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Medical (Health) Insurance in Dubai


Deadline: The new deadline for Dubai's mandatory health insurance has been set as March 31, 2017, for employees and their families and December 31 for visitors.

Dubai visa holders who have not obtained health insurance cover will no longer be able to renew their visas.

Also, no new visas will be issued if the individual concerned does not have health insurance coverage in place at the time of visa stamping or renewal.

Linked with Visa Renewal: According to a circular issued by the DHA last month, the system has been developed to monitor and ensure compliance with the law. It's also designed to detect gaps in insurance. For example: if an individual's health insurance policy expires on February 1, 2017 and their visa expires on January 1, 2017, when they renew the visa during January 2017, it will be renewed without any issues.

However, if the individual does not maintain constant health insurance coverage, the system will track and log the gap in insurance upon the next visa renewal, ie, if they were uninsured for two months between visa renewals, they will incur a fine of Dh1,000 (Dh500 per month) at the time of renewal.

Mandatory health insurance is implemented in three phases in Dubai. New visa and renewal are linked to medical insurance.

Phase III that will end on June 30, 2016, all companies with 100 or below employees will be covered.

Grace period for spouses, dependents and domestic workers till end of 2016. read more

In Phase II
that ends on July 31, all companies with 100 to 999 employees will be covered.

In Phase I
of the implementation that ended on October 31, 2014 all companies with above 1,000 employees were covered.

• As of 2016, it will be the employees’ responsibility to purchase medical policies for their dependents living in Dubai.

• With effect from August 1, 2015, no new residence visas or renewal of existing visa applications will be processed without mandatory health insurance coverage in Dubai, for companies under phase II.

• Employers can choose health insurance packages from 45 approved insurance companies that have Dubai Health Insurance Permits.

Employer’s Responsibility: The stipulation for the Dubai directives is that it is the employer’s responsibility to cover its workforce. Unlike the legislation in Abu Dhabi and Saudi Arabia, a Dubai-based employer is not responsible for covering the spouse or dependents.

Essential Benefits Plan: Under the DHA scheme, special consideration has been given to employees earning less than Dh4,000 a month. This category of employees must be insured with one of the seven approved insurers authorised to offer the ‘Essential Benefits Plan’.

Minimum Basic Package, which has a cover of up to Dh150,000, with premiums ranging between Dh565 and Dh650. This includes all the blue collar workers, including domestic help, maids and nannies.
Wife & Children: Dh1750 or a little more unless the dependants are above 60 years of age.

Parents and individuals above 60: Whether employed or a dependant, with or without a history of diseases: Dh2,500. The pre-existing conditions will not be covered for a period of six months and after that everything will be covered.

Maternity: Under the new directives, at least eight outpatient maternity visits must be covered for check-ups and tests. Inpatient maternity must be covered up to Dh7,000 for normal delivery and Dh10,000 for complications in childbirth. Newborn babies must be covered under the mother’s policy for 30 days.

Existing medical policies can continue in their present form until the first renewal date (no later than 12 months) after the applicable implementation date. After this, all benefits must be aligned with at least the mandatory minimum.

Employer Information Pack downloadable from www.isahd.ae

How it works?: There are two ways of applying for a new visa or renewal — manual or electronic. If it is manual the GDRFA asks for the insurance certificate copy to be attached with the application. In case the organisation is applying electronically (www.ednrd.ae) for new visas or renewals, automatically a window pops up on the screen asking for the insurance certificates of all the applicants. Scanned copies have to be uploaded to complete the application process.

Complaints and Feedback: DHA has launched a website ipromes.eclaimlink.ae for consumers to register complaints and provide feedback in case they are not getting all the services promised in their insurance package. The DHA will act on a complaint once it is registered electronically on this website.

The DHA website www.isahd.ae has a comprehensive list of all 46 registered insurance providers in UAE.

Certain conditions excluded: Some medical conditions are standard exclusions in insurance with some insurance companies; these include medical issues at birth, issues caused by medical procedures or research work, radiation, nicotine addiction, sex transformation, as well as hormone therapies, among others.

What does the essential health cover package cover?

The basic cover includes outpatient consultancy at clinics, referrals to specialist and for surgical and pathology investigations, maternity health cover, emergency visit to hospital and any surgeries required. While employers have group insurance schemes for their employees, a resident can shop for a tailor-made cover for his dependants that includes spouse, minors and domestic house help.

