What to look for in health insurance?

What to look for in health insurance?
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7-key points one should know about health plan...

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By Ambareen Musa

Published: Sun 13 Mar 2016, 5:05 PM

Last updated: Sun 3 Apr 2016, 2:45 PM

The Dubai health insurance Law No. 11 in 2013 makes it mandatory for all residents to be covered by a level of health insurance that meets or exceeds minimum benefits stipulated by DHA (Dubai Health Authority). This plan for compulsory health insurance was rolled out in three phases, with the last phase scheduled to be implemented by June 30, 2016.
Essential benefits plan - making health insurance affordable
To ensure that sponsors aren't overburdened with the cost of providing insurance, DHA assessed a number of participating insurance companies and selected seven, which could provide an Essential Benefits Plans (EBP) on a cost effective basis to the segment of the resident population earning Dh4,000 or less per month. The premium for these packages ranged between Dh500-700 per person per year providing adequate cover at a reasonable cost.
In most cases, companies provide health insurance to their employees. However, this cover provided by employers doesn't always extend to spouses, children or dependents of the employees. In such cases, it's the responsibility of the employee or sponsor to ensure that their spouse, dependents and domestic workers are covered.
With the deadline for the third phase approaching, all dependents of residents in the country must have a health insurance cover. Failure to comply will result in the sponsor being held legally liable and fined for non-compliance at the time of visa renewal.
If you're on a lookout for an insurance plan for your family or dependents, the UAE is not short of options. But, remember to compare and search before you pick one. You can also leave your details on Souqalmal.com and our partners we will get back to you with health insurance options. To help you get started with your search, below is a list of policy features you should carefully consider before opting to buy a plan.
Does the plan offer local, regional or international cover?
All insurance providers have a specific list of hospitals and clinics that are covered under specific policies. For instance, 'local' plans are lower premium policies which provide medical cover within the UAE, and don't always include the premium private hospitals. On the other hand, a regional plan will cover all hospitals and clinics. Make sure to check if your choice of doctor or hospital falls under your provider's network, if you're not willing to change your preferences. You may also be interested in paying more for an international cover if you travel abroad frequently.
How much would you be paying out of your pocket?
Health insurance providers will give you options of different cost deductibles, co-insurances and co-payments and your policy pricing will vary accordingly. While deductibles are a fixed amount of your medical bill that you would be paying, co-insurance divides the percentage you and your insurance provider will bear. Co-payment is a fixed sum of money you will be paying on every visit to the hospital. All three of these payments will be made by you towards your medical bill, and your insurance provider will take care of the rest.
How much is the maximum claim amount? Is it enough?
It may not be something you would normally think of checking, it's important to plan for the future when taking a health insurance policy. Predicting how much health care you're going to need is difficult, but you still need to consider the maximum that is being offered by your health insurance provider. In the worst-case scenario where you use up the full amount, you will need to continue paying out of your own pocket.
Pre-existing conditions? Make sure you disclose all details
According to ISAHD (Insurance System for Advancing Health in Dubai), medical cover can't be denied due to pre-existing conditions, and the maximum waiting period for such cover must not exceed six months. When taking out a new policy, your health insurance provider will ask you to disclose any pre-existing conditions and undergo medical check-ups in case you have any. Be sure to disclose all pre-existing conditions to ensure they are covered; failure to do so may result in your claim being denied or disqualified.
What about maternity cover?
Did you know that according to DHA legislations, as of January 2015, various elements of maternity cover were made mandatory in the Dubai. Under the new directives, the minimum level of benefits that must be provided by any health insurance plan offered must include at least eight outpatient maternity visits. Inpatient maternity must be covered up to AED 7,000 for normal delivery and AED 10,000 for complications in childbirth. While the policyholder must pay 10% of the costs, there is no longer a waiting period. New born babies must be covered under the mother's policy for 30 days.
Looking for health insurance for seniors? Be prepared to pay higher premiums
Getting senior health insurance for the over-50s, either for yourself or your parents is costly. Depending on how comprehensive your plan is, the premium for these can go above Dh30,000. Insurance providers factor in pre-existing medical conditions and age, and may require additional medical tests before calculating the final cost.
A few insurance companies may not even provide cover for seniors over a certain age, with 65 being a common cut-off age. If you have parents who have just moved to Dubai from their home country, compare the cost of the local plans with the international plans they were previously on.
The author is the founder and CEO of Souqalmal.com. Views expressed are her own and do not reflect the newspaper's policies.

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