Medical Insurance in Dubai

Image source: gulfnews.com

Image source: gulfnews.com

The obviously reason to purchase Medical Insurance is to have the means to take care of yourself and family if needed. From regular checkups at the doctors to surgery, it takes the burden off you financially and gives you a peace of mind knowing you have the best care available.

There are different Companies in Dubai that have medical insurance available for you to purchase. Some give you basic coverage, others offer full benefits and then there are comprehensive plans that extend your benefits worldwide. Here are a few questions you may want to keep in mind when purchasing medical insurance.

  • Is there coverage for long term illness like cancer?

Yes there is coverage you can purchase that does cover any long term illness.

  • Will they cover for pre-existing conditions?

Yes, most plans do NT have coverage for a pre-existing medical condition and it would cost additional funds for that type of care.

  • How do I find out what medical plan is best for my family?

There are different types of plans available which are set up to accommodate everyone.

  1. Basic Coverage – This type would be for individuals who do not travel and only need basic insurance coverage.
  2. Broad Coverage – Another type would insure you while traveling regionally and contains additional coverage as well.
  3. Comprehensive Coverage – This plan is the best coverage if you are continually traveling internationally and need a broader form of coverage.
  • Will these medical plans cover dental work?

The broad plans do cover standard dental work and emergency situations.

  • What about pregnancy and pre-natal care?

Yes, there is a limited amount of coverage for all pregnant women and the new additions to their families.

  • What about my drug prescriptions I use monthly.

Yes, they will cover your medication. Some plans do have an annual deductible that is usually paid at the beginning or end of the year.

  •  What about my children, will they be covered?

Any child under the age of 21 can be added to your insurance plan. Once they are over 21 they must purchase their own policy.

There are always optional coverage that can be added to an existing medical plan as individual needs change.  Periodically, there are also various benefits added to the plan. They do have monthly payment plans to make the insurance more affordable for everyone. The price of Medicare is so expensive that if you get ill locally or abroad, it can cause financial ruin. Most people do not have hundreds of dollars put away that they can access for an unexpected accident.

Many Insurers do have a website set up so you can log in to check any information you need. You can contact them 24/7 for any assistance that you need for a medical emergency.  You will receive a benefit card which you should keep with your drivers’ license. That way should you have any sort of accident while you are alone, the first place they will look for identification is your drivers license.

Come visit InsuranceMarket.ae to receive a comparison of all the medical insurance policies that will suit your very requirement.

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Things you need to know about group medical insurance in Dubai

A couple of days ago I wrote an article that identified the fundamental structural differences between an individual health cover and a group policy. I explained how price is usually not the key difference – the cover is. Predominantly, you will find that group medical policies have the ability to disregard medical history and therefore cover pre-existing conditions – in addition to lots of other things like maternity without waiting periods and general check-ups.

This article serves to firstly define group medical policies, identify the different kinds of group medical policies available here in Dubai and thereafter some recommendations on what you should be doing in order to get it right.  A group medical insurance policy is usually bought by a registered organisation – it could be a for-profit entity or otherwise. As a result of being on a ‘group’ basis, the individuals within the group benefit from economies of scale and scope.

medicinesPractically speaking, though it is possible to quote on a ‘group’ basis for a company having as low as two employees, the real benefits of being structured as a group come about when an organisation is able to insure at least ten employees. The main feature here is that you would usually require more than five employees to start having a ‘medical history disregarded’ policy whereby all pre-existing conditions are covered without a medical history being declared by each of the individual members within the group.

When reviewing different group medical insurance policies in Dubai, you would find prices varying significantly from product to product. Indeed you can have a policy that costs just AED 400 per member all the way up to AED 50,000 per member or even more! As a result, it’s important to understand the differences between policies when purchasing.

HMO – Health Maintenance and Organisation – plans for blue collar workers – usually priced between AED 400 and AED 900.

Family Plan – individual policies grouped by family – prices range from around AED 2000 per member to over USD 15,000 depending on various factors and product covers.

Capped Pre-existing SME – plans for usually smaller companies with a limited coverage for pre-existing conditions.

In-Patient Only Plan – a very cost effective solution that only covers the financial catastrophe that is in-patient. Usually these policies have a higher excess as well.

