Does your insurance cover your pre-existing condition?

medical insurance cover

In Dubai, coverage for pre-existing conditions is mandatory by law. An insurance company cannot deny medical insurance to a resident or ex-pat with pre-existing conditions, and the maximum waiting period cannot exceed 6 months, according to the new regulations of the Insurance System for Advancing Healthcare in Dubai (ISAHD).

So, does this mean anyone in Dubai can buy medical insurance with pre-existing conditions and can claim benefits after the waiting period ends? The answer to this question is not straightforward because there is still a lot of scrutiny and red tape associated with pre-existing conditions.

To understand things better, first, you need to know what exactly pre-existing condition means. Not comprehending the meaning of pre-existing conditions can lead to unnecessary rejection of medical claims.

What does pre-existing condition mean in terms of medical insurance?

A pre-existing condition is a health condition known or unknown to the person applying for medical insurance. It also includes those conditions for which you have received consultation, diagnosis, surgery, treatment, or pharmaceutical drugs before purchasing the insurance policy.

More importantly, you need to be aware that pre-existing conditions don’t only refer to conditions that you have at the time of buying a medical cover, but it also includes a complete medical history of any condition that you have suffered from within the last five to ten years. It can include past hospitalizations, heart attacks, surgeries, diabetes, high blood pressure, thyroid disorder, skin disorder, and accidental injuries.

However, congenital diseases and birth defects are not considered pre-existing conditions, and they are treated differently and may require a separate cover.

What You Must Know Before Buying Medical Cover for Pre-existing Conditions

  • Under an individual plan, pre-existing and chronic conditions will be covered only when they are declared in the application form. Latest medical reports along with ongoing medicine details may be asked by the insurance to assess your current health conditions.
  • Usually, insurers cannot exclude coverage for any preexisting condition, it may be excluded only when not declared in application form and insurer might consider to cover it during next renewal with additional premium. Insurers typically load the premium to cover pre-existing conditions, depending on the medical history. Accordingly, an insurer will cover it from day 1 or put a waiting period of up to 6 months.
  • Never lie about your pre-existing conditions in any scenario. While it may be tempting to hide pre-existing conditions, it subjects you to serious financial risk in the future. When you suffer from a significant and expensive medical emergency and the insurer comes to know about your pre-existing condition after buying the medical coverage, they can reject your medical claim even if the medical emergency is not related to the pre-existing condition.
  • Even though the waiting period of up to 6 months is attached to medical insurance coverage for pre-existing conditions, the Dubai Health Insurance Corporation (DIHC) allows the waiting period to be waived off if a pre-existing condition develops into an emergency.
  • Group or corporate medical insurance, usually, has a 6-month waiting period on policyholders with pre-existing and chronic conditions for the first scheme (when buying insurance for the first time in the UAE). Also, if insurance has expired for more than a month, then an insurer will consider it as the first scheme.
  • In case of a job change, the insurance company of the first employer is required by law to provide medical cover for 30 days after the cancellation of the policy to ensure continuous access to the medical insurance cover. However, if the policy expires earlier, the cover will be offered until the expiration date.
  • When joining a new company, make sure that you share your previous insurance proof to get continuity of coverage, or else 6 months waiting period will apply.

If you do have one or more pre-existing condition, choosing the right medical insurance plan in Dubai can be complicated for you. At New Age Insurance Brokers, LLC, we can help you find the right medical plan that covers your pre-existing conditions and walk you through the whole process with ease and comfort. For any queries or further information on medical coverage for pre-existing conditions in Dubai, please get in touch with us.

Understanding the Exclusions of Your Medical Policy

Insurance Policy Agreement Terms Document Concept

Having medical coverage doesn’t mean that you will get coverage for all health and wellness issues. Before you invest in health insurance, you must understand that medical insurance covers illness and not wellness, unless it is specifically added to your policy. In the real world, no health insurance plan covers every medical condition regardless of how expensive the policy is.

