UAE Workers: A Guide to the New Basic Health Insurance Benefits and Exclusions
As of January 1, 2025, all private sector employees and domestic workers in the UAE are required to have basic health insurance coverage.
This new mandate primarily affects workers in Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah, and Fujairah, ensuring that all employees across the emirates have access to essential healthcare services.
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Who is Responsible for Insurance?
Employers are now tasked with purchasing this mandatory health insurance policy as a prerequisite for issuing or renewing residency permits through the DubaiCare Network or any approved provider.
This requirement does not apply to individuals holding valid work permits issued before January 1, 2025; however, they must obtain insurance upon the renewal of their residency permits.
Understanding the Workers’ Health Insurance (WIH)
The health insurance plan for employees is designated as ‘Workers’ Health Insurance (WIH)’, which can be acquired from the DubaiCare network by Dubai Insurance.
Coverage Exclusions
This mandatory insurance specifically applies to workers in the Northern Emirates; employees in Abu Dhabi and Dubai already have established health insurance requirements. However, there are several exclusions to be aware of:
- Pregnancy and childbirth
- Dental care
- Hearing and vision aids, including vision correction surgeries
- Smoking cessation programs and nicotine addiction treatment
- Cosmetic healthcare
- Treatments for obesity
- Mental health diseases, except in emergency situations
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Family Member Coverage
Workers can include their dependent family members in the health insurance plan with the same benefits and pricing. For policies covering children, proof of the parent’s insurance is mandatory.
Additionally, dependents over 64 years old must provide a medical application form, along with recent medical reports and prescriptions. To obtain coverage for dependents, the insured and sponsor must provide copies of their passports, visa pages, and Emirates ID.
Pre-existing Conditions
One of the notable benefits of the basic health insurance plan is that it covers pre-existing chronic diseases without imposing a waiting period.
Basic Health Insurance Benefits
The basic health insurance plan offers a range of benefits, including:
- Inpatient Care: A 20% co-payment is required, capped at Dh500 per visit and Dh1,000 annually. The insurer covers 100% of costs exceeding these limits.
- Outpatient Care: A 25% co-payment is applicable, with a maximum of Dh100 per visit. No co-payment is needed for follow-up visits within seven days.
- Coverage for Medicines and Treatments: Inpatient tests, diagnoses, and treatments are covered for non-urgent cases (subject to prior approval) with a 20% co-insurance, capped at Dh500 per encounter and Dh1,000 annually.
- Laboratory Tests: Covered with a 25% co-insurance.
- Physiotherapy: Up to six sessions covered (prior approval required).
- Drugs and Medicines: Coverage up to Dh1,500 with a 30% co-insurance.
- Telehealth Services: Included in the coverage.
For more detailed information about the policy terms and conditions, you can visit the official Workers Health Insurance website at www.whi.ae.
This new health insurance policy marks a significant step in ensuring that all workers in the UAE have access to necessary healthcare, enhancing overall well-being and security in the workforce.
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