Compulsory health cover for expats in capital

ABU DHABI — The President, His Highness Shaikh Khalifa bin Zayed Al Nahyan, has issued Law Number 23 for 2005 in his capacity as the Ruler of Abu Dhabi which makes it incumbent upon all expatriates in the capital to be covered by health insurance.

By (Wam)

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Published: Sun 11 Sep 2005, 10:46 AM

Last updated: Thu 2 Apr 2015, 9:17 PM

Article 2 of the law stipulates that the system shall, thereinafter, be applied on all foreign residents of Abu Dhabi. Expatriates who are on parent-sponsored visit visa may also be covered by the system.

According to article 3, categories of people who are exempt from the provisions of the law include:

1. Employees of the companies operating in the emirate which have their own certified (approved) medical facilities, provided that exemption is sanctioned by the Abu Dhabi General Authority for Health Services (GAHS)

2. Foreign wife of UAE citizen.

3. Children of national women married to foreigners.

4. Visitors on tourist visa.

5. Those who may be exempt following a resolution by GAHS which must be endorsed by the executive council.

Unless otherwise stated in articles 2 and 3, all foreign residents and their family members must participate in the compulsory health insurance system. The system is, however, optional for UAE citizens.

The law obliges employers to participate in the health insurance system for all their employees. The employer shall secure health insurance to each employee, along with wife and three children under the age of 18. It is mandatory for the employees to secure health insurance to the persons they sponsor, who are not covered by the employer.

The law links issuing of residence visas to foreigners and their families with their compliance to the provision of participating in the health insurance system.

Companies licensed by GAHS to operate in health insurance shall provide services to resident foreigners, their families and others who are willing to benefit from such services.

Health insurance companies shall pay the cost of the insured treatment to the medical treatment providers.

The law states that health insurance companies may not own, manage or co-manage treatment facilities or offer in any form treatment services.

Treatment providers may not own, manage or co-manage such companies.

Article 9 of the law stipulates that public and private healthcare facilities shall provide medical treatment services to the insured covered by the heath insurance system. Private providers must obtain permission from GAH to offer such services.

Article 12 identifies medical treatment services covered in the health insurance system, including: check up and primary healthcare by general practisioners and specialist doctors at clinics and health centres, laboratory tests and X-rays, in-patient treatment, dental and gum treatment, excluding orthodontics and dentures and medicines.

Expenses of an escort in critical cases GAHs has the right to add or delete any of the services if needed.

Article 13 specifies cases not covered by health insurance, such

as: self-inflicted injuries, diseases caused by unprescribed dopes or tranquilisers, plastic surgeries, unless necessitated by severe damage, comprehensive check ups, treatment of pregnancy and delivery for women covered as single, recreational treatment and physical fitness programmes, occupational diseases/accidents, venereal diseases communicable through sexual intercourse, expenses of the period that follows diagnosis of HIV, expenses of dentures and bridges and orthodontic surgeries, visual and audio tests, unless ordered by treating doctor, expenses of transporting the insured by means other than licensed ambulances, treatment of hair falling, balding and wigs, psychiatric treatment, allergy tests, equipment, drugs and hormone treatment for birth control and impotence, treatment of deformation that existed before issuance of insurance policy, organ transplant and cases that require treatment abroad.

The law mandates minister of justice, in coordination with the chairman of GAHs to empower some of GAH employees to search the facilities licenced to provide treatment under the health insurance system.

Article 24 of the law states that a penalty of no less than Dh300 shall be leveid on employers/sponsors who refrain from taking part in the system or from renewing the policy.

Violators of the provisions of this law shall pay a fine of no less than Dh5,000 and no more than Dh20,000.

The law shall be published in the official gazette and shall go into effect four months after its publishing.

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