Insurers in the UAE follow a common exclusion list regulated by Dubai Health Authority (DHA). These exclusions can be in the form of certain treatments, time-related restrictions, and various limitations.

This guide will help you understand the exclusions of a medical policy in detail.

Undeclared Pre-existing Conditions

Basic health insurance can cover pre-existing conditions. If a health plan does cover pre-existing conditions declared in the form, you will pay an increased amount of premium. However, any claim made for undeclared pre-existing conditions will not be covered.

Health Supplements

Supplements are often prescribed to replenish nutrients in your body. They don’t come under the purview of medicines essentially required to treat illnesses. Your insurance provider will not cover over-the-counter supplement purchases. However, if your doctor deems a health supplement to be necessary and prescribes it to you, then its cost might be covered by your insurer. One classic example is vitamin D which is covered only when deficiency is justified by your doctor.

Cosmetic Treatments

All kinds of cosmetic treatments and surgeries are regarded as exclusions in every medical insurance policy in the UAE. It includes facelift, deviated septum, implant surgeries, eyelid surgeries, and so on.

Dental and Optical Treatments

Basic health insurance plans generally exclude dental and optical treatments from their coverage. If you want these treatments to be covered, most insurers can cover them in exchange for an additional premium. However, some comprehensive health insurance plans may include them. Cataract surgery might be an exception as it comes under medically necessary treatment.

Alternative Treatment Practices

If you are someone who prefers alternative treatments, you must know that some alternative medicines and treatments are included in all health insurance policies. This includes Ayurveda and Homeopathy. Others such as Aromatherapy, Massage Therapy, Acupuncture, Hypnosis, etc. are exclusions. Besides that, chiropractic therapies are also excluded from most health insurance plans.

Treatments for Fertility Issues

Any fertility treatment for men and women is not covered under health insurance policies in the UAE. Hence, fertility prescription medications and in-vitro fertilization treatments are excluded as well.

Treatments for Weight Loss and Obesity

All kinds of treatments required for weight reduction are regarded as non-essential treatments in most cases. Thus, they also go under general exclusion from a medical policy.

Treatments for Certain Injuries

Most medical insurance policies don’t cover the expense of treatment for injuries caused by the following reasons:

  • Self-Harm, Conflicts, War, and Terrorism: No health insurance and even travel insurance will cover the cost of treatments that are received for injuries inflicted by self or caused by other reasons, such as acts of terrorism, war, and conflicts.
  • Natural Disasters: Injuries caused by natural disasters are also listed under the exclusion as ‘an act of God’.
  • Adventure and Professional Sports: Most medical policies exclude adventure sports and professional sports injuries; however, you can find some insurance policies designed specifically to cover such injuries.
  • Hazardous Activities: Injuries and illnesses sustained from hazardous activities, such as horseback riding and flying a plane, also fall under exclusions.
  • Accidents that involve illegal activity: Even though most health insurance plans cover almost all accidental injuries, they will not cover the expense if accidental injuries were caused due to involvement in illegal activity.
  • Military Training: The training for military training is extremely rigorous and can be even dangerous. Still, most health insurance plans do not cover any injury caused by military training.

Optional Medical Treatments

All health insurance providers offer coverage for expenses for only the treatments that are deemed absolutely essential by your doctor. Any non-essential and optional medical treatments fall out of the scope of your medical coverage. This applies even to the illnesses specifically mentioned and covered in the medical policy. Before a claim is approved, you are required to provide a medical record or statement from your doctor that declares that the treatment you are getting is indeed necessary and not optional. Otherwise, the medical claim will be denied for sure.

Apart from these, there are also other exclusions, such as growth hormone therapy, immunotherapy, contraception, prosthetics and other similar aids, and treatments and services received from healthcare providers outside of the network of your insurer.

