Health Insurance Abu Dhabi

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Health Insurance Abu Dhabi

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Protecting your and your family’s well-being is one of the most important responsibilities you need to fulfil. From providing them with the best possible healthcare services to ensuring preventive care, there are a lot of small steps one can take to ensure good health. Finding proper health insurance coverage is one such thing you need to do here; easier said than done. While buying health insurance Abu Dhabi is quite easy, choosing the right plan can be tricky at times. Moreover, plans and benefits change as per the emirate you reside in. Here, we will focus on finding everything you need to know about Abu Dhabi health insurance policies and their features, top health insurance companies in Abu Dhabi, buying procedures, claims, and most asked questions of all times.

Features and Benefits of Abu Dhabi Health Insurance 

  • Hospitalisation Benefits: Most Abu Dhabi medical insurance plans cover hospitalisation expenses when you need to be admitted for a procedure. This applies to hospitalisation due to any disease covered in your medical insurance plan. 
  • Day Care Cover: In addition to procedures and conditions that require you to stay in a hospital, Abu Dhabi medical insurance also cover daycare procedures. Daycare procedures are the ones that do not require to stay in a hospital for more than 24 hours. This can include some surgeries like cataract surgery or dental surgical procedures. 
  • Cashless Treatment Facility: Cashless treatment facility allows the policyholders to have their treatment charges paid directly by the insurance company. Most Abu Dhabi medical insurance plans come with a cashless treatment facility aka a direct claim facility. This eliminates a significant amount of paperwork that is required when you make reimbursement claims. 
  • Doctor Consultation: Consultations with your primary care physician are generally covered by health insurance in Abu Dhabi. However, many Abu Dhabi health insurance policy also cover consultations with specialists when recommended by your PCP. 
  • Pre and Post Hospitalisation Benefits: In addition to all the expenses you incur when admitted to a hospital, Abu Dhabi health insurance policy also cover pre and post hospitalisation services. Ambulance rent is an example of pre-hospitalisation expense while follow-ups and medicine are examples of post-hospitalisation expense. 
  • Room Rent Benefit: The room rent benefit of health insurance Abu Dhabi is offered to cover the expenses of the hospital room after your surgery. This benefit is offered in-room rent benefit can differ as per the type of rooms in a hospital. For example, semi-private rooms, private rooms, wards, etc. 
  • Preventive Services: Preventive healthcare cover is another benefit you can look forward to here. Most Abu Dhabi medical insurance plans cover preventive services like immunisation. This is generally available for children but depending on the plan benefits, services like immunisation via vaccines can also be covered for adults. 
  • Critical Illness Benefit: Illnesses that can be life-threatening are categorised as critical illnesses. Abu Dhabi health insurance field has special plans designed specifically to cover critical illnesses. These plans offer a lump sum compensation amount when the policyholder is diagnosed with a covered critical illness.
  • Pharmaceutical and Diagnostic Tests: Most prescribed drugs and medicines are also included in Abu Dhabi health insurance policy widely. Diagnostic tests like CT Scans and MRIs are also covered by these plans. 

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Types of Abu Dhabi Health insurance policies

  • Individual Health Insurance: As evident by the name, individual Abu Dhabi health insurance policies are designed to cover a singular policyholder. Individual health insurance policies are one of the most basic kinds of health insurance policies available around the world. The benefits included in these plans can range from the basic ones like hospitalisation cover to the most exclusive ones like organ transplant cover. The plan structure may differ as per the level of coverage you choose. 
  • Family Health Insurance Abu Dhabi: A very cost-effective way to ensure well-rounded protection for your family’s health. Family health insurance policies in Abu Dhabi are designed to ensure that all your dependents get the optimum level of coverage as per their individual needs. You can find two kinds of family Abu Dhabi health insurance policies. One with capped assured sum limit and the other with no capping. Capped family health insurance policies divide the total assured sum among all insured members of the plan. This way, everyone gets to use a part of the assured sum. Family health insurance policies without any capping leave the complete assured sum to be utilised by any insured member of the plan. Many family health insurance policies in Abu Dhabi may have a capping on the maximum number of members to be insured as well. 
  • Critical Illness Abu Dhabi Health Insurance: Critical health insurance policies, as the name suggests, are typically made to cover critical illnesses only. Critical illnesses are the ones that can present a potential threat to life, for example, cancer. However, unlike terminal illnesses, critical illnesses are treatable in the early stages. Critical illnesses insurance plans work a little differently than normal health insurance policies. Policyholders get a lump sum compensation amount when they get diagnosed with a critical illness. The compensation amount can be used to cover the medical expenses or in other ways the policyholder sees fit. 
  • Senior Citizen Health Insurance Abu Dhabi: Endowed with special benefits and services, Abu Dhabi health insurance policies for senior citizens cater to Abu Dhabi residents older than 60 years. The age bar can go up or down a little as per providers. Most benefits included in senior citizen Abu Dhabi health insurance policies are similar to that of basic plans. However, some added covers are also included here. This can include health camps and check-up seminars for policyholders. Senior citizen health insurance policies are generally more expensive given the higher risk involved. Medical check-ups may also be required as a part of the application process. 
  • Group Medical Insurance Abu Dhabi: This is a commercial health insurance plan used by businesses. Group health insurance policies are provided to employees of a company. One plan covers all employees at once here. Since employers in Abu Dhabi also have to cover dependents, group health insurance policies cover employees and their dependents under a single policy. 