Full Pre-existing SME subject to individual critical illness application – usually for companies with more than five employees and less than twenty five. All members would have pre-existing conditions covered subject to a confirmation from each one that nobody has a critical illness (as defined by the insurance company).

Medical History Disregarded (MHD) – MHD plans are usually offered to companies with more than ten employees. While these plans are not cheap, they would cover all pre-existing conditions without any questions asked or declarations completed.

Large Corporate – plans that cover groups of employees starting from a census of fifty. These are usually able to cover pre-existing ailments to the policy limit however in view of the recent poor performance of most of these portfolios (i.e. a higher amount being paid in claims than insurance premium), the benefits may be restricted in order to meet certain budgetary requirements.

As there are various types of products available in the UAE insurance market, sometimes you may find a combination of the above plans. It’s best to completely understand the policy you are buying before you buy it and make sure you have a very trustworthy advisor who is not trying to simply make a sale but rather developing a long term service relationship backed by solid logical reasoning as to why a certain product would work best for you.

Do you have queries on insurance? Do you need expert’s advice? Meet Alfred at Youtube.

[Image source: nomedicallifeinsurance.ca]

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And Alfred Receives Yet Another ‘Letter’!

Hi friends, today I will be sharing with you a letter written to me by one of my Group Health Care Insurance Plan buyers, who are offering this plan to its employees as part of the benefits program. I visited my client’s office yesterday to educate the staff about the cover and the procedures to follow if they face the need to go to a doctor or file a claim. Soon after I received an email from my client as below. Hope you enjoy a piece of correspondence we usually have with our clients!

Dear Alfred,

Thank you very much for dropping by our office and discussing the policy cover with us. Many of us were shocked to realise how we were unaware of the benefits that could be reaped through a health insurance policy till yesterday, and are certainly relieved to have finally understood the cover in great depth and detail.

It was in our great interest to learn that we are now covered for an extensive list of medical conditions including regular dental checks and orthodontic procedures. Usually this is a separate benefit offered to us for which most, if not all, of us usually opt for. It is a great relief to have it all covered under one policy, with the same company and with the same medical card.

Also, thanks for making it clear that medication, if prescribed, is also covered. Most of the times, our staff members have gone out and paid for them not knowing correctly what they can and cannot claim for.

We also find it extremely helpful to have an accessible list of recommended hospitals around the world where our medical card would simply suffice to obtain an immediate treatment without any additional costs. Our employees are usually travelling as part of their jobs and therefore will find it highly beneficial to know where they can potentially go if they encounter an injury or impairment. Adding on to that, several countries have strict vaccination requirements before we travel. Given that we have some amount of money allocated towards this expense is to our great advantage.

Overall, this will greatly help our company with significant reduction in absenteeism and the number of days taken off as sick leave. Since medical treatments are extremely expensive in Dubai, many tend to go back to their home countries for these. With this new healthcare plan, such scenarios can now be avoided, in turn largely improving the productivity of the company.
Some have, however, raised a few questions that you might be able to help us with:

. Why is that our pre-existing conditions are not taken into account? Of course, it is to our benefit but out of curiosity, doesn’t it harm your business? What if someone has a medical history of high blood pressure and diabetes and has already had one heart surgery! From what I have heard, typically, pre-existing conditions are excluded when you purchase a private health insurance. Or at least was the case for one of my relative! Can you please confirm that this does not apply to us?

. One of our employees is already covered under his spouse’s health insurance policy, but that policy does not provide enough cover as you do. What should he do? Can he cancel his policy? Can he also advise his spouse to cancel hers and include her into his new policy with us? If yes, that will take some time but you have a cut-off date to confirm addition of dependents till only next week!

. We understand that we have a global cover excluding the US. Does that strictly mean that medically nothing is covered in the US or is there some leeway around it e.g. paying a higher amount of excess, etc?

. One of the employees has been going for her regular maternity checks to a doctor in a hospital that is not mentioned in your list of recommended hospitals. She prefers not to pay excess simply because she had chosen a hospital prior to knowing what you had to offer. Ideally, she would not want to switch doctors due to various reasons. Would it be necessary to do so to avoid that excess? We really don’t want to upset our employees!

. If the claim for a treatment were on reimbursement basis, would its medication also be on reimbursement? Or can I use my medical card for the prescribed medicines?

