Medical Insurance

Medical Insurance, also known as health insurance, is a deal between the insurer and the insured under which the insurer pays for the insured's medical and surgical expenses. A Medical Insurance policy is the best and most reliable form of offering financial security to the policyholder's family. In the United Arab Emirates, Medical Insurance is a mandatory requirement. If your company does not have health insurance, you will have to purchase it privately for yourself and your family.

A good Medical Insurance policy would protect the policyholder for things like day-care hospitalization, as well as pre and post-hospitalization care. In reality, some of the most well-known health insurers cover cashless hospitalization at network hospitals for the duration of the policy. All medical costs are either billed directly to the health care provider or reimbursed.

There are two types of Medical Insurance available in UAE. They are-

Basic Medical Insurance

Basic Medical Insurance is offered by most of the companies in UAE. These type of Medical Insurance offers a list of predefined hospital with full medical coverage. Orient Insurance Company, Oman Insurance Company and Union Insurance Company gives basic policy. But MetLife doesn’t offer the Basic Medical Insurance. Basic Medical insurance is available for the northern Emirates and Dubai and it is cheaper than Abu Dhabi.

Enhanced Medical Insurance

Enhanced Medical Insurance is much more useful than Basic Medical Insurance as it offers more benefits and medical coverage.

Following are the features and benefits of Medical Insurance in UAE-

Benefits of Medical Insurance

Cashless Treatment

If the insured or any of his or her covered family members is admitted to a network hospital, the insured or any of his or her covered family members will use the cashless care facility for medical treatment. The policyholder only needs to have the policy number, and the hospital and Medical Insurance can take care of the rest.

Coverage for Pre and Post-Hospitalization

Any of the best medical care plans cover pre and post-hospitalization costs for a set number of days before and after the policyholder is admitted to the hospital.

Medical Check-up

A successful health care package entitles the policyholder to routine medical exams.

Transportation Expenses

If the insured is admitted to the hospital, the Medical Insurance coverage will cover the costs of an ambulance ride.

Room Rent

If the insured is injured, he or she will be liable for paying room rent. Medical Insurance guarantees that all of these risks are covered to a certain degree.

No Claim Bonus

When there is no claim received during the effective policy span of one year, the No Claim Bonus is offered as a discount on the premium or as an increase in the amount guaranteed.

Following are the different types of Medical Insurance offered in the UAE-

types of Medical Insurance

Individual Medical Insurance Plan

Individual Medical Insurance policies are sold by Medical Insurance providers in the UAE to a single policyholder, as the name implies. It provides financial insurance against such illnesses as well as a range of benefits such as cashless hospitalization, pre and post-hospitalization treatment, and so on. Only one person receives the entire amount guaranteed.

Family Medical Insurance Plan

Family Medical Insurance policies are the best mix of affordability and coverage when it comes to Medical Insurance  in the UAE. Rather than buying individual Medical Insurance premiums for each family member, family benefits may be used to protect the entire family under one umbrella. The number of policyholders in these types of Medical Insurance policies is typically limited to one partner and a set number of children. The sum guaranteed is shared by all family members covered by the policy in family Medical Insurance policies.

Senior Citizen Medical Insurance Plans

These types of health insurance policies are tailored primarily for people over the age of 60. Health care for senior citizens usually has a lower premium rate. While only a few health insurance companies in the UAE have such policies, they can include a medical test before selling them. Furthermore, since senior citizens are more vulnerable to illnesses and health diseases, such programmes can be marginally more costly than health benefits for young people.

Group / Employees Health Insurance Plans

Employers usually have these forms of health insurance policies. Furthermore, they are structured to include and exclude workers when they enter and leave the company. Because of the low risks involved, community health insurance schemes typically have low premiums.

Plans according to the Nationality

Certain health insurance agencies provide marginally better coverage to UAE nationals than government medical insurance firms in Dubai and other emirates. For expatriates, this form of medical insurance plan has different benefits than for UAE nationals.

Some of the best medical insurance plans available are as follows-

Noor Takaful Health Insurance

It covers Network Hospitals over 1600 care centers and Accidental death coverage.

Inclusions

  • Yearly benefit limit of AED 150,000
  • In-patient co-payment
  • Laboratory services co-payment
  • Examination services co-payment
  • Prescription drugs co-payment
  • Maternity Services

Exclusions

  • Unnecessary healthcare services
  • Dental care
  • Health care services for domestic or internationally recognized epidemics
  • Self-inflicted injuries or suicide

SALAMA Health Insurance

It covers the Critical illness coverage, Medi-claim settlement, International assistance etc.