After seeing this long list of exclusions, you might think that investing in health insurance is not worth it. On the contrary, there are still so many benefits of having a health insurance policy that will protect you from the rising healthcare costs in the UAE.

It is extremely important and even mandated by the UAE government for every resident to have at least a basic health insurance plan. Even if there are exclusions in every medical policy, you can still find a great health insurance plan with the help of a dedicated health insurance broker.

At New Age Insurance Brokers, we strive to help our clients choose the best health insurance plans for themselves and their families. Your financial security, happiness, and optimum health are our priorities. So, before you make the final decision, get in touch with us to find a health insurance plan that best serves your medical needs.

Steps to Take During an Emergency Medical Situation

side-british-ambulance

A medical emergency can take place anyplace and at any time. It is a circumstance that demands immediate action. The primary role of a person should be to focus on first aid and contacting emergency care at 998. Calling a healthcare professional will help you respond and treat any emergency. Remember, your action can save someone’s life.

A few noticeable conditions in an emergency medical condition include excessive bleeding, heart attack or stroke, burns, breathing problems, chest pain, seizures, shock, and head injury. When you see this happen, you should take the necessary actions.

Here are some steps to follow during an emergency medical situation:

  1. Recognize if Emergency Exists

You can confirm the emergency by checking for particular signs. The indicators are:

  • Dilated pupil
  • Slurred speech
  • Difficulty in breathing
  • Chest pain
  • Sleepiness
  • Unexplained confusion
  • Uncharacteristic skin color
  • Pale face
  • Unconsciousness
  • Sweating
  1. Taking an Action

In a medical emergency, time is a valuable thing. So, as soon as you recognize the signs, you should take immediate action. The action can involve:

  • Calling for medical assistance at 998
  • Offering comfort to the patient
  • Giving first aid to the victim
  • Any other service you can provide at the moment

You can help in a medication situation in several different ways. Sometimes people cannot recognize the medical emergency, while other times, they don’t care to act. But if you can help, you should take action because it can save someone’s life.

  1. Contacting Emergency Professional

Generally, people give comfort and confidence to the patient, which often helps them calm down. The next thing is to call an emergency expert because they can begin the treatment right away as they arrive.

  1. Care for the Patient Until Professionals Arrive

Avoid moving the patient from their place until they’re at risk. That’s because you may not be aware of where the injury is; so, it’s best to leave it for the professionals. The conditions that are life-threatening emergency are:

  • No breathing
  • No pulse
  • Severe bleeding
  • Unconsciousness

So, until the medical help comes, check for changes in the patient’s breathing level and whether they’re losing consciousness. Help the victim rest comfortably but without moving their body. Protect them from getting overheated or chilled.

Preparation for a Medical Emergency

  • Keep a First Aid Box

Prepare your first aid box that should contain scissors, roller bandage, antiseptic cream, pain killer, sterile cotton, and thermometer. Replace the item before its expiry. Also, keep the box in a safe and accessible place.

  • Save Crucial Contact on Speed Dial

Save all the vital contact you may need in case of emergency on your speed dial. These numbers can include the number of medical professionals, partners, neighbors, relatives, and friends.

  • Knowledge of the Medical Clinics Nearby

You must know the address and name of the hospitals near you.

It is essential to have medical insurance. Many people are unable to treat the condition because of no insurance coverage. Given the current expense of medical cost, it is best to get coverage.

  • Basic Training Against an Emergency Situation

Take some basic training to life support causes. Almost every hospital runs these. It can help save the life of many people.

The Bottom Line

Emergencies are often overwhelming and frightening. You may have a hard time deciding, so follow these steps during an emergency medical situation.

New born? How to Buy Medical Insurance for Your Newborn

Holding Hands

When a little one is born into a family, his/her protection is the topmost priority of new parents. If you are expecting a little one to enter this world soon, the first thing you should do is to have a medical plan for your newborn. Medical costs are exorbitant in the UAE, especially in private healthcare facilities. Having medical insurance for your newborn will offer protection in the unfortunate circumstance when the newborn might need immediate medical attention.

