospitalization recovery costs to a certain extent.

Having health insurance is important for several reasons. Uninsured people receive less medical care and less timely care, they have worse health outcomes, and lack of insurance results in a financial burden for them and their families. Moreover, the benefits of expanding coverage outweigh the costs for added services.

Mandatory Health Insurance Coverage in Dubai

The mandatory health insurance coverage is under the Dubai Health Insurance Law that came into existence in January 2014. According to the law, every sponsor is now responsible for providing a mandatory basic health insurance plan to all expats regardless of their salaries. By this, Dubai government makes sure that even the low paid employees, mostly who work under AED 4,000 can also have access to adequate healthcare.

Health insurance plans can significantly vary depending on the cost and coverage. While most of the health insurance packages don’t include optical and dental coverage, you can have these covered for a higher cost in premium medical insurance plans.

In Dubai, you can have the list of hospitals and clinics that are listed on your cover. With more comprehensive health coverage plan, you can also have an access to a better and extensive health network of hospitals and other healthcare providers

Two types of Health Insurance Coverage

Basic Health Insurance Coverage

With basic health insurance coverage, you can have access to hospitals and clinics under DHA (Dubai Health Authority). DHA has currently a large network of clinics and hospitals all across Dubai offering easy and quick access to medical services. The basic health insurance coverage is specifically designed for expats with lower salaries.

Comprehensive health insurance coverage

A comprehensive health insurance policy offers extensive coverage and acts as a financial pillow in case of medical emergencies. Unlike basic health insurance plans, a comprehensive policy covers outpatient access to Hospitals as well as inpatient treatments, including consultations and medical tests.

What are the components included in health insurance?

  • Sum Insured – is the amount of money that an insurance company is obligated to cover in the event of a covered loss. This term is commonly associated with homeowner’s or property insurance. The sum insured amount is dependent upon the premium price that is being paid for the insurance coverage2. 2.
  • Network Provider – the level or category of the medical facilities that would accept the insured members for medical treatments and procedures. This includes a wide range of clinics, medical centers, different levels of hospitals, care units, diagnostic centers, laboratories, radiology facilities, dental offices, pharmacies, rehabilitation and other medical units.
  • Wellness Benefits – these are specific benefits that are considered as “extra” than the usual medical cover. Wellness benefits includes Vaccinations, Dental, Vision, and Hearing that usually can be provided through a separate plan. Once included in the same medical policy, premium can increase and would extend only a particular sub-limit of cover.
  • Maternity – a special cover to assist in gestation or pregnancy, delivery and post-natal period. This is a standard benefit for married females that cannot be removed from any Dubai health insurance plan.
  • Claims Reimbursement – It is the provision of the plan to cover members outside of the network, or where a service is received in a facility that is not contracted with the insurer for the specific plan involved. Note that not all health policies allow reimbursement, and if at all will be allowed, it is subject to the policy terms. Normally, reimbursement is not in full and will not be based on the actual cost.

The insurer may accept the reimbursement but will process it based on their usual and customary rates, applying only a specific percentage and any involved cost-sharing options. Hence, it is best and advisable to stick with the network for any medical treatment.

At New Age Insurance Brokers, we understand that choosing the plan that suits your need and budget could be very challenging. With our in-depth knowledge of medical plans and our association with all leading product providers, we are in a unique position to help choose the right plan which will take care of you and your loved ones in those difficult times.