Medical Insurance in the UAE

Medical insurance helps eligible UAE residents access covered healthcare services through the provider network assigned to their policy. It may reduce the amount an insured member must pay for eligible consultations, medicines, tests and hospital treatment.

Medical-insurance requirements vary according to the emirate, residency status, employment category and sponsorship arrangement. The benefits available also depend on the selected plan, schedule of benefits, medical network, annual limits, co-payments, exclusions and approval requirements.

Medical Insurance Requirements in the UAE:

The applicable requirements depend on where and how a person is sponsored:

1. Dubai: Residents must maintain valid medical insurance under Dubai’s health-insurance framework. Employers and sponsors have responsibilities according to the insured person’s employment and sponsorship category.
2. Abu Dhabi: Abu Dhabi operates its own mandatory health-insurance framework. Eligibility, sponsor responsibilities and available programme categories depend on the resident’s circumstances.
3. Northern Emirates: Since 1 January 2025, employers must arrange health insurance for eligible private-sector employees and domestic workers in Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah and Fujairah as part of applicable residence-permit procedures.
4. Family Dependants: Sponsors may need to arrange separate medical coverage for spouses, children or other eligible dependants who are not covered under another valid policy.
5. Self-Sponsored Residents: Investors, freelancers and other self-sponsored residents may need to arrange their own medical insurance according to the applicable residency requirements.

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, scans and other investigations, subject to benefit limits and approval requirements.
3. Prescribed Medicines: Approved medicines may be covered according to the applicable formulary, 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 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 included near your home or workplace.
2. Annual Coverage Limit: Check the total annual limit and any separate limits applying to medicines, maternity or other benefits.
3. Co-payments and Deductibles: Understand how much the insured member may need to contribute when receiving healthcare services.
4. Referral and Approval Rules: Check whether specialist consultations, tests, medicines, procedures or hospital admissions require a referral or prior authorisation.
5. Geographical Coverage: Confirm 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 and conditions that are excluded, restricted or covered only after a stated waiting period.

How to Use Your Medical Insurance:

Before receiving non-emergency treatment:

1. Check the Assigned Network: Confirm that the healthcare provider is included in the network shown on your medical card or digital insurance card.
2. Present Your Identification: 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 and whether a co-payment applies.
4. Obtain Approval When Required: The healthcare provider may need to submit a prior-authorisation request before certain services are provided.
5. Keep Supporting Records: Retain prescriptions, medical reports, invoices, receipts and approval references related to the treatment.

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 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 provider network, benefits, limits, co-payments, exclusions and geographical coverage.
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
8. Proof of relationship for family dependants, 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. Digital Medical Card: Eligible members can access a digital insurance card for presentation at participating healthcare providers.
4. Policy Support: Dedicated channels are available for new enquiries, policy issuance, renewals and endorsements.
5. Medical Claims Support: Members can access assistance for network enquiries, prior-authorisation requests and reimbursement claims.

Frequently Asked Questions: