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Choosing a Basic Health Insurance Plan in UAE: The Essential Benefits Plan (EBP)

Basic Health Insurance Plan - Health Insurance - Gargash Insurance 27 Apr, 2023

Looking for affordable basic health insurance plans in the UAE? An EBP plan is a great option to avail protection for yourself and your loved ones.

What is meant by basic health insurance or EBP plans in UAE?

Essential Benefits Plan or EBP refers to the minimum or basic health insurance coverage that nationals and expat residents are mandatorily required to have as per UAE residency laws.

Quick Read Section

  • The Essential Benefits Plan, also known as the EBP, is the minimal level of health insurance that residents of the United Arab Emirates are legally obliged to have.
  • It is most suitable for UAE citizens with incomes under AED 4,000 and for dependents who are not employed at all.
  • EBP plans are significantly less expensive than comprehensive health insurance policies.
  • EBP plans are available for different monthly and yearly premiums that cover medical expenses.
  • In the UAE, basic health insurance is available at an average annual premium of AED 550 and AED 650. Each emirate in UAE also has its own rules for basic health insurance plans for individuals, families & aged dependents.

Individuals residing in UAE must at least be enrolled under an EBP plan if they cannot afford comprehensive health insurance plans with higher premiums. The Essential Benefits plan is best suited for UAE residents earning an income lower than AED 4,000 and for their dependents who do not work at all.

The Essential Benefits plan ensures that residents across the UAE get access to healthcare facilities to cater to their medical needs and are not neglected services in case of emergencies. It also provides a way to make certain that vulnerable workers are protected under a health insurance plan. The cost of EBP plans are much lower than health insurance plans that offer comprehensive coverage.

 

 

Which insurance companies offer DHA-approved basic health insurance plans?

Every resident of Dubai is required by the Health Insurance Law to have health insurance coverage that either meets or surpasses the DHA's minimum requirements for benefits. 

The Essential Benefits plan can only be provided by insurance firms that can offer cost-effective and profitable plans, who can effectively manage large turnover, and at the same time display exemplary levels of customer service.

According to ISAHD's list of Participating Insurers, the companies that are authorized to sell DHA- approved EBP plans are:

 

INSURANCE COMPANY

INDEX RATE

1.

ADNIC- Abu Dhabi National Insurance Company

AED 575

2.

NGI- National General Insurance 

AED 550

3.

Union Insurance Company

AED 550

4.

Orient Insurance

AED 550

5.

Cigna Insurance

AED 730

6.

Watania Takaful Insurance

AED 550

7.

DNI- Dubai National Insurance Company

AED 535

8.

Sukoon Insurance (previously Oman Insurance)

AED 560

9.

Al Saqr National Insurance Company

AED 525

 

What is the difference between basic and comprehensive health insurance?

  • Basic health insurance plans offer coverage against medical expenses as a result of an injury or illness. Health insurance companies in UAE offer EBP plans that provide basic health insurance coverage to both individuals and families. EBP plans can be purchased at various monthly and annual premiums that cover treatment costs. Unlike comprehensive health insurance, basic health insurance plans do not cover certain medical conditions and have a sum limit on insured coverage.

 

Reach out to an insurance broker to choose health insurance coverage that benefits you at times of need.

  • Comprehensive health insurance offers extensive protection against treatment costs and covers lab tests, consultation fees, cost of medicines, and inpatient and outpatient medical expenses. Comprehensive health insurance also gives you the benefit of coverage for alternative treatments such as homeopathy and ayurveda. You can also include dental and optical coverage as an add-on.

 

How much does basic health insurance cost in UAE?

Dubai Health Authority (DHA) announces premium rates that participating insurance companies offering EBP plans must adhere to each year. For employees, the premium rates presently cost between 500 and 750 AED annually.

Category

Average EBP Premium Rates

Non-working individuals aged between 0-65

AED 550 per year

Non-working married females aged between 18-45

AED 1771 per year

Senior Citizens

AED 4,000 per year

Domestic Workers earning below AED 4,000

AED 535 per year

 

EBP plans in UAE can be availed at a fixed premium cost ranging between AED 550 and AED 650 per annum. Coverage under EBP plans includes emergency costs, medical invoices, lab tests, inpatient and outpatient treatments, surgery costs, and maternity treatments.

EBP plans have an average annual sum limit of AED 150,000 and the coinsurance payable by the insured is 20% for basic in-patient treatments. These inpatient treatments have a limit of AED 500 per visit and an annual limit of AED 1000, the insured has to pay for costs exceeding these limits. Medication cost coverage has an annual sum limit of AED 1,500 and the coinsurance payable by the insured is 30%. Treatment for pre-existing conditions is not covered in the initial six months and is included under coverage only in the later months. Maternity coverage includes outpatient services such as blood tests, three ultrasound tests, and eight pre-delivery consultations. As for inpatient services, up to AED 7000 for normal delivery and up to AED 10,000 for C-section deliveries are covered. The coinsurance payable by the insured for maternity services is 10%. Maternity treatment for the first month after delivery is also covered under EBP plans.

