Health Insurance

What is health insurance?

Health insurance is an insurance policy designed to protect you from the rising cost of health care. It can help cover expenses ranging from routine doctor visits to major surgical costs from a serious illness or injury. You can buy different types of policies that offer various levels of cover, at varying costs. There are basic plans and premium plans, local and international plans and so on.

Having a good health insurance policy in place can help ensure you receive prompt and effective care should you or a loved one falls ill or gets injured.

What does it cover?

Health insurance mainly includes cover for treatment you get as:
An Inpatient

This includes staying in a hospital bed for tests or surgery.

An Outpatient

This includes consultations, diagnoses and treatment when you do not need to stay overnight

In addition to that, plans can be customized to include a wide range of additional benefits that can help you take control and pro-actively manage the health and wellbeing of you and your family.

  • Wellness Test and Screenings
  • Dental Care
  • Vision Care
  • Maternity Benefits
  • Medical Evacuation and Repatriation Services
  • Return Home Cash Benefit
  • and several more…

What to consider when choosing health insurance coverage?

There is a wide choice of health insurance policies available – they range from basic through to comprehensive – which is the best for you depends on your circumstances, needs and budget. Here are some of the important things to keep in mind when choosing a health insurance plan

Tip 1

Always buy your insurance through a reputed insurance broker – Like Edge!

Tip 2 – Provider Network

Do the health care providers, hospitals and pharmacies you prefer fall within the approved network of the particular plan? It’s important to remember that in-network services and medicines are generally covered under a plan, while out-of-network services and medicines require additional out-of-pocket costs or are not covered at all. It is advisable to choose an insurance policy which covers at least some of the major health care providers near your home.

Tip 3 – Geographic Coverage

Keep in mind that some local plans may only cover your emirate, while others may provide UAE-wide coverage. Regional plans can cover the GCC, Middle East, Indian Sub-Continent etc. and International Plans can provide cover in US and Canada within worldwide coverage.

Tip 4– Coverage features

Health insurance plans, nowadays, offer a wide range of coverage features which make them different. Every plan is composed of different coverage features and you should understand the benefits offered under every plan before you buy one

Tip 5 – Waiting Periods

Waiting periods prevent you from being able to make claims for certain benefits, soon after purchasing an insurance plan, such as for maternity or pre-existing conditions. The duration of a waiting period varies among insurance companies, usually 6 months but in some cases can even be up to 12 months, depending on the plan. It is best to speak with one of our advisors to find out more information on waiting periods and how they are applied to specific coverage options.

Tip 6 – Deductibles, Copay or Coinsurance

Deductibles are fixed charges that you must pay out of pocket before your coverage kicks in. Co-payment mandates that the policyholder will bear a pre-defined percentage of the overall treatment cost and the rest will be settled by the Insurer. You can choose different options of deductible and co insurance to arrive at the premium suiting your budget and coverage needs.

Tip 7 – Pre-existing conditions

A Pre-existing Condition is any ailment, illness or medical condition in which the policyholder was aware of, experienced symptoms of or received treatment before the start date of a Health Insurance plan. This has an impact on the overall policy premium. Most insurers exclude pre-existing conditions. The few insurers who accept it do it on a case-by-case basis depending on the condition. Others may apply a waiting period and a sublimit.

Tip 8 – If you decide on a very basic policy

Take the time to read any exclusions and make sure that you’re comfortable with what’s covered – you could find the list of covered benefits are very limited.

Tip 9 – Exclusions

The last consideration is the exclusions list. All policies are subject to exclusions. it would be prudent to read and understand the exclusions that are listed in the policy before you buy it.

The Basic Plan

Looking for health insurance coverage to cover your basic medical needs?

The Essential Benefits Plan, a scheme that the Dubai Health Authority (DHA) has made obligatory in the Emirate of Dubai, is the minimum Healthcare Insurance cover that every employer/sponsor will have to provide his employees & dependents.  To obtain a new visa or renewal through the General Directorate of Residency and Foreigners Affairs (GDRFA), you must have medical insurance.

This is an affordable plan for lower income members (earning less than AED 4,000 per month), as determined by Dubai Health Authority, with key benefits like:

  • An Annual Limit of AED 150,000
  • Medical visits to a general doctor in the UAE
  • Referrals to a Specialist
  • In-patient treatments
  • Emergency medical treatments or hospitalization
  • Diagnostic tests
  • Maternity
  • Prescription drugs (medications)
  • Physiotherapy
  • Preventative services (DHA mandatory vaccines and immunizations)

Who can be covered under this plan?

