Dubai Health Authority (DHA) has issued a law requiring all Emiratis and Dubai expats, including dependents, to have insurance in place to pay for their emergency and curative healthcare needs.
While Emiratis will be handled by a Dubai government-funded scheme, Dubai expats and their dependents will be handled under private health insurance schemes.
The law applies to all economic areas of Dubai including free zones, with its implementation phased in over the past couple of years, initially targeting companies with 1,000-plus employees then moving to those with more than 100 in July.
How Health Insurance Law for Dubai will be implemented:
The new Health Insurance Law for Dubai (Insurance Law No. 11) will be implemented in phases through to 2016, based on company size as follows;
– For employers with employees numbering 1000 or more: 31 October 2014;
– For employers with 100-999 employees: 31 July 2015;
– For employers with less than 100 employees: 30 June 2016;
– For spouses, dependents and domestic workers: 30 June 2016.
How Medical Insurance works in Dubai
Each year, the DHA will set a price range within which Participating Insurers (PIs) must set their premium pricing for the Essential Benefits Plan, the minimum level of benefits any plan can have.
For 2015, the premium range has been set at Dh520 to Dh730 per insured per year.
Companies with existing policies for employees earning less than Dh4,000 will need to satisfy the following two criteria;
– The scheme benefits must meet or exceed those of the Essential Benefits Plan.
– Cover must be provided only by PIs.
If necessary, employers will have to restructure their existing arrangements to meet this criteria by the first renewal date (and no later than 12 months) after the implementation deadline specified for a company of their size.
How Mandatory Medical Insurance Law will impact the Employees
Be aware of employee rights:
Firstly it is paramount that any employee understands his or her rights. This benefit must be provided by the employer and cannot be deducted from your salary and by law an employer cannot reduce salary to mitigate the cost.
Those earning less than Dh4,001 must have a plan provided by one of the nine PIs and cover levels must be equal to the minimum guidelines set out by the DHA.
Spouses, dependents and domestic workers
It will be the responsibility of the employee or sponsor to arrange insurance coverage for their own spouse, dependents and domestic workers and to pay the premiums directly to the insurer.
A company is not obligated to add dependents, so a husband wanting to sponsor his wife, children and domestic helper, for example, may need to take out a separate policy. While some companies will offer to insure an employee’s children at no extra cost, this cannot be on the basic DHA plan. Domestic helpers, though, must be covered on a separate policy.
Residents should compare all the options as the basic cover is designed for low-salaried individuals. The basic plan could be regarded as restrictive (in terms of facilities you can use) and has limiting copay options. It also only works in the UAE so would not cover someone electing for treatment overseas.
What Medical Insurance plans must include
The minimum level of benefits that must be provided by any health insurance plan offered in Dubai must include:
• An annual limit of Dh150,000 per person on all claims per year
• Pre-existing and chronic conditions – covered in full subject to a six-month waiting period
• In-patient treatment – covered with a 20 per cent excess up to maximum Dh500 per encounter or a maximum of Dh1,000 per year.
• Outpatient treatment – covered with a 20 per cent excess
• Cost of medicine – limited to Dh1,500 per person
• Maternity services – eight outpatient visits; inpatient treatment covered up to Dh7,000 for normal delivery, and up to Dh10,000 for medically necessary C-section and other complications. All maternity services are covered with a 10 per cent excess.
This move means everyone in Dubai is now covered to a minimum level. As medical history is disregarded, people who previously did not have access to affordable health care can now be treated.