How to Find an Insurance Plan That Works for You

As per DHA's recent laws, everyone who is a resident of Dubai and employed is covered by mandatory health cover provided by the employer. This also includes Free Zones, dependents of employees working in Dubai (in some cases) as well as domestic workers. This medical insurance covers both emergencies and curative health cover benefits.

The premiums of the medical insurance plans have to be borne by the employer. They are not allowed to deduct premiums from employees salary. However, if a company has different tiers of insurance based on salary, an employee can arrange with his employer to opt for a higher insurance coverage and pay the difference as a deduction of salary. Usually, the highest medical insurance tier in multi-level companies cover dental and optical health up to a certain amount and the difference in premium is not large.

Employees are responsible for paying the deductible or coinsurance amounts specified under the terms of the policy as well as any other treatment costs incurred which are not covered by the policy or which are in excess of any policy limits or sub-limits.

Health insurance packages are broadly classified based on the salary bracket of the employee. Employees under the AED 4000 salary range are provided with an Essential Benefits Plan that covers basic medical consultation, tests, medicines and maternity for a premium of AED 700.

As the salary goes higher, employees may be provided with plans which cover dental and optical health benefits too.

The DHA has also made maternity and new-born cover mandatory under all coverage plans of up to AED 7000 for normal delivery and AED 10000 for Caesarean delivery.

Ante-natal or out patient treatment is covered subject to 10% co insurance, with a maximum of 8 visits for regular check-ups during the pregnancy. Additionally, investigations like blood tests, urinalysis and 3 ultrasound scans are covered.

New-born babies are covered for up to a period of 30 days, including neo-natal screenings and mandatory vaccination.

Under the new DHA regulation, all medical / health insurance plans should cover pre-existing medical conditions up-to AED 150,000, after a waiting period of 6 months. However, it is mandatory to declare any pre-existing condition when applying for cover. The insurance provider will determine the premium based on the medical history of the insured.

In the case of pre-existing conditions, there is usually extra premium charged. In the unfortunate event of willful or ignorant non-disclosure; the claim will be declined by insurance providers, causing unnecessary delays and confusions during treatment.

In order to avoid hassles in future, make sure that your preferred clinic or hospital is included within the approved network of the particular plan. Different providers have different names for the network lists and bear in mind that a premium network with one insurance company may not be the same as the premium network with another insurance company. Make sure your preferred list of clinics is on the plan as desired.

This is also to be noted for geographical cover. Terms such as 'Local', 'GCC' and 'Worldwide' might have different implications to different insurance providers. Ensure that yoru desired provider explicitly confirms the geographical cover of your plan. It is noticed in Dubai that local covers all emirates. GCC covers the Middle East and Indian Subcontinent and Worldwide covers the globe with the exception of USA (although a higher premium may be paid to cover the States too).

Most plans have a co-insurance and or a deductible. You can play with different options of deductible and co insurance to arrive at the premium suiting your budget and coverage needs.

if you think that you or your family members may have to access health care quite frequently, then you should opt for the plan with lesser co insurance and/or deductible, other wise it would be prudent to choose an option with a higher co-insurance and or deductible since the services provided are better.

These pointers will help you determine if the plan you are currently under is beneficial for you or not. However, you should always consult an insurance broker if you need a plan that will be tailor-made to suit your needs. Think of shopping for insurance as buying a car - you need to find one that will fulfil your requirements, provide value for money and is beneficial to everyone who's a part of the plan.

And as a general reminder, always carry your original insurance card with you as most clinics and hospitals are very strict when it comes to issuing claims.