It also covers Flexible health care insurance plans-

  • Small group health plans
  • Group health plans

Inclusions

  • Home nursing service
  • Chemotherapy
  • Coronary & intensive care unit
  • Organ transplant
  • Parental accommodation
  • Internal prosthesis and stents

Exclusions

  • Vaccination
  • Physiotherapy
  • Consultation
  • Alternative medicines
  • Prescribed medicines
  • Diagnosis like Imaging, Radiology, & Laboratory

Orient Health Insurance

  • Coverage of critical illnesses
  • Flexible health care insurance plans:
  • Orient Care Plus
  • Woman Care
  • Individual & Family Health Insurance

Inclusions

  • Worldwide coverage
  • In-patient & out-patient cover
  • Regional cover
  • Repatriation expense cover
  • Emergency medical evacuation
  • Maternity Benefits
  • Immunization & preventive services

Exclusions

  • Unnecessary healthcare services
  • Home nursing & private nursing care
  • Dental care
  • Obesity treatment
  • Custodial care
  • Health care services for smoking cessation programs

Union Health Insurance

  • Comprehensive coverage
  • Easy claim settlement
  • Individual plans:
  • SANAD
  • Essential Benefits Plan
  • Corporate Plans:
  • Small and medium Enterprises
  • Corporate Plans
  • Essential Benefits Plan

Inclusions

  • In-patient cover
  • Out-patient cover
  • Maternity benefits

Exclusions

  • Unnecessary healthcare services
  • Custodial care
  • Dental care
  • Obesity treatment
  • Contraception treatment & services
  • External prosthetic devices and medical equipment

There are various factors that effects Medical Insurance Policy in UAE. They are as follows-

Age

Health insurance rates for older people can be up to three times higher than for younger people.

Geographic Location

The policyholder's geographic position has a huge effect on his or her health premiums. The cost of insurance premiums is high in some geographic areas due to a lack of nutritious food choices, health and environment problems, and so on.

Individual/ Family Enrolment

Insurance companies can charge a higher premium for health insurance policies that provide coverage for a spouse, children, and/or dependents.

Policy Tenure

The length of a health insurance contract has a huge effect on the cost of medical premiums. The health premium would be lower if a person prefers a policy for a longer term. The premium, on the other hand, would be high for a limited time.

Occupation

The essence of an individual's work and the amount of risk he or she faces at work have a direct impact on the cost of health insurance premiums. 

Tobacco Usage

Health insurance providers charge those who use cigarettes a rate of 50% higher premiums than those who don't.

Body Mass Index

As compared to those who are healthy, those with a higher body mass will experience more medical problems, necessitating more doctor visits. As a result, the cost of health insurance premiums varies depending on an individual's body mass.

Medical History

Individuals with a family medical background are more likely to pay higher medical insurance rates than others because they are more likely to receive additional medical treatment in the future.

Pre-existing Medical Conditions

When purchasing a health insurance policy, policyholders must report any pre-existing medical conditions (if any). Although few plans cover pre-existing medical conditions, some do not, resulting in a higher premium. This has an effect on or raises the rate of health insurance premiums.

Medical Insurance Related FAQ

Frequently Asked Questions

  • Why is it so essential to declare my pre-existing medical conditions?

    Patients are communicated to tell their physicians all about their medical history in order to get the best care, and health insurance policyholders are asked to tell their provider all about their pre-existing conditions in order to get the best coverage. Furthermore, if there are any inconsistencies in the medical insurance policy, the insurance company can cancel the policy.

  • What is the extent of medical insurance coverage in the UAE?

    The regional limit to which a health insurance policy's benefits are available is referred to as the scope of coverage. For example, in the UAE, health insurance with a definition of ‘Within the UAE' would only compensate policyholders for medical services received in the UAE.

  • Are family plans the cheapest health insurance available in the UAE?

    Family policies undeniably deliver some of the best coverage at the most affordable prices, making them one of the most cost-effective health insurance choices in the UAE. Even family health insurance policies, however, have their own limitations, such as a limited number of dependents and other constraints. When applying for a job, it is suggested that applicants spend some time reviewing the different inclusions and exclusions.

  • What are the Medical Insurance Policy for female in UAE?

    Medical insurance Policy for females are expensive because of the pregnancy related costs that occurs to the insurance companies. Whereas policy for female aged below 40 is too expensive compared to female aged above 40.