Medical Insurance in the Northern Emirates

The Northern Emirates generally include Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah and Fujairah. Medical insurance helps eligible residents access covered healthcare services through the provider network assigned to their policy.

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

Who May Need 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 insurance 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 coverage.
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 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, imaging 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 pre-authorisation.
5. Emergency Treatment: Emergency medical services may be covered according to the policy conditions 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 Choose Medical Insurance:

Review these important policy details:

1. Medical Network: Confirm that suitable hospitals, clinics, pharmacies and specialists are available in your emirate or nearby locations.
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, across the UAE or outside the country.
6. Exclusions and Waiting Periods: Review treatments that are excluded, restricted or available only after a stated waiting period.

How to Use Your Medical Insurance:

Follow these steps before receiving non-emergency treatment:

1. Check the Assigned Network: Confirm that the healthcare provider 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 requested consultation, test, medicine or treatment is covered.
4. Obtain Approval When Required: The healthcare provider may need to submit a pre-authorisation request before certain services are provided.
5. Pay the Applicable Share: The member may need to pay a co-payment, deductible or non-covered expense.

How to Request Medical Insurance:

Follow these steps:

1. Provide the Applicant’s Details: Enter 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 medical conditions, previous treatments and other requested 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 quotation journey.
2. Medical Network Search: Members can search healthcare providers by network, emirate, 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: