Basic Health Insurance in Dubai

Basic health insurance helps Dubai residents access essential medical services through an approved healthcare-provider network. Dubai’s minimum health-insurance standard is commonly known as the Essential Benefits Plan, or EBP.

The services available under a policy depend on its schedule of benefits, assigned medical network, annual limits, co-payments, exclusions, waiting periods and approval requirements.

Who Needs Health Insurance in Dubai?

Medical coverage must be arranged according to employment and sponsorship:

1. Employees: Employers must arrange suitable health insurance for eligible employees working for Dubai-registered companies, including applicable free-zone companies.
2. Spouses and Children: Sponsors are responsible for arranging coverage for eligible dependants when they are not insured through another valid policy.
3. Domestic Workers: Sponsors must arrange suitable medical insurance for eligible domestic workers under their sponsorship.
4. Self-Sponsored Residents: Investors, freelancers and other self-sponsored residents may need to arrange their own health insurance.

What May Basic Health Insurance Cover?

Depending on the issued plan, benefits may include:

1. Outpatient Consultations: Eligible consultations with general practitioners and approved specialists within the assigned network.
2. Diagnostic Services: Medically necessary laboratory tests, scans and other investigations, subject to benefit limits and approval requirements.
3. Prescribed Medicines: Approved medicines may be covered according to the applicable formulary, policy limit and co-payment.
4. Inpatient Treatment: Eligible hospital admissions, surgeries and related medical care, subject to medical necessity and pre-authorisation.
5. Emergency Treatment: Emergency medical services may be covered according to the policy terms and geographical limits.
6. Maternity Services: Eligible maternity benefits may be included, subject to applicable limits, co-payments, waiting periods and policy conditions.

How to Use a Basic Medical Policy:

Follow these steps before receiving non-emergency treatment:

1. Check the Medical Network: Confirm that the hospital, clinic, pharmacy or specialist is included in the network shown on your medical card.
2. Visit a General Practitioner: EBP members may need to consult a general practitioner and obtain a referral before visiting a specialist or consultant.
3. Present Your Documents: Show your valid Emirates ID and medical insurance card at the healthcare provider.
4. Obtain Approval When Required: Certain medicines, investigations, procedures and hospital admissions require prior authorisation.
5. Pay the Applicable Share: The insured member may need to pay a co-payment, deductible or non-covered expense.

What to Check Before Selecting a Plan:

Review these policy details carefully:

1. Provider Network: Confirm that suitable hospitals, clinics, pharmacies and specialists are accessible from your home or workplace.
2. Coverage Limits: Review the annual policy limit and any separate limits applying to medicines, maternity or other benefits.
3. Co-payments and Deductibles: Check how much you may need to contribute when receiving medical services.
4. Referral and Approval Rules: Understand when a GP referral or prior authorisation is required.
5. Geographical Coverage: Check whether treatment is available only within Dubai or through providers in other emirates.
6. Exclusions and Waiting Periods: Review services that are excluded, restricted or available only after a stated waiting period.

How to Request Basic Health Insurance:

Follow these steps:

1. Enter the Applicant’s Details: Provide the applicant’s personal, identification, contact and residency information.
2. Provide Sponsor Information: Submit the applicable employer, family sponsor or self-sponsorship details.
3. Complete the Medical Declaration: Disclose existing conditions, previous treatment and other requested medical information accurately.
4. Review the Available Plan: Check the benefits, medical network, limits, co-payments and exclusions.
5. Submit the Required Documents: Provide the requested identification, residency and supporting records.
6. Review the Quotation: Confirm the premium and policy conditions before completing the application.

Documents Required:

You may need the following documents:

1. Emirates ID
2. Passport copy
3. Residence visa copy or visa application details
4. Employer or sponsor information
5. Previous medical insurance details, if available
6. Medical declaration
7. Medical reports or supporting documents, if requested

Why Choose Al Buhaira Insurance?

Eligible customers and members can access:

1. Online Medical Quotation: Applicants can submit their personal and medical information through the online medical-insurance quotation journey.
2. Medical Network Search: Members can search healthcare providers by network, emirate, provider type and speciality.
3. Policy Support: Dedicated channels are available for new enquiries, policy issuance, renewals and endorsements.
4. Medical-Service Support: Members can request assistance with network enquiries, pre-authorisation and reimbursement claims.

Frequently Asked Questions: