What are the main exclusions of a Dubai health insurance policy?
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What are the main exclusions of a Dubai health insurance policy?

So you have your health insurance policy, and now you're all set against whatever life may throw your way, right? Not so fast! As it turns out, not all health insurance policies are created equal. In fact, most of them have specific lists of items that will not be covered under any circumstances. These are called exclusions, and different policies have different numbers of them. Want to know what common exclusions are? Have a look at this article to find out.



We all expect the best in life, but frequently we find out that things are not all that they are cracked up to be. While this is true for many important aspects of modern living, it is especially true when it comes to health insurance. While many of us are very happy to be provided with employer-sponsored health insurance plans, when we dig a little deeper, we may find that our health insurance doesn't protect us to the extent that we might have expected.

Yes, insurance companies have done their homework. They know that there are many items out there that, while unlikely to occur to the average person, are extremely costly to treat if they happen. What's more, over the centuries insurance companies have become wise to various scams and schemes that dishonest people have used to defraud insurers. This is where exclusions come in. An exclusion is a particular item, action, incident or treatment that is not covered by an insurance policy. By effectively utilizing exclusions in policies, insurers can reduce their costs, which benefits all other members in the pool of individuals insured by an company. This keeps premiums lower for every customer across the board.

For this reason, it may be good to examine the reasons behind exclusions before digging into specific exclusions themselves. Common reasons for exclusions include, but are not limited to:

  • Catastrophic incidents that affect a large number of people simultaneously

  • Incidents already covered under another insurance policy

  • Risks that are easy for the insured to control

  • Incidents that are not accidental in nature

  • Problems caused by maintenance issues or usual wear & tear

  • Illegal actions

 

Listing common exclusions

There are numerous different exclusions out there, and not every insurance policy has the same exclusions. This can make it a real headache to keep track of which specific things an insurance policy will and will not cover. This is especially true if you have recently switched policies and/or insurers, as the exclusions on a new policy could have some major differences to the ones from your previous policy that you may have been more familiar with. To better arm you with knowledge the next time you encounter an insurance plan with unknown exclusions, below if a helpful list that you can use when you are discussing details with your insurance provider. Feel free to run down the items and make sure that you become well versed in what your policy will and will not cover.

  • All medical care received must be deemed medically necessary. This means that items like elective surgery or unnecessary medical tests will not be covered.

  • Dental treatment and orthodontics are often excluded, but a separate coverage can be purchased.

  • Home nursing care.

  • Items purchased for convenience or personal comfort, such as beauty services, a visit from the barber, a new television, etc.

  • Any purely cosmetic medical services related to replacing breast implants. However, this is not to be confused with cosmetic surgery for improved physiological function, which is usually not excluded.

  • Any weight loss program or treatment for obesity, whether surgical or non-surgical.

  • Experimental research, procedures or treatments.

  • Any medical service received from an unauthorized care provider.

  • Smoking cessation programs.

  • Sterilization or contraception.

  • Gender reassignment surgery or associated treatment.

  • Prosthetics or similar medical equipment. One note here is that it may be a good idea to purchase Accidental Death and Dismemberment Insurance, which will pay out a large lump sum should you lose a limb. This money could be used to pay for any prosthetics needed.

  • Treatment related to hazardous activities, such as participating in professional or combat sports, rock climbing, horseback riding, water sports, vehicle racing or piloting a flying vehicle.

  • Growth hormone therapy.

  • Visions or hearing aids and testing.

  • Mental health conditions, with the exception of emergencies.

  • Patient treatment supplies that are not used during a medical emergency at a hospital or similar certified medical facility. As well, any supplies which are not considered medical in nature, such as toiletries, sanitizers, exercise equipment, arch supports, air conditioners or purifiers, food supplements, skin care products, etc.

  • Allergy tests and allergy desensitization treatment.

  • Any medical service administered by a family member.

  • Tube feedings.

  • Chiropractic services.

  • All forms of alternative medicine, including homeopathic remedies, ozone therapy, aromatherapy, massage therapy, hypnosis, acupressure or acupuncture.

  • Most forms of fertility treatment, including in-vitro fertilization (IVF).

  • Treatment for a deviated septum.

  • Dialysis.

  • Viral hepatitis, except Hepatitis A.

  • Birth defects.

  • Alzheimer's disease and dementia.

  • Medical evacuation or unauthorized transportation.

  • Inpatient treatment without prior approval, or medical emergencies of which the insurer is not notified within 24 hours of admission.

  • Inpatient treatment that could have been delivered on an outpatient basis.

  • Having more than one consultation with a medical specialist in the same day, unless referred by a treating physician.

  • Organ transplants, including complications or follow-up treatments.

  • Immunotherapy.

  • Sleep disorders.

  • Educational programs or services for handicaps.

 

Other considerations

There is another host of exclusions for conditions sustained as a result of incidents considered to be outside the scope of insurance. These include conditions sustained as the result of war, terrorist attacks, natural disasters, chemical or nuclear contamination, criminal acts on behalf of the insured, road traffic, the intake of alcohol or banned substances, treatment not prescribed by a doctor, suicide or otherwise self-inflicted injuries, epidemics, and HIV/AIDS.

Now that you know which exclusions to watch out for, go a step further by partnering up with an insurance broker like UAE Medical Insurance for your future insurance needs. By doing this you can compare insurance plans and prices from a number of different insurance companies all at once, all while being lead through the process by a knowledgeable UAE insurance professional that can answer any questions you may have. Contact UAE Medical insurance today for a free quote!

 

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