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Health Insurance in UAE: Benefits and Legal Framework

Health Insurance in UAE: Benefits and Legal Framework
Vidur Dhawan
10 months ago
366
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Insurance

The idea of insurance was generated while to protect the loss of goods during inland transit between the Chinese and Babylonian merchants. The idea developed after some time to turn into a business of giving protection against various risks. Presently, the insurance business is entrenched and as yet advancing with the time and needs of the customers. Insurance is a legal contract between two parties – who are entitled to get the protection and the insurance company that promises to compensate for the loss and protect the risk. A fixed amount called premium is to be paid by the insured to continue the insurance plan.

Health Insurance in the UAE

Under the ‘Thiqa’ program, Abu Dhabi Government gives fully coverable health insurance to all UAE nationals, residing in Abu Dhabi. Residents get a Thiqa card, through which they get complete access to countless private and open medicinal services suppliers enrolled inside Daman’s system. It also incorporates broader geographic coverage and extra health benefits.

To be eligible for the Thiqa program, UAE nationals living in Abu Dhabi who are 18 to 75 years of age need to go through the Weqaya screening, made compulsory by the Department of Health – Abu Dhabi. This screening is done to know whether the citizen is already exposed to or prone to cardiovascular risk factors.

On 1st July 2016, under the Thiqa program and the Abu Dhabi Basic Plan, several amendments were announced by the Department of Health in Abu Dhabi. These amendments were done to increase the overall efficiency across the sectors so that the health insurance system can meet both, current and future demands.

For the citizens who currently do not benefit from any government health program, Saada is the solution provided for the citizens of Emirate of Dubai. Once the citizens have subscribed to the Saada plan, all the health insurance-related information is uploaded on their Emirates ID card. This allows them to get access to treatment from various healthcare providers in the Dubai Health Authority healthcare center and the private sector. In Ajman, the government provides health insurance to all employees and citizens. The Ministry of Health in UAE, oversees the healthcare regulation of Ras Al Khaimah, Ajman, Umm al Quwain, Sharjah, and Fujairah. Some of these Emirates have also incorporated their institutions concerning health care. In Emirate of Sharjah, all the employees and their dependents who are working for the government are provided with health insurance, while it is not necessary for all of the Emirates, for the employer to provide health insurance to employees and their dependents.

Health Insurance Benefits

Since the launch of the Saada program, many citizens of the Emirate of Dubai has registered for the same. The citizens welcome the new health insurance scheme with happiness because it consists of many solutions to regular problems and various easing offers to take health insurance. The applicants can get themselves registered in less than 2 minutes online. After they have registered, all the information regarding their subscribed health insurance gets updated on the Emirates ID, which allows them to avail of free health treatment in private hospitals, costing up to Dh 500,000 per person yearly.

In this program, the citizens can fix the appointment with doctors online only and also update information regarding their health. Khaleeji Times reported that there has been quite an improvement in the outpatient clinics of the Emirate of Dubai. The new online appointment feature has cut down the queues outside hospitals. Saada health insurance program has contributed to providing health insurance benefits not just to the office employees but also to elderly people, retired ones, and to those who work in the private sector.

For the employees of the Dubai Government, the Health Insurance Committee aims at developing, modernizing, and raising the level of health insurance benefit. A program called Enaya was launched to meet the same goals. It explains that DHA’s health facilities are based on 4 pillars, namely- quality, effectiveness, patient’s needs, and efficiency of health professionals. Enaya program covers mother and pregnant women from the beginning of pregnancy to the end period. This plan provides insurance for the newborn from the time of birth until he leaves the hospital. Newborn health insurance is provided and is subject to the terms and conditions of expiry. Moreover, the employees get geographic coverage. This means that wherever they are in the world, they will be covered under the health insurance provided by the Enaya program.

To become a Thiqa member in Abu Dhabi, one is required to submit only 3-4 documents and have their membership ready. The cardholders of Thiqa, in the Emirates of Dubai, get an unlimited 12 months health insurance policy. They also get inpatient and outpatient care from the Daman network of healthcare providers. Information regarding the subscribed Thiqa plan is uploaded on the Emirates ID of citizens. It provides 100 percent medical coverage in hospital stays, fees of consultant, surgeon, and any other fees, home nursing, and emergency services in case of a medical emergency. Regarding outpatient clinics, such as Doctor consultations, diagnostic tests, radiology and laboratory test, pharmaceutical, psychotherapy, etc is fully covered under the health insurance policy of the Thiqa program.

