Basic Medical Insurance in Dubai

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

Actual coverage depends on the issued policy, schedule of benefits, medical network, annual limits, co-payments, deductibles, exclusions and prior-authorisation requirements.

Who Needs Medical Insurance in Dubai?

Coverage must be arranged according to the member’s circumstances:

1. Employees: Employers must arrange suitable medical insurance for eligible employees working for Dubai-registered companies.
2. Spouses and Children: Sponsors must arrange coverage for eligible dependants when they are not covered through another valid policy.
3. Domestic Workers: Sponsors are responsible for arranging 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 medical insurance.

What May Basic Medical Insurance Cover?

Depending on the issued plan, benefits may include:

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

How to Use Your Medical Insurance:

Follow these steps before receiving non-emergency treatment:

1. Check the Assigned Network: Confirm that the hospital, clinic, pharmacy or specialist is included in the network shown on your medical card.
2. Present Your Documents: Show your valid Emirates ID and medical insurance card at the healthcare provider.
3. Confirm the Benefit: Check whether the consultation, test, medicine or treatment is covered and whether a co-payment applies.
4. Follow Referral Requirements: EBP members may need to consult a general practitioner before visiting a specialist or consultant.
5. Obtain Approval When Required: Certain medicines, investigations, procedures and hospital admissions may require prior authorisation.

What to Check Before Selecting a Plan:

Review these important policy details:

1. Medical Network: Confirm that suitable hospitals, clinics, pharmacies and specialists are available near 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 the insured member may need to contribute when receiving medical services.
4. Referral and Approval Rules: Understand when a general-practitioner referral or prior approval is required.
5. Geographical Coverage: Confirm whether the plan provides access only in Dubai or through healthcare providers in other emirates.
6. Exclusions and Waiting Periods: Review treatments that are excluded, restricted or available only after a stated waiting period.

How to Request Basic Medical Insurance:

Follow these steps:

1. Provide the Applicant’s Details: Enter the applicant’s personal, identification, contact and residency information.
2. Provide Employer or Sponsor Details: Submit the applicable employment, family sponsorship or self-sponsorship information.
3. Complete the Medical Declaration: Disclose existing conditions, previous treatments and other requested medical information accurately.
4. Review the Available Coverage: 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 applicants 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 according to their assigned network, emirate, provider type and speciality.
3. Policy Support: Assistance is available for new enquiries, policy issuance, renewals and endorsements.
4. Medical Claims Support: Members can access support for network enquiries, medical approvals and reimbursement claims.

Frequently Asked Questions: