What Does a Basic Medical Insurance Cover by DHA Include?

Are You Covered Healthcare Insurance Protection Concept

The UAE has one of the best healthcare infrastructures in the world and is an attractive place for expats looking to move there. Today, health insurance is obligatory for Dubai nationals and residents. The UAE nationals are covered under government insurance programs. On the other hand, expats with a valid Dubai residency can avail of medical insurance services from registered insurance companies.

If you’re not a UAE national, you’ll require private medical cover. Your employer is legally required to provide you with basic medical insurance. However, it may not include your dependents. If you want to bring your family with you to Dubai, it’s better to take private health insurance.

Medical Coverage in Dubai:

  1. Basic Health Benefits

Medical Coverage

The Essential benefits plan covers the following subject to an annual limit of Dh 150,000 per insured member per year.

  • In-patient Treatment: It includes non-urgent (emergency and non-emergency) medical treatment, including tests, surgeries, and diagnosis-20% copay max cap of AED 500 per encounter.
  • Basic plan covers companion and parent accommodation (for children below the age of 16). The cost of accommodating individual accompanying an insured child up to the age of 16 years is max 100 AED per night.
  • Out-patient Treatment: This includes examination, diagnosis, and treatment routinely, with 20% paid by the insured
  • Lab tests, physiotherapy sessions (at most six per year), and radiology tests with 20% payable by the insured
  • Preventive medication or immunization procedures for newborn babies and children
  • Medicines – up to Dh 1,500 per individual, including 30% paid by insured per prescription.
  • Emergency health care and ambulance service during an emergency.
  1. Maternity Benefits

  • Three antenatal ultrasounds, antenatal blood tests, eight pre-delivery visits
  • The newborn is covered under the mother’s insurance scheme for 30-days from the date of birth – for screening, neo-natal tests, and other tests.
  • Initial investigations of anti-natal services include:
  1. FBC and platelets
  2. Blood group, Rhesus status and antibodies
  3. Venereal disease research laboratory test
  4. MSU and urinalysis
  5. Rubella serology
  6. FBS, random s or A1c
  7. HIV
  8. Hep C (if necessary)
  9. GTT (if necessary)
  10. 3 antenatal ultrasound scan

Visit to include reviews, checks and tests in accordance with DHA Antenatal Care Protocols.

  • 10% copay is applicable on all such services.
  1. Pre-existing or Chronic Conditions

Assert any pre-existing or chronic medical conditions at the time of the insurance application. The insurance company will provide comprehensive coverage for those conditions after a six-month waiting period. During the waiting stage, any emergency health care related to the disorders will be covered like any other claims under the program.

  1. Geographic Coverage Offered by the Plan

The basic healthcare services are covered within the Emirate of Dubai. On the other hand, Emergency medical treatment is covered within all emirates of the UAE. However, insurer can extend the geographic scope of coverage at their discretion.

Decide the type of geographic coverage you require. Make this decision based on visits that you make abroad. Some plans will only cover your city, while others will provide you the coverage in the entire UAE.

Some insurance companies offer international plans. Thus, these plans can cover you outside the UAE.

  1. Medical Network Coverage

An insured person can have direct access to provider’s available in network list suggest by insurer under basic plan. Generally, this network is limited and member can visit network hospitals for inpatient services and network clinics for outpatient services. The network coverage list differs from insurer to insurer. Thus, it’s essential to go through network list to know best providers.

Things Not Included in the Medical Insurance Policy:

There will be several things that won’t be included in your basic medical insurance plan. You must check the list to ensure that your claims are included in your policy. Also, check the exclusions so that you select a suitable option. Thus, in this way, you minimize the risk of getting your claims rejected.

The Bottom Line

In recent years, UAE witnessed several casualties due to a lack of health coverage. Thus, medical insurance became mandatory in Dubai and other Emirates.

You must do thorough research regarding health care coverage and seek insurance providers that will facilitate you in the longer run.