Compulsory Medical Insurance Update

29/04/2014

Dubai Health Authority [DHA] have released more information regarding the roll out of the compulsory health insurance schemes due to become mandatory for all residents over the next 2 years. Having read through the latest update I have summarised the document in this blog.

Prior to the issuing of the latest update we knew the purpose and timing of the legislation.The purpose was to provide all residents of Dubai with healthcare, particularly the lower paid members of our community who may not be able to afford conventional health insurance or did not have it provided as part of their employment package.

The timing depended on the size of the company concerned. Those with more than 1,000 employees would need to have a compliant plan in place by October 2014, those with over 100 staff by mid 2015 and those with 100 or less by the end of June 2016 when spouses and other dependents such as domestic workers would also need to be covered by their sponsor. We also knew that the basic plan would be required as a minimum for visa renewals.What was lacking was some of the finer details and the names of those companies who are able to provide the products.

The DHA has introduced a number of key parties to the implementation of the Law. These are Dubai Health Insurance Permit Holders [HIPs] and Participating Insurers [PIs.] HIPs are those companies who are allowed to provide insurance policies within the Emirate of Dubai and there are currently 43 companies.

Out of the 43 companies operating in Dubai, 7 have chosen or been awarded the title of Participating Insurer [PI] these companies will be able to offer the Essential Benefits Plan [EBP]. This plan is designed for employees earning AED4,000 per month or less and forms the basis for all of the compliant plans. It is anticipated that the EBP will cost between AED500 and AED700 per annum for each member.The PI’s for 2014 have been announced as follows:

2014 Participating Insurers
AXA Insurance
MetLife Alico
National Health Insurance Company (Daman)
Oman Insurance Company
Orient Insurance Company
Ras Al Khaimah National Insurance Company
Takaful Emarat

So, what are the basic benefits being offered by these companies. We have yet to see the products offered by each of the companies listed but DHA has issued guidelines of what minimum levels of cover will be required to make their plans compliant. There follows a high level summary, please contact me for more information.

1.Geographic Limit

Policy must cover the Emirate of Dubai for elective treatment and the whole of UAE for emergency cover.

2. Annual Claimable Limit

At least AED150,000

3. Pre-existing & Chronic Conditions

Treatment may be excluded for first 6 months of membership but must be covered thereafter. Cover cannot be refused by the insurer.

4. Inpatient Treatment

Emergency treatment, ground transport emergency services, non-emergency treatment, tests and diagnosis including surgery.

A 20% co-insurance will be charged payable by the insured up to a maximum of AED500 per course of treatment and or AED1,000 per year.

5. Maternity Services

Up to AED7,000 for normal delivery or AED10,000 for medically necessary c-section. 10% co-insurance

6. Outpatient Treatment

Drugs and Dressings up to AED1,500 per annum inclusive of 30% co-insurance. No cover in excess of this limit.

Physiotherapy, CT & MRI etc are all available subject to pre-approval

Many insurers are now checking their plans to make sure that they comply with the basic requirements of the DHA plan and in most cases they will provide significantly better cover.

As always I will keep you informed as further information becomes available but if you have any questions please contact me.