In the case of pregnancy and pregnant mothers, the health insurance policy includes accommodation and care of both mother and child. They also cover the treatment of diseases and complications in childbirth. Infertility treatment for females or males is also provided. Services such as dental treatment, medical equipment, and medications are subject to 50 percent cover in the private sector and 100 percent cover in the public sector.

The legal framework of health insurance in the UAE

Before the expansion of the foreign force within the United Arab Emirates at the start of the millennium, associate degree leader was solely needed to pay some hundred dirhams to get a health card for its staff to be treated at medical facilities.

With the rise in demand for the supply of health services thanks to the surge in population, that needs to be lined by public funds, the authorities aimed to additionally regulate the care sector and guarantee its handiness to residents and the native population.

The care sector within the Emirate of Abu Dhabi was regulated and operated by the Ministry of Health until 1999 once it was replaced by the final Authority for Support and Development of care (GASDH). The aim of building GASDH was to support the Ministry of Health among the Emirate of the United Arab Emirate’s capital. Later the name was modified to “General Authority for Health Services” (GAHS), which was after modified to the Health Authority Abu Dhabi (HAAD).

In 2007, the Emirate of Dubai enacted Law number thirteen for the Year 2007 establishing Dubai Health Authority (DHA) with a “vision to incorporate strategic oversight for the whole health sector in Dubai and enhance non-public sector engagement.”

Abu Dhabi was the primary to deal with the problem of insurance and enacted Law twenty-three for the Year 2005, the insurance Law of Gregorian calendar month 2005 that came into force four months later as explicit in Article twenty-seven of the same law. Abu Dhabi was followed by the Emirate of Dubai once in 2013, the Insurance Law for the Emirate of an urban center, Law no.11 for the Year 2013, was enacted Abu Dhabi and Dubai are the sole 2 emirates of the UAE with obligatory insurance laws. The aim of enacting insurance laws in Abu Dhabi and Dubai was to confirm that each one resident and nationals of Abu Dhabi and Dubai can have access to care services.

The insurance Law of Abu Dhabi has been enforced since 2006, but the insurance of Dubai is within the method of being enforced in phases that supported the employer’s range of staff. The insurance Law of urban centers can become enforced by the year 2016. The Abu Dhabi council approved the regulation “Implementing laws of Law number twenty-three of 2005 regarding the insurance within the Abu Dhabi”. It elaborated on all procedures needed to implement Law no. 23 of 2005.

Both laws need the employer/sponsor to ensure the provision of a minimum level of care services for those below their support. The responsibility falls on the leader to produce such advantages by covering the worker, his wife, and 3 kids below the age of eighteen. In cases wherever the leader doesn’t line dependents, any range of dependents higher than that are mentioned within the law shall be the responsibility of the worker (sponsor of his dependents). Both the governments of Abu Dhabi and Dubai are funding care expenses for nationals registered with the health authorities of each emirate. Under Abu Dhabi law, the minimum level of care services is stated as “Basic Health Insurance Policy,” whereas Dubai law refers thereto because the “Essential advantages arrange.”

Under Abu Dhabi law, minimum health and emergency services, access to a medical care service, tests and investigations, referral to specialists and surgical procedures, and maternity care.

The laws of the Emirates’ impose an inventory of penalties on the violators of the laws. This includes employers, sponsors, and care suppliers. Schedule four of the laws impose a monthly penalty of three hundred Dirhams on associate degree leader or sponsor for failing to buy those below his support. The three hundred Dirhams penalty shall apply for every violation. Whereas, Article twenty-three of the Dubai law imposes penalty travel between five hundred and a hundred and fifty AED for violating the law. Additionally, it’s not permissible for employers to deduct premiums from the worker or to scale back the pay to mitigate the value.

Conclusion

Overseeing all the benefits and legal changes brought inform by the health care and governmental departments in the United Arab Emirates, the citizens are majorly getting benefitted where almost every medical treatment is being covered. The legal framework makes the regulation and processes easy for the departments and companies to provide healthcare in the private and public sectors, to operate accordingly.

About Author

Vidur Dhawan

Vidur has provided legal advice and support to dominant names in various industries in UAE, Asia, Europe, and across the globe. His passion towards the art of cross-examination and understanding human instinct made him a skillful defense attorney that plays crucial roles in maintaining the perfect balance between business and legal guidelines for various multinational organizations. Having received many appreciations for document drafting and the art of internal organizational investigations, Vidur has worked with high-profile clients obtaining favorable results.

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