A Detailed Discussion on the Mandatory Medical Insurance Law in Dubai

The Health Insurance Law of Dubai, No 11 of 2013, compels every resident to have a level of health insurance that either meets or exceeds the minimum benefits stipulated by the Dubai Health Authority. The law was approved by his Highness Sheikh Mohammad Bin Rashid Al Maktoum, vice-president, prime minister, and Ruler of Dubai in 2013. The law came into effect in 2014.

The law further states that all Emiratis and Dubai ex-pats, including dependents, must have an insurance policy so that they can afford to pay their bills during any emergency or curative health needs.

The law is applicable on all economic zones of Dubai, including the free zones. The law initially focused on companies with more than 1000 employees, but it gradually came into effect in companies with 100+ employees. No residence visas are now issued in case the applicant doesn’t have medical insurance.

How is the Government Planning to Implement the Medical Insurance Law?

The Government of Dubai is planning to implement mandatory medical insurance in law in phases. The idea is to implement the plan based on the employment count of the company.

  • For employers having more than 1,000 employees, the law was put in place on 31stOctober 2014. Any violation would lead to strict penalties.

 

  • For employers having 100 to 999 employees, the law came into effect on 31stJuly 2015. Any violation would lead to strict penalties.

 

  • For employers having less than employees, the law was implemented on 30thJune 2016. Any violation would lead to strict penalties.

 

  • For spouses, dependents, and domestic workers, the law was put in place on 30thJune 2016.

How Does Medical Insurance Work?

The Dubai mandatory medical insurance law is well-coordinated. Every year, the authorities set a budget, within which the participating insurers must set their premium pricing concerning the essential benefits plan. Since 2015, the minimum range has been fixed at  Dh 520 to Dh 730 insured per year.

Businesses that already have a policy for employers earning less than Dh 4000 will need to satisfy the following criteria –

 

  • The scheme benefits must meet or exceed those that are already covered in the Essential benefits Plan.
  • The cover must be provided only by Pls.

If deemed necessary, the employers will have to restructure their existing policy to abide by the guidelines stated by the law, before the first renewal date (but not later than 12 months). The company must adopt the changes before the deadline specified, as per the company size.

 How Will It Impact the Employees?

It’s essential for every employee to understand his/ her rights. The employer must provide the benefits at zero deduction from the employee’s end. The law also states that the employer also doesn’t have the right to reduce the salary to mitigate the cost.

Any individual earning less than Dh 40001 must be secured by any one of the nine Pls. The coverage level must be equal to or more than that is defined by the DHA.

What Impact does It have On Spouses, dependents and domestic workers?

The employer shall be solely responsible for arranging the insurance coverage of the employee’s spouse, dependents, and domestic workers, and also pay the premium timely to the insurer.

There’s no obligation for the company to provide coverage to the dependents. Though some companies provide coverage to the employee’s children at no extra cost, there’s no provision to include it in the basic DHA plan.

The residents must compare all the options as the basic plan is devised only for individuals with a comparatively low income. However, the employees must remember that the plan is valid only in  UAE, and therefore would not work for someone willing to opt for a treatment process overseas.

What does the Plan Must Comprise?

The minimum benefits that any health insurance plan in Dubai must provide –

    • A minimum annual limit of Dh150,000 per person.

 

    • The pre-existing and chronic conditions must be covered.

 

    • In-patient treatment must be included with a 20 percent excess. The maximum limit is Dh500 per encounter, with a maximum limit of Dh1,000 per year.

 

    • The outpatient treatment cost must be covered with a 20 per cent excess.

 

    • Cost of medicine must be included, but limited to Dh1,500 per person.

 

  • The plan must comprise maternity services. It shall comprise at least eight outpatient visits; an in-patient treatment cost up to Dh7,000 for normal delivery, and up to Dh10,000 for C-section and other complications. It is to be noted that all maternity services must be covered with 10 per cent excess.

 

Penalties

The authorities have clearly stated that fines will be imposed on any employer failing to comply with the regulation. A penalty of AED 500 shall be imposed each month under non-compliance. Additionally, no new visas will be granted, and the existing visas shall not be renewed. Fines will also be imposed by the concerned authorities on the event of renewal or cancelation of residence visas.

So, this was a detailed discussion on mandatory medical insurance law in Dubai. Still confused, or have some questions? Feel free to comment below, and we’ll cut the clutter.

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