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Addressing costs beyond essential benefits: When your insurance isn’t enough
Posted on Nov 02, 2017 by Travis Jones
Does your current health insurance policy provide all the benefits you will need. If you have one of Dubai's essential benefits plans, the answer to this is quite possibly, "No." Here, UAE Medical Insurance examines this topic and offers you solutions.
If you are at all new to Dubai, you may not even realize that you are now living in a much different emirate than long established Dubai residents are used to. Not because there has been an astounding amount of cultural, political, social or even economic change in the UAE in recent years, though.
This big change (which you may not even be able to identify, especially if you come from a country with universal healthcare) is that every person here now has Dubai health insurance, whereas before there were many uninsured individuals. The thing is, some people have the notion that their new health insurance plan may not reliably provide all the medical insurance protection they need. Is this fear well founded? What can people do to ensure their access to the best healthcare available? Find out more below.
Vote of low confidence
Do people in Dubai really not have faith that their health insurance will provide the coverage they need? Well, according to a survey from major worldwide insurance company Cigna, for about half of Dubai residents, this is indeed the case. The 2017 Cigna 360 Well-being Survey states that nearly 50 percent of its respondents are concerned that their insurance will be insufficient to pay for their or their family’s healthcare costs. Of course, this is even though these respondents already have a government approved Dubai health insurance plan in place.
Even with health insurance in place, ~20% of those surveyed still delay necessary health checks, while a staggering 93% opt to self-medicate when they are ill. Of course, this may be related to the finding that 43% of UAE residents surveyed state that they do not trust insurance companies. Those taking the survey largely recognize the value of their health insurance - with 66% of those surveyed stating their work coverage is important to them - but that isn’t to say that they haven’t identified issues with this coverage. The truth about company-sponsored insurance and its gaps in coverage is then evidenced by some survey takers indicating that they are still forced to spend out-of-pocket on medical costs despite being health insurance policyholders.
So where does the issue of gaps in Dubai medical insurance coverage stem from? It all starts with Essential Benefits Plans.
Essential Benefits Plans and you
Many people in Dubai receive their health insurance from their employer. On the other hand, people who work for themselves, and working people with families that need health insurance, will have to arrange for a policy that will cover them. People in these camps, as well as businesses that source group health insurance, will sometimes make cost their number one concern when selecting an insurance plan.
Traditionally the cheapest plans available are also the ones with the weakest coverage, so the Dubai Health Authority (DHA) has taken steps to ensure that every health insurance policy delivers on the promise of covering medical costs to a reasonable extent. This is where Essential Benefits Plans come from. Essential benefits, in this case, refer to Dubai medical insurance policy benefits that meet the minimum requirements for coverage, as laid out by the DHA. These include:
An annual maximum benefit limit of AED 150,000
Basic health coverage at any Dubai hospital
Emergency coverage at any UAE hospital
In and out-patient maternity insurance coverage
Coverage for pre-existing conditions
An annual maximum medication limit of AED 1,500
And much more
It should be noted that many benefits on Essential Benefits Plans include a co-payment of up to 20%.
With the above in mind, it is also important to note that there are certainly situations where the limits of an Essential Benefit Plan’s coverage elements can be reached. In such a case, the burden of settling any costs beyond these limits will fall upon the patient to address out-of-pocket. Just how worried should people be about this scenario, though?
As an example, let’s look at a story that was in the news in 2017: An American man living in the UAE spent quite a long time in a hospital in Abu Dhabi in 2016 thanks to a broken back. During the course of his stay, the expat managed to rack up a bill of AED 230,000! Applying this case to the maximum annual benefit of AED 150,000 that is available on Essential Benefits Plans, and you could easily be on the hook for AED 80,000! Clearly this is no good, and people are right to investigate how they can address these types of overages.
Addressing medical costs
Fortunately for UAE residents, there is already a product available on the market which can address exactly the problem described above. If you are, say, someone whose employer has provided them with an Essential Benefits Plan, and you want to increase your level of coverage, you really have two options.
The first option is to purchase a totally new health insurance plan with much higher maximums and superior benefits. While this solution will get you the coverage you want, it can certainly be pricey, and it will really not be taking advantage of the plan your employer has already provided you at all. As such, the value you get out of both plans will be diminished.
The second option is known as a top-up health insurance plan. This nifty type of insurance plan does not give you an entirely new plan, so much as an addition to your normal plan in that it picks up where you Essential Benefits Plan leaves off. For example, once you reach the annual maximum of AED 150,000, a top-up plan will then continue providing benefits up to a new additional amount. These types of plans can also add benefits that are not found on your existing plan, such as vision insurance, and all for a cost that is likely to be much less than buying a completely new health insurance policy.
Just to be clear, top-up plans can work in conjunction with any other type of health insurance plan, not just Essential Benefits Plans. They do not even necessarily have to come from the company providing your existing insurance.
If you think that your current health insurance plan may not adequately address your family’s insurance needs, and top-up insurance may be a product that’s right for you, contact UAE Medical Insurance today! Our agents will gladly examine your policy and let you know where you may be most exposed to medical costs. Not only that, they will gladly offer a number of top-up solutions and free price quotes.