General Inclusions of Abu Dhabi Health Insurance 

  • Hospitalisation expenses and room rent expenses 
  • Pre- and post-hospitalisation expenses such as ambulance fees, medicines, follow-ups with the doctor, etc. 
  • Pre-existing health condition, after a waiting period
  • Critical illnesses
  • In-patient benefits 
  • Doctor consultations with primary care physician
  • Specialist consultations 
  • Routine health check-ups and tests
  • Vaccination 
  • Daycare procedures
  • Maternity cover and infant cover
  • Prescription medicines
  • Organ transplants
  • Diagnostic tests 
  • Cover for psychological illnesses
  • Rehabilitation therapy
  • Home nursing expenses

General Exclusions of Abu Dhabi Health insurance policies

  • Sexually transmitted diseases like AIDS
  • Any kind of alternative medicine treatment 
  • Cosmetic surgeries like plastic surgeries
  • Any other kind of surgery that is not medically necessary 
  • Injuries or treatment required due to suicide attempts or self-inflicted wounds
  • Medical treatment for obesity 
  • Injuries and diseases caused by radioactivity or explosions
  • Benefits like maternity, dental and optical are also treated as exclusions when not covered as add-ons or basic benefits

Common Add-ons of Abu Dhabi Medical Insurance Plans 

  • Dental cover 
  • Optical cover 
  • Maternity and pregnancy cover
  • Personal accident cover
  • Hospital cash benefit
  • Second opinion benefit
  • Critical illness cover
  • Room rent waiver 
  • Geographical extension cover

Top Health Insurance Companies in Abu Dhabi

Abu Dhabi Health Insurance Companies Details of Plans and Benefits
Takaful Emarat Comprehensive plans with over 4000 medical facilities in their network
Orient Insurance PJSC Over 15 different comprehensive and basic plans with 5400+ medical facilities and 8600+ pharmacies
Abu Dhabi National Insurance Company (ADNIC) Five choices of health insurance policies with comprehensive as well as essential benefits plans in choice. 
Watania Health Insurance  Plans with comprehensive benefits and over 7300 pharmacies and 3900+ clinics and hospitals
Alliance Insurance  3000+ clinics and hospitals in the network and multiple comprehensive health insurance policies
Adamjee Insurance Over 900 clinics and hospitals with multiple levels of comprehensive health insurance policies
Noor Takaful 400+ clinics and hospitals with dental services 
Daman Health Insurance Dedicated individual, senior citizen and family health insurance policies with multiple options

How to Choose the Perfect Abu Dhabi Health Insurance

  • Compare Health insurance policies: Finding the right Abu Dhabi medical insurance can be tricky since there are so many options available. The ideal way to go about it is to compare your options properly. Choosing a health insurance plan without comparison may lead you to have insufficient coverage or unnecessary benefits you don’t need. 
  • Evaluate Employer-Provider Insurance: Since every working professional and dependents are eligible to get employer-provided health insurance Abu Dhabi, you may have one too. But not all employer-provided health insurance policies offer good enough coverage. Make sure you evaluate the coverage your group health insurance plan offers before you get a personal plan. Unlike car insurance plans, you can have multiple health insurance policies. But buy another plan only when and if you need it. 
  • Scout Different Providers: Just like you get multiple options for Abu Dhabi health medical insurance plans, you also have multiple options when it comes to providers. Make sure that you research well about the provider you want to go with. Gather reviews from existing customers as well as. Check the claim settlement ratio and customer support system as well. Make your final choices only after you have conducted all the research properly. 
  • Know What You Need: Knowing your needs is very important when it comes to choosing the right Abu Dhabi medical insurance plan. Check your medical history, family history of illness, etc. See what kind and level of healthcare services you use in a year. Choose a health insurance plan based on your evaluation. For example, if you only need Abu Dhabi medical insurance for general healthcare services, choose a plan that comes with preventive healthcare cover and an annual full-body diagnostic test cover. 
  • Obtain Multiple Quotes: make sure you get multiple quotes even after comparing plans and finding your top choices. Getting quotes will help you find the cost-effectiveness of each plan that you have chosen. Pick the final plan once you have all cards on the table. 
  • Check Network Hospitals: Abu Dhabi medical insurance plans come with a network of hospitals. These hospitals have a tie with the insurance providers. Only your network hospitals accept your insurance coverage benefit. Ensure that the network hospital list of the plan that you choose includes plenty of hospitals from your area. 
  • Get Preventive Health Services Covered: Preventive healthcare services like immunisation are more important than we may think. Ensure that your health insurance plan covers them since vaccines can be quite expensive. 
  • Choose Add-ons Carefully: Using add-ons to customise your Abu Dhabi medical insurance plan is a good idea. However, do not get add-ons when you don’t need them. Choose your add-ons carefully since they come with an added premium. 

