Basic Medical Insurance in Sharjah

Basic medical insurance helps eligible Sharjah residents access essential healthcare services through the provider network assigned to their policy. The available benefits, limits, co-payments and exclusions depend on the issued plan and its schedule of benefits.

Since 1 January 2025, employers must arrange health insurance for eligible private-sector employees and domestic workers in Sharjah as part of applicable employment and residence-permit procedures.

Who May Need Basic Medical Insurance?

Medical coverage may need to be arranged for:

1. Private-Sector Employees: Employers are responsible for arranging the required medical insurance for eligible employees.
2. Domestic Workers: Employers or sponsors must arrange suitable medical coverage for eligible domestic workers under their sponsorship.
3. Self-Sponsored Residents: Investors, freelancers and other eligible self-sponsored residents may need to arrange their own medical insurance.
4. Family Dependants: Sponsors may request separate coverage for spouses, children or other eligible dependants who are not insured under another valid policy.

What May Basic Medical Insurance Cover?

Depending on the issued policy, 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 applicable limits and approval requirements.
3. Prescribed Medicines: Approved medicines may be covered according to the applicable formulary, benefit limit and co-payment.
4. Inpatient Treatment: Eligible hospital admissions, surgeries and related medical treatment, subject to medical necessity and prior approval requirements.
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 limits, co-payments, waiting periods and other policy conditions.

How to Use Your Medical Insurance:

Follow these steps before receiving non-emergency treatment:

1. Check Your Medical Network: Confirm that the hospital, clinic, pharmacy or specialist is included in the network shown on your medical insurance 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: Some specialist consultations may require a referral from a general practitioner, depending on the policy.
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 in Sharjah or nearby emirates.
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 consultations, medicines or treatment.
4. Pre-authorisation: Understand which tests, medicines, procedures and hospital admissions require approval before the service is provided.
5. Geographical Coverage: Check whether the policy can be used only within a limited network or through providers in other emirates.
6. Exclusions and Waiting Periods: Review treatments and services 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, 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. Employment or domestic-worker details, where applicable
6. Previous medical insurance details, if available
7. Medical declaration or supporting reports, 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. Sharjah Medical Network Search: Members can search healthcare providers according to their assigned network, provider type and speciality.
3. In-House and TPA Networks: Medical policies may use an Al Buhaira network or an appointed Third Party Administrator, depending on the issued plan.
4. Medical Insurance Support: Assistance is available for policy enquiries, renewals, endorsements, network questions, medical approvals and reimbursement claims.

Frequently Asked Questions: