Dubai: Where can I receive treatment if I have the basic benefits plan?
Explained: What's covered, where to get treatment and avoid surprise medical bills
Dubai: If you are covered by a basic health insurance plan, it is essential to understand the scope of your coverage. This knowledge will be crucial in the event you need treatment or surgery, particularly in emergencies, to avoid unexpected out-of-pocket expenses. To help Dubai residents with the basic package understand their coverage, the Dubai Health Authority (DHA) recently shared the following information:
Where can I receive treatment under the basic benefits plan?
According to the DHA, you should first ensure you have the following:
A certificate confirming your enrolment in the plan from your insurance provider.
Access to your insurance network - a list of healthcare providers where you can receive services (such as hospitals, clinics, etc.). Your insurer (or its third-party administrator) will have a network of providers in Dubai and possibly in other emirates.
To find out which facilities are available to you, you can:
Refer to your member handbook.
Check your insurer's website.
Contact the Third Party Administrator (TPA) directly for guidance on which facilities you can use.
What is covered under basic insurance in Dubai?
According to the DHA’s website (dha.ae), the basic benefits include:
Pre-existing conditions
Basic healthcare services (in-patient treatment at authorised hospitals)
Out-patient services in authorised clinics, hospitals, and health centres
Maternity services
Preventive services
Vaccines and immunisations
Excluded healthcare services are only covered in cases of medical emergencies.
Geographic scope of basic coverage in Dubai
For basic healthcare services, coverage is valid within Dubai (and possibly other Emirates or countries, depending on the insurer). For emergency medical treatment, including ambulance charges, coverage extends across all emirates of the UAE.
National health insurance in the UAE
As of this year, private-sector and domestic workers in the Northern Emirates now have access to mandatory basic health insurance, which is provided by their employers.
Residents of the Northern Emirates seeking treatment in Dubai should review the details of their medical insurance policies to ensure they are covered for outpatient consultations at facilities in Dubai, according to a recent Gulf News report.
Who is covered?
This mandatory health insurance applies specifically to workers in the Northern Emirates (Sharjah, Ajman, Fujairah, Ras Al Khaimah, and Umm Al Quwain). It does not extend to employees in Abu Dhabi and Dubai, where mandatory health insurance has already been implemented.
What is covered?
Treatment for chronic diseases and pre-existing conditions is included without a waiting period, which is a key benefit as most insurance policies typically do not cover such conditions during the first six months of the policy. The insurance network covers seven hospitals, 47 clinics, and medical centres, as well as 44 pharmacies.
Patients can also access telehealth services, including medical consultations via phone or online, enabling them to receive advice and treatment without needing to visit a clinic or hospital. These services are provided without any co-payment, except for pharmacy services.
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