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Which Abu Dhabi Health Insurance Plan is Right for You?

Your Requirements Ideal Abu Dhabi Health Insurance
Critical illnesses or pre-existing conditions  Critical illness health insurance
Complete accidental coverage Personal accident cover
Maternity and pregnancy services Maternity health insurance policy
Cover for the whole family  Family floater plans
Cover for your elderly parents  Senior citizen health insurance policy
Reimbursement/funds for hospital room  Hospital cash plans
Wide coverage  Exclusive, comprehensive Abu Dhabi medical insurance plans

Factors Affecting Abu Dhabi Health Insurance Prices

  • Age of the Policyholder: The age of the policyholder makes a huge impact on the premium of a health insurance plan. Younger people are less likely to fall ill and even less likely to develop a condition that requires hospitalisation or intensive care. This makes them less of a risk for insurance companies. This means that the premium is lower for young health insurance policyholders. Similarly, since older people are more prone to fall ill and submit a claim against their health insurance policies, the premium for their health insurance policies is higher. 
  • General Health: Generally healthy people have a higher chance of scoring lower premiums for their health insurance policies. The logic applied here is similar to the one that applies in the case of age. Generally, unhealthy or weak people get higher health insurance premiums since they are a bigger risk for the insurance company. 
  • Lifestyle Choice: Both healthy and unhealthy lifestyle choices can make a huge impact on the premium of your Abu Dhabi health insurance plan. Habits like smoking and regular drinking will increase the premium since they create a health hazard. On the other hand, people who take on healthy habits like exercising daily get lower premiums for their health insurance policies. 
  • Geographical Conditions: Some places increase your chances of catching a disease. For example, if you live near a plant that produces fumes, you have a higher chance of getting respiratory diseases. Living in regions that may make you prone to catching diseases will increase your Abu Dhabi health insurance premium. 
  • Plan Tenure: Short-term health insurance policies are generally more expensive as compared to long-term plans. Short-term plans can be a few months long while long-term health insurance policies are generally one year long. 
  • Work Conditions: Conditions at your workplace can often lead to heightened Abu Dhabi health insurance premiums as well. For example, if your work in a factory that produces harmful fumes, the premium of your health insurance policies would be higher. This is because you are at a higher risk of getting respiratory diseases than someone who works at a desk job. 
  • Pre-existing Conditions: Having pre-existing health conditions is one of the biggest factors behind increased health insurance prices. While Abu Dhabi health insurance policies are required to cover all pre-existing diseases, the providers do charge more money for it. Yet again, being at an increased risk of falling ill is the reason here. If you are a patient of asthma, you become a high-risk customer for insurance providers.
  • Medical History: Another thing that makes you a high-risk customer is your medical history. People who have a history of falling ill often will attract high Abu Dhabi health insurance premiums. 

How to Buy Health Insurance Abu Dhabi 

Buying health insurance policies is quite easy when you have all the resources and information you need. There are two ways you can buy Abu Dhabi health insurance policies – online and offline. Offline purchases are generally conducted with a broker or at a branch of the provider you choose. While online purchases can be conducted from your phone, tablet or laptop. You can buy your Abu Dhabi medical insurance plan from Policybazaar UAE or the provider website. 