Today, we will discuss different health insurance options available for a newborn child in the UAE.

 

How to Obtain Medical Insurance for Your Newborn in the UAE?

For Dubai visa holders as per DHA Circular, a newborn baby is covered for the first 30 days under the mother’s policy. Within this period parents have to arrange medical insurance for newborns. For non-Dubai visa holders, parents have to arrange medical insurance for the newborn earlier. In order to do that,

 

First, Check Whether Your Company Insurance Policy Covers Your Newborn

As an expecting parent, your first step is to confirm whether your company covers dependent in their group policy. If yes, your newborn can be added on a pro-rata basis with the same benefits. As soon as you receive the birth certificate number, you should send a request to the insurer for adding the dependent (newborn) to the policy.

If your company does not cover dependent, then you can opt for a separate individual plan. You have the following two options when choosing a separate health plan for your child:

  • For Dubai visa holders, one option is getting a basic policy with Minimum Essential Benefits as mandated by the DHA.
  • Those seeking better medical coverage and for those living outside Dubai, one can get a comprehensive insurance plan from private insurers in the UAE

 

  1. Basic Policy with Minimum Essential Benefits as Mandated by DHA – For Dubai visa holders only

With a basic policy, the provider pays for only medical expenses that are absolutely essential, as mandated by the Dubai Health Authority (DHA). Any medical expense that falls out of the scope of minimum essential benefits will be paid out of your pocket. You can check the basic policy through this link.

 

  1. Comprehensive Insurance Plan from Private Insurers in the UAE

If you want greater coverage for your newborn, you can consider buying a comprehensive plan which comes with a wide variety of benefits and flexibility in terms of choosing desired healthcare providers, such as hospitals and clinics.

However, most of the insurers are reluctant to provide a child-alone policy, and those who provide separate medical insurance for your child require you to provide insurance proof of both parents.

To buy a comprehensive health plan for your baby, you will need to submit mandatory documents that include a medical application form (with the declaration of any ongoing condition) and a birth certificate.

When you choose to obtain a health insurance policy for your newborn child in the UAE, it protects your baby against the rising costs of quality health care for the rest of his/her life.

 

Can I Add My Newborn to My Existing Health Plan?

Parents with self-sponsored/individual plans can get their newborn added to the same health plan. Most healthcare insurance providers allow Dubai residents to make their newborns a part of the family’s existing health plan and provide newborns with immediate access to the entire range of covered benefits.

 

Do I Get Free Newborn Child Benefit in the UAE?

Yes. The majority of insurers in the UAE offer a Free New Child Benefit as part of their maternity cover. This benefit enables your baby to get a pre-defined amount of health coverage. However, once the financial limit or time limit is exhausted, you are required to file a new medical application with the insurance provider to ensure that your child gets continuous insurance protection.

Another thing you must know about Free New Child Benefit is that once this benefit is exhausted, any of your child’s medical conditions will be labeled as a pre-existing condition when you will apply for new coverage. While this alternative seems budget-friendly, it can be risky if your baby develops a medical condition in utero.

Before we end this discussion, let’s take a look at the changes that the Dubai Health Authority (DHA) has made regarding health access for newborn babies with parents holding Dubai visas in the last couple of years.

 

No waiting period

No insurance provider can deny the treatment for any health condition for the first sixth months when adding a newborn baby to an existing plan/group policy or buying a new health plan for the newborn. So, as a parent, you don’t need to worry about paying out of your pocket for the treatment your baby needs from day one.

 

Backdating is allowed

You can add or enroll a newborn child with a start date that can be 7 days prior. This way, medical insurance covers all the medical expenses from your baby’s first day. If the baby is initially covered under the maternity cover, then the start date of baby insurance can be backdated and any expenses will be deducted from the child’s health policy instead of the mother’s insurance.