Dependents

Who is considered a dependent?

A person who is sponsored by another individual like:

– Spouse

– Children

– Parents

Due to obvious health reasons, insurance premium for elderly parents (older than 65) is higher and so is the premium for married females (aged 18 to 45), who are considered most susceptible to pregnancies.

Salaried Individuals

Who is considered as a salaried individual?

A self-employed individual under his or her company’s sponsorship or an individual sponsored by an entity and earning a fixed salary; such as:

– Housemaid

– Nanny

– Driver

– Gardner

– Cook

  • We answer any question you may have & compare multiple insurance quotes within minutes.
  • We highlight any areas of your quote where you might have too much or too little coverage, so we are sure that you are provided with the best insurance to protect yourself and your loved ones.
  • We compare Insurance plans from multiple insurance providers to find you the ideal coverage for your needs and help save on your insurance premiums.
  • If you need help our insurance advisors can offer assistance by phone or email.
  • Even after you buy your insurance, we help you with claims and make any policy changes you may require.
  • Your age, as it costs more as you get older
  • Your medical history, e.g. if you have pre-existing conditions such as diabetes or high blood pressure
  • Your family’s history of conditions like heart disease, cancer or strokes
  • Your lifestyle could make premiums higher if you smoke or are overweight
  • What you cover, as including more conditions and types of treatment costs more

Buying health insurance may seem a little daunting, especially that there are multiple key things to consider, and no one wants to feel like they are missing something crucial. So, when you request Edge to compare health insurance quotes, we’ll initially ask you to fill a Medical Application Form and to provide information about yourself, such as your age, height, weight, and answer other general health and well being questions like ongoing medications, and recurring or chronic illnesses or diseases.

We’ll then ask you for your ideal budget so that we can help you find affordable coverage.

Heath Insurance Feedback and Complaints

If you have feedback, complaints, suggestions or compliments with regards to a service provider, please share your experience with us or submit directly on the DHA’s Insurance Partner Relation Management E-system.

Frequently Asked Questions (FAQs)

Quickly find out if we’ve already addressed your query.

The Third-Party Administrator is a company that the insurance company appoints to provide service to its insured members. The TPAs work closely with insurance companies and provide administrative, network and claims management support.
Coinsurance is a percentage of the costs of outpatient treatment (such as consultations, diagnostics etc) that you are responsible for. For example, if you have 10% coinsurance and your bill comes to AED 100, you are responsible for AED 10. Coinsurance helps reduce the premium to be paid.
A deductible is another potential out-of-pocket cost you may be responsible for each year before the plan contributes towards the cost of healthcare services.
Non-disclosure of a medical condition will result in claim rejection and the Policy becoming void.
You plan will cover pre-existing and chronic conditions with no waiting period for members who were previously insured, this will be subject to evidence of previous medical insurance cover. Otherwise a 6-month waiting period will apply.
You are covered for medical treatment in all Emirates except Abu Dhabi and Al Ain where services are covered on emergency basis only.
Doctors and hospitals often have tie-up arrangements with insurance companies to become part of the company’s “network.” The contracts spell out what they will be paid for the care they provide. If you go to a doctor in your insurance company’s network, you will pay less out of your own pocket than if you go to a doctor who doesn’t have a contract with your insurer.
If you have selected Agency Repairs coverage then your vehicle will be repaired at the vehicle’s authorized dealership. Otherwise, Insurers will select one of their Approved Garages for the repair.
Yes, you can. You have to pay the charges in full and file a reimbursement claim for eligible expenses. Check your policy or ask us if it allows for reimbursement.
  • Medical Reimbursement Claim Form (English / Arabic) – Fully completed, signed and stamped by your Treating Doctor along with your signature.
  • Original Bill / Invoice – Providing a detailed breakdown of all charges
  • Proof of payment (Paid stamp on invoice, original receipt, credit cards payment receipt, etc.).
  • Original and Detailed Medical and Diagnostic Reports
  • Prescription(s) for Medication
  • Copy of all relevant X-Rays / Echography / MRIs and Reports – with your name and date they were taken
  • Copy of all Lab Tests & Reports – that are related to the incident
    Medical Report & Discharge Summary signed & stamped by the treating Doctor
  • Pre-authorization Form – if applicable
  • Any other medical information that may be deemed necessary by your Insurer
  • All documents in relation to the claim shall be in English or Arabic. With respect to documents in other languages, it shall be the responsibility of the claimant to provide a translated document in English or Arabic to the Insurer and shall also ensure that the translated document is complete and accurate.

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