 

EBP Plan Coverage

Annual Sum Limit

Co-pay %

Medicines

AED 1500

30%

Inpatient treatments

AED 1000

20%

Maternity treatments

AED 7000 (Normal)

AED 10,000 (C-section)

10%

 

Does my basic health insurance plan cover surgery?

Yes, emergency care is covered by EBP policies along with outpatient and inpatient care, surgery, medical exams, and medication. Therefore, surgery costs are covered under the Essential Benefits plan.

However, it is necessary to obtain prior approval or pre-authorization from the insurance provider first because it is possible that certain in-patient coverage, such as diagnostic tests, treatments, and surgeries in non-life-threatening cases, will not be covered. Additionally, since it is a basic plan, there are limits and limitations that should be known regarding EBP, such as a maximum coverage per year of AED 150,000.

 

 

Best Basic health insurance packages available in Dubai

  • ADNIC Insurance

ADNIC offers EBP plans at a basic starting rate of AED 575 and covers inpatient and outpatient treatments, physiotherapy, diagnostics, and medicines with a 20% to 30% copay. Additional benefits include emergency and repatriation expenses, diabetes screening, cancer screening and can also be extended to include pregnancy and newborn cover. 

  • Sukoon Insurance

Sukoon offers EBP plans at a basic starting rate of AED 560 per annum which includes coverage for inpatient and outpatient treatments, emergency cover, lab tests, and maternity treatments.

  • National General Insurance

NGI Insurance offers EBP plans at a basic starting rate of AED 550 and coverage for in-patient consultations, diagnostics, treatment, surgical procedures, pre-existing conditions and physiotherapy sessions with 20% copay. Outpatient benefits include physiotherapy, radiology diagnostics, and lab tests. Additional benefits include maternity services and new born cover. 

  • Union Insurance

Union Insurance's EBP plans can be purchased at a basic starting rate of AED 550 and include coverage for pre-existing and chronic conditions, accommodation room charges, consultations and
diagnostic procedures, pre-approved minor surgical procedures, prescribed medicines and dental treatments. Additional benefits include preventive medicine, vaccines, and maternity services. 

  • Cigna Insurance

Cigna offers EBP coverage at premium rates starting from AED 730. Their EBP plans benefits include in-patient services such as tests, diagnosis, treatments and surgeries in hospitals for non-urgent medical cases with 20% copay. Outpatient treatment benefits include Laboratory tests, Radiology diagnostic services, Physiotherapy, preventive services.

  • Dubai National Insurance

DNI’s EBP plans are suitable for employees with low salary band, below AED 4000 and have a basic starting rate of AED 535. The plan covers pre-existing and chronic conditions, inpatient treatment services such as hospital accommodation, Intensive care unit and coronary artery disease treatment, physiotherapy, chemotherapy, and radiation therapy. Outpatient benefits include diagnostic procedures, surgery, vaccines, cancer treatments and maternity services.

  • Watania Takaful Insurance

Noor Takaful Insurance plans have a basic starting rate of AED 550 and provide a yearly cover of AED 150,000. Their EBP plans offer coverage for chronic conditions, hospital accommodation, vaccination, physiotherapy, scans, and health checks. Coverage for pre-existing conditions is not included under this plan.

  • Orient Insurance

Orient Insurance offers DHA EBP plans which are categorized into IMed, DMed, and EMEd policies. EMed plans offer medical coverage to employees and domestic workers with incomes lower than AED 4,000. DMed plans offer coverage for non-working dependents or parents. And IMed plans offer medical coverage for investors. Orient EBP plans can be purchased at a premium rate starting from AED 550 including coverage for inpatient and outpatient treatments, chronic pre-existing conditions, medications, preventive medicine, and maternity coverage.

 

Is choosing a basic health insurance plan worth it?

The Essential Benefits Plan offers standardized health insurance plans that cover basic benefits and can be availed at reasonable rates per year. Purchasing an EBP plan is ideal for those who cannot afford to buy health insurance for their dependents at higher premium rates. EBP plans reduce treatment costs for health checkups, emergency medical bills, and other medical expenses.

But if you’re looking for health insurance plans offering a higher annual sum limit or worldwide coverage, then EBP plans are not worth investing in. Since EBP plans offer basic coverage that is only valid in UAE, these plans are not suitable for those looking for plans that cover overseas treatments. Worldwide coverage and other benefits are provided by enhanced health insurance coverage which can be availed at an average annual premium of AED 15,000.

 

Get assistance from Gargash Insurance Services

With the help of a trustworthy insurance broker like Gargash Insurance, ensure that you obtain the appropriate insurance plan to meet your requirements. We help compare quotes from top insurance companies in UAE so you can quickly find the best option for your budget, whether you're looking for family insurance, medical insurance, car insurance, or other kinds of insurance.

Contact us today for all your health insurance needs!

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