However, you must know that even though DHA has waived the waiting period in Dubai, there might be a waiting period before you can get your newborn added to your existing health plan in other parts of the UAE. Thus, you should also confirm whether the waiting period is scrapped if your emirate is other than Dubai.

If you have any queries about Newborn Child Insurance options in the UAE, feel free to contact us anytime at info@newageib.com or 04-3573378.

6 Things to Consider While Buying a Medical Insurance Plan in Dubai

medical insurance in Dubai

Medical insurance is a secure insurance plan under which the insurance company covers the medical costs or guarantees compensation for medical expenses of hospitalization in case the insured falls ill or meets with an accident, like falling down a staircase.

The importance of medical insurance has substantially increased these days. Undoubtedly, Dubai is bestowed with an advanced healthcare system, but medical costs are very high, especially in the private health sector. This is why buying the right medical insurance in Dubai can help you carry the burden of heavy medical bills should you have a medical emergency.

You must choose the right medical coverage that encompasses your medical expenses fully or to the extent possible. Thus, here, we are going to discuss the things that you need to know upfront before you choose a medical insurance plan.

  1. Mandatory Health Insurance

In Dubai, it is mandated that all employees, workers, and ex-pats must have medical/health insurance from their employers or sponsors regardless of their salaries. This insurance must provide at least the minimum limit of coverage as defined by the Dubai Health Authority. This way, the Dubai government makes sure that even the employees with a low pay scale can have access to adequate healthcare.

  1. Quality of Healthcare Facilities

If you are an ex-pat from the USA, UK, Canada, or another country with robust healthcare infrastructure and residing in Dubai to explore education, job, and business opportunities, you can have peace of mind. The quality of healthcare facilities in Dubai matches the standards of western countries. Besides, you have an added advantage that the cost of certain surgical operations is considerably less due to less expensive labor and different forms of medical insurance plans.

In Dubai, you have a wide range of choices as there are local and international plans, basic and premium plans, and plans with deductibles and no deductibles. By having the right insurance consultant, you can easily find which medical insurance in Dubai would suit you best.

  1. Geographic Coverage

While choosing a medical insurance plan, you also need to take the type of geographic coverage into account. You need to decide how frequently you go to other emirates or foreign countries. Some medical insurance plans cover only your city, some plans cover the entire UAE, regional plans may provide coverage in GCC countries or MENA regions, and some plans also cover international trips. International insurers also provide direct billing facilities outside UAE so you can enjoy cashless facility by just carrying your medical card.

  1. Maximum Coverage 

Maximum coverage is the ceiling amount that your plan offers annually and it is aggregated based on the limit of your medical insurance plan. The lower your maximum coverage, the lower your premiums. The higher your maximum coverage, the more robust your medical insurance plan is.

  1. Maternity Benefits

Maternity benefits must be considered if you are getting married or starting a family. So, check if all the services (outpatient as well as an inpatient) required by you are included in the plan. Outpatient services include lab tests, ultrasound scans, and prenatal checkups, while inpatient services include the delivery of the baby and any emergency medical procedures. Also, while getting an individual medical policy, one must also confirm if there is any waiting period on maternity.

  1. What’s Not Included

There are a lot of things that some medical insurance plans don’t cover. So, you need to search this list to see whether your particular requirements are included in the plan or not. For instance, if you want your dental treatment to be covered, you need to make sure that it is included in the plan. Alternative medicines, dental, optical are optional covers depending on the plans you choose. However, there are certain exclusions that are applicable on all plans. These include cosmetic treatments, supplements, diet plans, medical equipment etc.  Checking exclusions is important so that one knows fully well what is covered under their medical insurance plans.

At New Age Insurance Brokers, we can review your current insurance plan to see if it meets all your needs and also recommend the right plan for you and your family. Reach out to us for a free consultation and we will ensure that you get the best plan that suits your exact needs.