Our employees seem very excited and delighted to have this plan or rather a security by their side. You might have noticed that our company is highly female dominating, some of who are currently pregnant and they greatly appreciate having all their maternity expenses covered. We are confident that you will provide us with an outstanding service and claims assistance having had a great working relationship and experience with you on other classes of insurance in the past.

We appreciate that you have provided us with an online portal system to register our claims, track the progress of claims and get access to all the important documents such as the policy itself, recommended hospital/providers, etc. It is not just an accessible platform but also a mechanism to save time and relieve much of the employees’ stress relating to their claims, especially when they are travelling.

Thank you again for your support and guidance. I look forward to hearing from you soon.

Yours sincerely,

Ms. Jones

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What’s the difference between a group and an individual health insurance policy in the UAE?

health-insurance

There is admittedly sometimes a bit of a misunderstanding about the benefits of having a group policy over an individual policy.  Hopefully, this article can clear things up a bit for you. Firstly, a group policy is usually structured for an organisation (eg. for a business, usually with more than ten employees but there are some products for companies with just two employees onwards) while an individual policy is structured for an individual person or a nuclear family. Certainly, some group policies can give you an option to add family members of employees as dependents – but how group policies work and differ is outside the scope of this article– I will publish a separate article about this shortly.

When referring to a ‘group’ policy, one may assume that this is simply a portfolio or ‘grouping’ of some individual policies and that as a result of the scale economies or efficiencies brought about, a ‘group’ or ‘corporate’ discount is offered. However, this is not quite the case – usually far from it – indeed you may find group policies working out to be more expensive per member than an individual one!

It’s not that group policies do not bring about the benefits of scale – they most certainly do. But rather than these benefits straightforwardly reflecting themselves on the lower cost of insurance, they’ve found better uses – namely in terms of scope – the covers and benefits offered under the policy.  It is widely known that you can’t buy (as of now) an individual medical insurance policy in Dubai and most other Emirates that covers you for pre-existing conditions (i.e. ailments that you may have prior to taking up the policy). Why? Well, the common analogy is to that of car insurance – you can’t buy an insurance policy on your car after it’s had an accident – after all, insurance isn’t for certainties – otherwise it wouldn’t work. They’d simply know how much they have to pay out and add on their expenses and profit margin to come up with your insurance premium! But the story differs if you’re talking about group policies where you can indeed cover pre-existing conditions.

Similarly, in addition to not covering any pre-existing conditions, individual insurance policies offer restricted (if any) covers for maternity or pregnancy – you may either find those with nine or twelve or twenty four months long waiting periods or those that do not cover anything pertaining to maternity costs or sometimes those that cover only complications or acute conditions of maternity.

With a group policy, however, you can cover pre-existing conditions and maternity without a waiting period because of the inherent benefits of a portfolio approach. The concept of a group health insurance policy is often compared to a societal financing scheme whereby medical costs borne by a few are shared by many – this is essentially the conceptual definition of insurance itself.

health-insurance-2nd

But in essence, the insurance company uses the volume of premium created by group medical policies to open up the floodgates a bit and cover for conditions which they would otherwise just not be able to cover because of the risk involved. From major covers like pre-existing conditions and maternity to the luxury covers like wellness, optics, vaccinations and even life insurance compensation – group medical insurance truly opens up opportunities for increased benefits. After all, it’s unlikely that every female in the group would become pregnant or every member has a serious pre-existing medical condition – therefore the risk can be calculated based on probabilities and a price be put on a group. If you’re wondering why this can’t be done for an individual – the one-word answer is that a policy with such benefits would create ‘anti-selection’ i.e. all the people with the intention of claiming under a certain section insure with a company that covers that particular situation.

For example, very recently the portfolio of a major local insurer collapsed because they were covering maternity for individual policies without a waiting period. Even though they were charging more than double the premium that others were charging for a roughly equivalent product (other than this specific difference), they could not contain claims costs and eventually had to book major losses and go back to imposing a waiting period like everyone else – they just could not afford to pay for almost every other policyholder that was claiming for pregnancy – essentially people were just signing up when it was time for them to have a baby! And only those that wanted babies were signing up – why would anyone pay so much more otherwise?

