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13 April 2024

Dubai mandatory health insurance: Latest updates... Does your plan cover you?

By Majorie van Leijen

The first steps in the roll out of the mandatory health insurance scheme of Dubai are being rolled out and insurance companies are gradually submitting their new packages, complying with the new requirements.

However, some companies will need a little extra time to toe the line.

In December, the Dubai Health Authority (DHA) announced the timeline of the roll out of the scheme, which is expected to be fully in place by mid-2016.

The insurance companies were the first to be held responsible for complying with the new Law; in order to participate they were required to apply for a permit, for which they had until January.

But, they have been given some more time, as not all companies were able to meet the new requirements.

"At the moment 49 companies have been approved under the new rules.

“We might see some more companies joining this list, as we have given them until February  to comply with the new requirements," explains Haidar Al Yousuf, Director of Health Funding at the DHA.

According to him, there are certain technical requirements that might  "not be very conventional. For example, companies need to show their plans, and they might not be used to that," he explained.

While all insurance companies have been asked to comply with a new set of requirements, the companies that would like to offer Essential Health Benefits (EHB) have the longest list of conditions, Al Yousuf explains.

Essential Health Benefits

The EHB is minimum health insurance coverage that should be available for all citizens, residents and visitors to the UAE.

It is the package tailored for the employee with a salary of Dh4,000 and below, and expected to be offered against a premium between Dh500-700.

"This package caters to a very specific audience, a very large audience.

“The list of requirements for companies that would like to provide this package is much longer. These companies might need some more time to meet these requirements."

Although Al Yousuf would not reveal how many of the registered companies would be providing the basic package, he said that there were "quite some".

The companies that have received a permit can already offer the package.

The full list of companies provided with a permit is expected to be complete in February.

The DHA said earlier that it would announce the list to the public

The EHB package covers the following:

- Access to general physician/ family physician.

- Referral to specialists.

- Surgical procedures.

- Laboratory services: Tests and investigations provided to help a doctor diagnose an injury, illness or condition, or to monitor the effectiveness of a particular treatment.

- Emergency services: Medical attention required for conditions that could lead to serious disability or death if not treated immediately, such as accidents or sudden illness. Prior authorisation is not required for such cases.

- Maternity care – Medical care that women receive during pregnancy (prenatal care), throughout labor, delivery and post-delivery.

Meanwhile, insurance companies will be permitted to offer competitive packages, with an expected average price tag of Dh600.

Companies may also offer varying co-payment possibilities.

However, there are requirements for the co-payment cap.