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Dubai Mandatory Health Scheme- Essential Benefit Plan, explained
The nine companies that are offering the Essential Benefits Plan( EBP) are:
1 AXA Insurance
2 Ras Al Khaimah National Insurance Company
3 National Health Insurance Company (Daman)
4 Oman Insurance Company
5 Orient Insurance
6 MetLife Alico
7 Takaful Emarat
8 Dar Al Takaful
9 National General Insurance Company
EBP eligibility and annual Premium
Domestic workers with a salary of less than DH 4000.00 (DH 650.00)
Not active at work people aged between 0-65 years (DH 650.00)
Not active at work married Females aged between 18-45 years will have to pay between (DH 1600.00 TO DH 1750.00) but avail of the same benefit.
Not active at work parents aged 65 years and above (DH2500.00)
Features of the package Include
The insured have to pay 20 percent as co-insurance
The package has an annual upper aggregate of DH 150,000.00
There is a cap of DH 500 payable on every encounter.
There is also an annual aggregate cap of DH 1000.00 for the insured.
Above these caps, the insurer will cover 100 per cent of the treatment
Dental treatment as well as hearing and vision aids are not covered.
What is covered in the package?
Tests, diagnosis, surgeries in hospital for non-urgent medical cases.
Healthcare emergency for cases with chronic diseases.
Ambulance services in emergency
Accommodation of a person along with in-patient (DH 100 per night)
Examination, diagnostic and treatment services by authorized general practitioners, specialist and consultants.
Follow up visits within seven days.
Preventive services vaccines and immunizations.
10 percent co-insurance payable by the insured as well as eight visits to PHCs
Antenatal blood tests
Maximum Benefit of DH 7000.00 for normal delivery and DH 10,000.00 FOR C-section (10 percent coinsurance)
One-month cover for newborn and tests included in mother’s cover
Treatment for chronic and pre-existing conditions is excluded for first six months of coverage.