Of course, the extent of benefits and pricing on group and individual policies depends on various factors and this is worthy of a separate article – UAEbut in essence, I hope one can now appreciate how not to just simply expect a ‘cheaper’ policy because it’s a group policy but rather a more beneficial one. Certainly, it’s possible to structure a group policy as a collection of individual policies and thereafter offer a group discount but what’s the point? Anybody on an average individual insurance plan in the UAE would tell you how these plans have many caveats and restrictions to them and as a professional insurance broker I can add a disclaimer to anyone with an individual policy that if, God forbid, a serious medical condition comes up your insurer may actually find ways to disallow you from renewing your policy – terrible fact of reality in this part of the world, but it has happened frequently in the recent past – note here that your insurance broker would have to play a crucial role at such times by standing by your side and fighting the big, bad insurers – make sure you find the right one!

Whether you’re looking to take up an individual health insurance policy or structuring a group portfolio for your company, please be in touch with us on InsuranceMarket.ae and we would be happy to give you various options, implement the cover and thereafter also manage your claims for you on a fast-track basis. 

[Image sources:

topnews.ae/content/25185-uae-health-insurers-face-huge-challenge

gulfnews.com/business/banking/uae-health-insurance-premiums-may-rise-by-up-to-20-this-year-1.798593

telegraph.co.uk/health/expathealth/8015363/Expat-guide-to-the-UAE-health-care.html ]

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Why do you want to buy individual health insurance?

health_insurance_UAEIn the UAE, like many places around the world, the healthcare sector is a hot topic. Specifically often, medical inflation can make it financially crippling and difficult to actually afford medically necessary treatment. As a result of this, citizens look to their government for its support and the government tries its best to be able to put a model in place that is sustainable and fair. Certainly, the people running the Emirates of the UAE are no different in this regard.

So, based on the above, one would assume that it is fairly logical to deduce that the main reason for buying a health ‘insurance’ policy is simply to avoid being in a situation where a financially crippling medical service needs to be paid for due to an unforeseen incident or diagnosis. While in principle this should be the reason to buy health insurance, in the UAE it is often bought for other reasons, hence making inflationary and prohibitory pressures actually worse! Due to a misunderstanding of the fundamental reason to buy insurance, people are either paying more than they should be or, which is even worse, buying inappropriate or insufficient policies.

To explain how buying the wrong product can actually increase your overall cost of healthcare, most simply put, if the insurance company is ‘cash swapping’ with you or an insurance portfolio has a high number (high frequency) of small claims (low severity) then they are adding a cost to the transaction – one that could have been completed more efficiently by the patient and the doctor. For example, it is widely popular to see plans in the UAE that have higher out patient deductibles (and therefore lower premiums) not selling or plans with out patient on reimbursement not selling purely because the potential policyholder says ‘what’s the point of an insurance card if I can’t actually use it?!’.  Well, if you have to use something often, it’s not insurance! The whole point is that there should be a financial support in the event that there is a catastrophe – an in-patient procedure, for example. For any other ‘regular’ costs, the insurance company can obviously forecast (to a surprising extent of accuracy) how much it is costing and hence add their operating costs and profit margins to it.Dubai-Healthcare-City

So, the next time you’re looking to buy your medical insurance, think about the in-patient capabilities of your plan. Think about how well the product would be able to cover you in the event of a large claim. Forget about the small claims – it’s actually more efficient to pay those yourself. Just have a higher deductible applied on your policy and you will see the difference in cost! Or why don’t you consider an in-patient-only plan? To answer the question in the title, I can say as a professional insurance broker that one should buy health insurance (or life insurance for that matter) in order to be financially stable in the event of a traumatic health condition or at the time of an accident. Of course, like most things in life one should note there are exceptions to this recommendation – for example, corporate group policies are priced and structured differently. Or, for example the functions of policies designed for blue collar workers may be different… But largely speaking, the above principle holds true.

At InsuranceMarket.ae we have a whole host of health insurance products – those that would cost you just AED 1000 annually to those that would rent you a studio flat in JLT!  Each kind of product has its own function and strength – and we can always find something to match your preference (even if it’s not as per the recommendations in the above article!) Why don’t you get in touch with us and we would help find the right solution for you.

[Image sources: thenational.ae/thenationalconversation/industry-insights/economics/uae-healthcare-system-deserves-better-from-its-insurers

arabiangazette.com/medical-professionals-welcomed-to-uae-20130213/]

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