What is the maximum coverage and how much is a beneficiary expected to pay?

The beneficiary with basic insurance cover gets a maximum coverage of up to Dh150,000 and has to pay 20 per cent [at every visit to the doctor]. So, if he has an outpatient bill of Dh200 he will have to pay Dh40.

What is a special protection package?

The protection package mandates that although a beneficiary has to pay a minimum of 20 per cent of co-insurance payment in case of a hospital stay or surgery, this is capped at Dh500. So, if someone has major surgery amounting to Dh40,000, even those in the basic package would be expected to pay Dh8,000 as 20 per cent. But the protection package mandates a ceiling of Dh500.

What are the fines and penalties? What happens in case a person has just renewed his visa?

Linking the visa renewal to insurance is a check mechanism. But every individual in Dubai has to get the health cover by June 30. If he or she fails to do this, his employer will be fined for every month beginning from July until the time his visa comes up for renewal. If the individual is a freelancer or self-employed, he will have to pay the fines himself. There are monthly penalties which will be levied with retrospective effect from June 30. Fines can range anywhere between Dh500 per person per month. It is cheaper to get an insurance than to pay for default as the fines are far higher than the actual cost of the essential benefits package.

Although basic cover provides maternity benefits is it true that a woman who is pregnant at the time of getting the insurance will not be covered?

That is true. Insurance is a protection or cover for future conditions or illnesses. So, even if a woman falls pregnant one day after getting the insurance she has to be covered. However if she subscribes to the cover after she conceives she will not be covered. In case of other conditions such as diabetes, hypertension and other lifestyle disease, the insurance will not cover these for the first six months after which all pre-existing conditions have to be covered.

What happens in case a blue collar worker has an accident or cancer?

The insurance company has to pay the bills up to the annual aggregate limit. It is Dh150,000 annually. Then insurance firms are linked to visas and the organisation has the right to take the decision of renewing the visa of an employee with an insurance renewal. But until the validity of the visa, his treatment episodes will be covered.

In the case of newborns who covers their medical expenses?

A newborn is covered under the mother’s health insurance cover for 30 days after which the parents have to get the child an individual cover. The child’s birth complications will be covered to the maximum aggregate limit of the mother’s cover. However, this cover will not include congenital conditions such as cleft palate, club foot, Down’s Syndrome and the like.

What about special needs children?

All special needs children have basic health requirements which will be covered by the regular health cover. Their requirements for flu, cough, cold and regular requirement will be covered. However, the insurance will not cover special services such as speech therapy, special school or physiotherapy.

Blue collar workers

Blue collar workers can get extended coverage in their home country, too.

Blue collar workers are now being offered an essential health benefit package by Takaful Emarat Insurance for Dh625 per annum that will provide them the same cover in their home countries such as India, Pakistan, Bangladesh, Sri Lanka and Nepal at no extra cost. Most South Asian workers come from these countries.

According to Dr Sanjay Patihankar, founder–director of Third Party Admistrator (TPA) for this insurance, said this is the first time that a UAE insurance has tied up with an international insurance provider, Vidal Net, that will give the workers a direct billing option in their home country. “While some insurance companies do provide extension of health services for workers back home, this cover provides direct billing facilities which no other cover in this category provides. The worker will be able to get adequate health cover in their country using the same insurance card with the same aggregate annual limit, etc. In India, for example, beneficiaries of this insurance can go to any of the 25,000 clinics and hospitals across the country.

Such a cover can help the worker in seeking standard medical facilities while on annual leave at home. (GN)

For details of different policies and procedures call:

Qusais (Damascus St): 04-258 6727, 054-300 5931

Naif (Deira): 04-259 6260, 050-538 3545

Bur Dubai: 04-358 6215

Qusais (Al Nahda-2): 04-239 1302

Hor Al Anz: (Deira): 04-265 8373, 050-715 0562
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UAE Employment Visa related service at Thiruvananthapuram. Our package includes: pick from your arrival point (Railway/Bus Stand), Accommodation, Medical (if required), Medical Certificate Attestation using our Credit Card without you standing in the queue, necessary guidance and drop at your travel point.
Explore International, Call +91-95 390 51 386, +91-894 33 28 266

 

   

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