Medical Insurance in Umm Al Quwain

Medical insurance helps eligible Umm Al Quwain residents access covered healthcare services through the provider network assigned to their policy. The available benefits, limits, co-payments and exclusions depend on the selected plan and its schedule of benefits.

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

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 coverage for eligible domestic workers under their sponsorship.
3. Self-Sponsored Residents: Investors, freelancers and other eligible 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 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 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 waiting periods, limits, co-payments and 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 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: Certain treatments, investigations, medicines and hospital admissions may require prior authorisation.
5. Pay the Applicable Share: The insured member may need to pay a co-payment, deductible or non-covered expense.

How to Choose a Medical Insurance Plan:

Review these important policy details:

1. Medical Network: Confirm that suitable hospitals, clinics, pharmacies and specialists are available in Umm Al Quwain 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 member may need to contribute when receiving medical services.
4. Pre-authorisation: Understand which services require approval before treatment is provided.
5. Geographical Coverage: Check whether the policy can be used only within a limited network or across other emirates.
6. Exclusions and Waiting Periods: Review treatments that are excluded, restricted or available only after a stated waiting period.

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 conditions, previous treatment and other requested medical information accurately.
4. Review the Available Coverage: Check the benefits, 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. UAQ 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, approvals and reimbursement claims.

Frequently Asked Questions: