As an expat, it can take some time to get used to the extreme weather conditions in the UAE. However, good career prospects, tax free income and a better quality of life more than compensate for the harsh climate. The UAE’s superior standard of living is also reflected in its world class healthcare facilities. Naturally, top of the line medical care is often expensive. To make sure that healthcare costs don’t get the best of you, take your time in selecting a comprehensive insurance policy.
There is a plethora of policies available in the market but one has to always consider various factors to ensure that the policy provides the most comprehensive and relevant benefits. Many insurance companies offer basic insurance policies, but such plans do not cover a host of common medical issues. An ideal insurance plan offers an extensive area of coverage, a wide network of hospitals and medical centers, efficient customer service and convenient claim settlement when treatment is received outside the network.
Understanding health insurance plans can be a nuisance. Most people don’t know where to look or who to consult for information on available healthcare products. Here are a few important things that you must consider before choosing an insurance policy for you and your family.
1. General aspects of coverage
The maximum coverage limit of an insurance policy is the overall amount that an insurer will pay for all of the medical expenses incurred by a member during the policy period (usually a year).
The area of cover refers to the geographical coverage of the policy (i.e. the countries in which you are covered under your policy). The coverage amount and area of cover are two important factors that impact the premium that you will have to pay for your insurance plan.
Another important detail to look into is whether the policy covers pre-existing conditions. For instance, if you have a pre-existing heart condition, would a cardiac surgery or angiography be covered by your plan or not?
2. Medical Network
Make sure that all major hospitals and medical providers that you normally go to, especially the ones closer to your residence, are part of the insurance provider’s network. Furthermore, it would be a good idea to ensure that the medical facilities in the network provide the types of treatments that you are most interested in (you can look at the specialties available at each of the facilities).
3. Benefits
One should also look at the list of benefits provided. Note that a policy may or may not have a sub-limit for specific benefits. In addition to the usual benefits, some policies offer extra covers such as dental, optical and wellness benefits. These optional benefits can often be availed by paying an extra premium.
4. Deductibles and co-insurance
Deductibles and co-payments are also important factors that should be considered. A deductible is the fixed amount that you have to pay from your pocket for a covered treatment (your share of the medical costs). It can range from AED 20 to AED 75 per treatment or consultation and is usually applicable for out-patient treatments. Co-payment or co-insurance is the percentage of the total cost that has to be paid by you for a covered treatment. For example, if the maternity benefit is covered with 10% co-insurance, then you will have to bear 10% of the maternity treatment cost and the insurer will cover the remaining 90% of the cost.
5. Exclusions
Just like there are treatments or conditions which are included in your plan, there are certain exclusions or excluded treatments in the plan as well. Exclusions are the medical conditions or treatments that will not be covered by the insurer for your chosen plan. No plan is completely comprehensive; thus, every plan will have a long list of specific conditions which are excluded. Some common exclusions are obesity, hair loss, cosmetic surgery, infertility, HIV or AIDS, vision correction, allergy testing, epidemics, etc.
6. Claim settlement
Another important component to be considered by the insured is the claims settlement procedure. Generally, the insurer provides direct-billing facilities for both in-patient and out-patient treatments. For out-of-network treatments, you can apply for reimbursement of the expenses incurred. This is not a major concern if you are dealing with a small claim but it can obviously cause serious financial burdens if you have to pay out of pocket for a significant treatment or surgery.
You should also note that if you opt for treatment outside the insurer’s network, the insurer might not reimburse you 100% of the healthcare costs.
7. Premium
A standard insurance policy from a good health insurance provider can cost anywhere between AED 1,500 to AED 10,000 depending on the coverage amount, area of coverage, age and gender of the insured, and the network selected. However, there are other factors that could affect the price of an insurance policy such as chronic and pre-existing conditions.
8. International Validity
If you have a job that requires you to travel outside the UAE frequently, you must ensure that coverage travels with you. Choose a plan that has international coverage to avoid coughing up large sums of money if you need medical attention while on a trip.
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