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Basics of Health Insurance: 
 
Different aspects of Health Insurance and why should you take it 
The three most popular things that are insured after life are cars, homes and health. Cars 
can and homes can be rebuilt and renovated but your health almost always in a state of 
degeneration with age. So it is important to keep yourself insured at all times. 
Dr. Haidar Al Yousuf, Director of Public Health Funding at DHA has stated that 75 per cent of 
Dubai expatriates are now covered by insurance, thanks to the mandatory health insurance 
law. 
“This means we have 25 per cent left to cover by June, we hope to have close to 100 per 
cent of Dubai expatriates covered by the insurance by the end of next month," said Dr Al 
Yousuf. 
Dubai Health Authority (DHA) will complete the implementation of Dubai’s Mandatory 
Health Insurance Scheme ISAHD (Bringing Happiness), by the end of June, 2016. DHA is 
currently in the third and final phase of implementing the scheme on companies with less 
than 100 employees, including all spouses, dependents and domestic workers. 
Typical benefits covered under a health insurance policy: 
• Inpatient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric vision
• Outpatient benefits
 
Types of Health Insurance Policy  
Individual – covered by self or employer: 
Health insurance that you purchase on your own or through your employer which 
covers only the medical expenses related to your health is called an individual policy.  
Family insurance: 
Such a policy covers an individual and their immediate family members including 
spouse, children and/or dependent parents. The policy can have a fixed coverage for 
each individual or a total coverage “floater”, which can be shared among all 
members.  
Do you know what insurance premium is? 
Premium is the amount the policy‐holder or their sponsor (e.g. an employer) pays to 
the health insurance provider for providing coverage. 
o Some of the popular health insurance providers in the UAE are: 
1. Axa‐gulf 
2. Aetna 
3. Bupa 
4. Orient Insurance 
5. Dubai National Insurance.. & many more 
 
 
Some health insurance terminology 
o Co‐payment:  The policyholder has to pay a certain percentage of the overall 
treatment cost. In the UAE, maternity benefits usually have 10% co‐payment, 
whereas dental treatments typically have a 20% co‐insurance. 
o Deductibles: Deductibles are fixed charges that policyholders have to pay out of 
their own pockets when undergoing a treatment. Also known as co‐payment or 
co‐insurance, there are a few types of deductibles: 
Generally, there are three types of deductibles available to customers: 
Annual Deductible or Excesses 
With an annual deductible, the insurance company will not start paying for any 
treatments until you have paid up to the deductible amount from your own 
pocket. Let’s say your health insurance policy has an annual deductible of AED 
1,000, and your overall medical expenses in the first six months amount to AED 
1,500, then you are supposed to pay AED 1,000 while the insurance company 
will cover the remaining AED 500. In addition, for the next six months, the health 
insurance company will cover the cost for medical treatments while you pay 
nothing. Annual deductibles are not very common in the UAE, of the 
approximately 100 medical insurance plans on Bayzat.com, only a handful (such 
as Bupa health insurance plans) have an annual excess. 
Fixed Deductible per Visit 
This type of deductible is very common in the UAE. Usually, the policyholder will 
have to pay a fixed amount for each outpatient visit to the doctor. This can range 
from AED 30 to AED 75 per visit. In the UAE, fixed deductibles typically only apply 
to outpatient treatments, which refers to procedures or doctor visits where you 
are not hospitalized overnight. With most medical insurance plans in Dubai and 
Abu Dhabi, the insurer covers in‐patient costs (i.e. when you are hospitalized) 
without applying a deductible. 
Co‐Insurance or Co‐Payment 
This is a form of cost‐sharing whereby out of the total amount paid for a medical 
treatment, the policyholder pays a percentage of the cost. Of course, this can be 
a risky type of medical insurance to purchase if you get very sick or require an 
expensive procedure. Some health insurance plans might have a fixed deductible 
per visit, combined with co‐payments for specific benefits. In Dubai, it is 
common to see a 10% co‐payment for maternity benefits, and up to a 20% co‐
payment for dental benefits. 
 
Know your exclusions 
Exclusions are specific treatments or conditions that are not included in your 
plan. Every health insurance plan in the UAE will come with exclusions. It is 
important that you thoroughly review the plans beforehand in order to find out 
what is covered and what is excluded under the policy. There are certain 
ailments that are permanently excluded. When choosing a health insurance 
plan, talk to an expert about specific medical conditions you want covered to 
make sure they are not excluded. 
o Pre existing disease : 
Some of us mistake pre‐existing conditions as ‘an illness or condition that a 
person might have at the time of buying a policy’. 
Well, pre‐existing condition does not only refer to an illnesses that a person has 
at the time of buying a policy but it also includes a thorough medical history of 
any condition ranging from heart attacks, diabetes, past hospitalizations, any 
surgeries, medications for any disease or illnesses like high blood pressure or 
thyroid, skin disorders, major accidental injuries and any signs or symptoms such 
as increase in sugar, or high blood pressure. The insurance company wants to 
know about absolutely any disease, condition or injury you’ve had 
Many insurance companies in the UAE now provide cover for pre‐existing 
conditions, however, there are a few steps they take to mitigate their risk.  
Some methods like Premium Loading , Waiting Period , Premium loading + 
waiting period , Exclusion of Pre‐existing conditions ..etc will likely impact you if 
you have an existing condition: 
 
• Tips to select a health insurance plan : 
o Choose your insurance company wisely 
o Plan according to your future needs 
o Make an informed decision about the type of health insurance 
o Think  on amount of ‘sum assured’ 
o Check the empanelled hospitals 
o Understand the premium calculation process 
o Read the fine print (clauses) 
o Check waiting Time 
 

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