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Abu Dhabi, UAEMonday 25 June 2018

How to pick the right health insurance for your dependants in the UAE 

From your children to your parents and your maid, here's how to ensure they have the best medical care possible

Health insurance rules in the UAE differ according to which emirate you live in. Getty Images/Tetra images RF
Health insurance rules in the UAE differ according to which emirate you live in. Getty Images/Tetra images RF

Sorting out health insurance for your dependants can be complicated, from dealing with a new-born baby to insuring your parents or a maid - the rules are different across the UAE. Whether you need to organise insurance yourself or it is down to your employer, these are the factors to consider when covering your family and dependants.

How do the health insurance rules differ in different emirates?

It has been mandatory in Abu Dhabi, for almost a decade, for employers to provide medical insurance to all employees and their dependants - unless you have a big family. The onus to insure a fourth child or subsequent children reverts to the employee, says Tarek Bayaa, the chief commercial officer of Bayzat.

In Dubai, as of last year, it has been mandatory for employers to pay for medical cover for their employees. Dubai law states that all dependants, including domestic workers, must be covered for basic health insurance - but the responsibility lies with the visa sponsor, warns Mr Bayaa, and not the employer.

In the northern emirates - Sharjah, Ajman, Fujairah, Ras Al Khaimah, and Umm Al Quwain - companies are not required by law to provide medical insurance to their employees, let alone to dependants. They can choose to provide cover but are not bound to do so. A UAE-wide Federal Law was drafted in 2013 and is with the Ministry of Finance for review.

What about basic plans?

In Abu Dhabi, there are two - the Thiqa for Emiratis and the Abu Dhabi Basic Plan for expatriates, provided by The National Health Insurance Company (Daman). In Dubai, there is the Essential Benefits Plan, provided by 12 companies.

All employees under the Abu Dhabi Basic Plan have to pay half of the insurance policy’s premium for their dependants (wife and three children) and fully bear the costs for parents.

How much am I covered for under a basic plan?

By law, the maximum cover per person per annum is Dh150,000 in Dubai and Dh250,000 in Abu Dhabi - which may not go far in the case of an emergency or ongoing treatment. Employers may choose to go higher than this, but are not obliged to.

What about additional benefits?

Your employer may only provide you for certain benefits but not, say for dental, eye care or vaccinations, says UAE wealth and wellness planner Rasheda Khatun Khan. It may be cheaper to cover yourself for additional benefits, she says, as you normally cannot add to a policy in between anniversaries.

Do the whole family need to be on the same plan?

No – and there are specific cases where you may end up on different plans, as in the example of a fourth child in Abu Dhabi. Most Dubai companies offer Dubai Health Authority compliant plans that can be offered to spouses, says Mr Bayaa.

A few companies do require that the whole family be insured under the same plan under the principle of "anti-selection", he adds, as there is a “higher risk of claim-related loss in insuring only part of a family” compared to the risk being spread across a larger group and a higher total premium for a whole family. Do ask about this before you go ahead with a plan.

My wife is pregnant - is the pregnancy automatically covered?

In both Dubai and Abu Dhabi, it is mandatory for all married women to have maternity cover as part of their insurance plan. For Dubai visa holders, normal delivery must be covered up to Dh7,000 and a required caesarean section to Dh10,000, says Mr Bayaa. But if a woman is already pregnant before applying for medical insurance, the insurance company would charge a “significantly higher premium” to insure her, with her premium potentially rising from Dh5,000 to Dh20,000.

“The cost of having a baby varies by hospital,” says Ms Khan, “but most covers are quite low. You have no idea if it’s going to be an emergency situation in the end, then you don’t have a choice but to pay the extra.”

Michael Routledge, the founder of savememoney.ae, says his wife’s insurance plan covered Dh25,000 for pregnancy and birth, but that the birth alone, an emergency Caesarean, cost Dh38,000. “To receive the higher cover for pregnancy we had to take a global policy with our insurer, which we did not need,” he says, “but there was no other option to increase the pregnancy cover. After pregnancy, he adds, his wife’s insurance premium increased by Dh5,000 a year. “Insuring my wife is more expensive than insuring me,” he adds.

Is my new-born baby covered?

If a pregnant woman is covered already, the new-born is then covered for 30 days from birth, says Mr Bayaa. Although “medically unnecessary” treatments are not.

But Ms Khan warns that if a new-born is covered within the maternity package, the insurance money available could already have run out with the cost of the birth.

New parents should begin the process of applying for insurance for their new child within the 30 days the baby is covered, to ensure they are covered from day 31. Mr Routledge says this process could be a lot “slicker” as his son was left uninsured for weeks while waiting for his birth certificate, his new passport to arrive from the UK and his visa and Emirates ID.

Ms Khan adds that, to speed the process up, most medical insurance companies will now accept a copy of the Emirates ID application form instead of the actual identity card - the same goes for insuring other dependants.

What about my parents?

Premiums for senior health insurance aged 50-plus can top Dh30,000, according to Souqalmal.com, a price comparison site, which could be higher than insuring a spouse or children. Sixty-five is a common cut-off age, it adds, and some insurers may refuse to cover pre-existing conditions, whack the premium up if they do, or even stop covering them later on. There may also be a waiting period of up to 24 months before pre-existing conditions are insured. The comparison site advises that it may be cheaper to get a family plan.

What about insuring my maid?

A maid’s insurance needs to be processed by the head of the household, who sponsors her. Typically, says Ms Khan, families choose a “minimal plan” for emergencies and A&E listed hospitals. Some basic individual plans start from Dh650, says Mr Bayaa, but you can get more comprehensive plans for tertiary dependants or domestic workers, depending on age.

How do I choose an insurance plan?

“We always ask at our doctor’s reception to see which insurers are better,” says Mr Routledge. The DHA website, isahd.ae, lists all 46 registered insurance providers in the UAE. Bayzat.com, Souqalmal.com and Compareit4me.com all provide comparison tools for health insurance.

Ms Khan adds that you should look for the hospitals you prefer then check which insurers provide direct billing (so you will not have to pay and claim back) for those. International plans are always better, “ she says. “You are covered worldwide and the claims process is so much faster.”

Should I just pick a basic plan?

No, says Ms Khan. “Healthcare is so important and medical insurance is one of those things you will use, even just for an annual medical check-up. If you just choose a basic plan, it becomes a cost of no value. As you have to pay the cost anyway, you may as well get the plan you want.” Plus, she warns, “so many people get into debt because of bills they can’t pay.”