Medical Insurance Companies in Sharjah
Medical insurance companies provide policies that help eligible Sharjah
residents access covered healthcare services. The insurer issues the
policy, collects the premium and assesses eligible claims according to
the stated benefits, limits and conditions.
Since 1 January 2025, employers must arrange health insurance for eligible
private-sector employees and domestic workers in Sharjah as part of
applicable residence-permit issuance or renewal procedures.
What Does a Medical Insurance Company Do?
A medical insurer may be responsible for:
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Issuing the Policy:
Providing medical insurance based on the applicant’s eligibility,
residency, medical information and selected benefits.
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Providing Medical Coverage:
Covering eligible healthcare services according to the policy schedule,
annual limits, co-payments, deductibles and exclusions.
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Assigning a Medical Network:
Providing access to participating hospitals, clinics, pharmacies,
laboratories and other healthcare providers.
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Managing Medical Approvals:
Reviewing requests for treatments, tests, medicines or hospital
admissions that require prior authorisation.
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Administering Claims:
Assessing eligible direct-billing and reimbursement claims according
to the policy conditions.
Insurance Company and TPA:
The insurance company and Third Party Administrator, or TPA, have different
roles. The insurance company provides the policy and remains the insurer.
A TPA may perform selected administrative services on its behalf.
A TPA may assist with:
- Medical-network administration
- Pre-authorisation requests
- Direct-billing claims
- Reimbursement-claim review
- Medical-card and member enquiries
Members should check their medical card or policy schedule to confirm their
insurer, appointed TPA and assigned provider network.
How to Compare Medical Insurance Companies:
Review these factors before selecting a policy:
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Authorisation:
Confirm that the insurance company is authorised to provide insurance
services in the UAE.
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Healthcare Network:
Check whether suitable hospitals, clinics, pharmacies and specialists
are available in Sharjah or nearby emirates.
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Medical Benefits:
Review the available inpatient, outpatient, emergency, medicine and
maternity benefits.
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Coverage Limits:
Check the annual policy limit and any separate limits applying to
specific medical services.
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Co-payments and Deductibles:
Understand how much the insured member may need to contribute when
receiving healthcare services.
-
Exclusions and Waiting Periods:
Review treatments that are excluded, restricted or available only
after a stated period.
What May Medical Insurance Cover?
Depending on the selected policy, benefits may include:
-
Outpatient Consultations:
Eligible consultations with general practitioners and approved
specialists within the assigned network.
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Diagnostic Services:
Medically necessary laboratory tests, scans and other investigations.
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Prescribed Medicines:
Approved medicines according to the applicable formulary, benefit
limits and co-payments.
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Inpatient Treatment:
Eligible hospital admissions, surgeries and related treatment, subject
to medical necessity and approval requirements.
-
Emergency Treatment:
Emergency medical services according to the policy conditions and
geographical limits.
-
Maternity Benefits:
Eligible maternity services where included, subject to limits,
co-payments, waiting periods and policy conditions.
How to Request Medical Insurance:
Follow these steps:
-
Provide the Applicant’s Details:
Enter the applicant’s personal, identification, contact and residency
information.
-
Provide Employer or Sponsor Details:
Submit the applicable employment, sponsorship or self-sponsorship
information.
-
Complete the Medical Declaration:
Disclose existing conditions, previous treatment and other requested
medical information accurately.
-
Review the Available Plan:
Check the medical network, benefits, limits, co-payments and exclusions.
-
Submit the Required Documents:
Provide the requested identification, residency and supporting records.
-
Review the Quotation:
Confirm the premium and policy conditions before completing the
application.
Documents Required:
You may need the following documents:
- Emirates ID
- Passport copy
- Residence visa copy or visa application details
- Employer or sponsor information
- Previous medical insurance details, if available
- Medical declaration
- Medical reports or supporting documents, if requested
Why Choose Al Buhaira Insurance?
Eligible applicants and members can access:
-
Online Medical Quotation:
Applicants can submit their personal and medical information through
the online medical-insurance quotation journey.
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Sharjah Medical Network Search:
Members can search healthcare providers according to their assigned
network, provider type and speciality.
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In-House and TPA Networks:
Medical policies may use an Al Buhaira network or an appointed Third
Party Administrator, depending on the issued plan.
-
Medical Insurance Support:
Assistance is available for quotations, policy enquiries, renewals,
endorsements, medical approvals and reimbursement claims.
Frequently Asked Questions:
Ans: Compare the provider network, medical benefits, annual limits, co-payments, exclusions, approval requirements and policy-support channels.
Ans: Since 1 January 2025, employers must arrange health insurance for eligible private-sector employees and domestic workers as part of applicable residence-permit procedures.
Ans: No. The insurer provides the medical policy. A TPA may administer provider networks, approvals and claims on the insurer’s behalf.
Ans: Coverage may include outpatient consultations, diagnostic services, prescribed medicines, inpatient treatment, emergency care and maternity benefits, subject to the issued policy.
Ans: A policyholder may select another insurer at renewal, subject to eligibility, medical disclosure, continuity requirements, waiting periods and the new policy terms.
Ans: Yes. Eligible applicants can submit their details through Al Buhaira Insurance’s online medical-insurance quotation service.