To buy your medical insurance Abu Dhabi offline, either find a broker or a nearby branch of the provider you choose. If you have a broker, let them know about the insurance plan that you want to buy. Mind that the broker has to be associated with the provider you choose. Once your broker knows the plan, they will initiate the buying procedure. You will have to fill out a few forms and then finalise the purchase. If you want to buy directly from the provider, simply go to the nearest branch in the emirate of Abu Dhabi. You will get assigned a representative there who will carry forward the purchasing process. Note that you can need to do your research about the plan beforehand here. You will not get to research as you go or choose plans more flexibly with offline purchases. 

To buy your Abu Dhabi health insurance online, visit either policybazaar.ae or the provider website. The purchasing procedure is pretty much the same for both. When buying your health insurance plan from Policybazaar UAE, you will be required to head to the health insurance page. Fill out the lead form given on the page using your basic personal info. Once you are done with that, a list of the most suitable health insurance plan will appear. Compare on the spot or take your time in doing so. Once you have finalised the plan you want, pick it up and go to the buying portal. Complete the purchase by adding the required information and documents. Make payment and you are done. Insurance documents are forwarded to you in your registered email. The coverage begins in a day or two. 

Advantages of Buying Abu Dhabi Health Insurance Online

While of course, you have options to buy your health insurance online as well as offline in the emirate of Abu Dhabi, buying your health insurance online comes with several added advantages. Given below are some of the reasons to choose online shopping over offline for your Abu Dhabi insurance for healthcare:

  • Flexibility: Where offline purchases require you to either be there in person at the branch or meet a broker, online purchases offer much more flexibility. You can simply sit back in the comfort of your house or at the office lounge and buy your insurance plan. The rigidity of meeting people and then buying the plan after several hours of paperwork and signature is not there with online purchases. 
  • Ease of Comparison: If you buy your Abu Dhabi insurance for healthcare online, the comparison is easy and swift. You can use the same websites for buying as well as comparing health insurance policies. For example, you can not only compare plans and providers on policybazaar.ae but then proceed to buy the plan you choose simultaneously. This is not possible when it comes to offline purchases. 
  • Simpler Process: The buying procedure is quite simple with online purchases. You do not have to deal with paperwork at all. You do not need to gather your documents in the physical form either. Scanned documents can be used to finalise your purchases. 
  • Instant Coverage: Health insurance policies bought offline begin once all the paperwork has been processed. This may take up to a week or more. While policies purchased online begin coverage almost immediately. The processing is the almost instant ad you receive the policy documents swiftly as well. Coverage for online plans begins in a day or two at max. 
  • Free and Instant Quotes: Obtaining a quote for any plan you like is instant and most important free when you are going with the online buying procedure. You can sit back, take your time, obtain some quotes and compare plans properly before you proceed to buy them. 
  • Added Discounts: Almost all Abu Dhabi health insurance companies offer special discounts on online purchases. While you may not come across many promotional offers when it comes to insurance, online purchase discounts are almost always there. 

Eligibility Criteria for Abu Dhabi Health Insurance 

Given below are the eligibility criteria to buy Abu Dhabi medical insurance policies:

  • All applicants must be older than 18 years of age. The maximum age to get an individual health insurance plan is 60-65 years, depending on the provider. After that, you can get senior citizen health insurance policies. 
  • Abu Dhabi medical insurance policies can be taken by residents and citizens of the emirate of Abu Dhabi. 
  • Newborn children can be covered as dependent from birth after their infant care coverage ends.

Health Insurance Claim Process for Abu Dhabi

Submitting claims against your health insurance plan is quite easy. You can make two kinds of claims for your insurance policies – reimbursement and direct claims. Given below is the complete process for both reimbursement and direct claim process. 

Abu Dhabi Medical Insurance Reimbursement Claims 

  • Obtain a claim form from the provider website. Most providers have links to reimbursement forms on the website claim portal. 
  • Fill out the form properly. Make sure you do not make any errors and do not leave out any important information. Incomplete claim forms or forms with errors are rejected. You will need to repeat the claim submission process if the form gets rejected. 
  • Once you have filled in the required information and expenses you want to get reimbursed, attach the form with the required documents. A detailed list of the documents is given below. 
  • Scan the filled claim form and the documents to submit them online. Or, take the physical copies to a branch and submit them there. You can also mail your documents to the claim settlement department of your provider. 

Direct Claims for Abu Dhabi Medical Insurance Policies

  • Cashless or direct claims are submitted directly in the hospital you are seeking to get admitted to.
  • Obtain the direct claim form from the provider website. Fill it out and take it to the hospital. 
  • Bring your insurance card with you here. A claimant can submit a direct claim form on your behalf as well if you are not able to do so yourself. 
  • Once you submit the claim form and your insurance information, the hospital will send it for approval. 
  • The approval generally arrives within a few hours. Once the approval comes, the hospital receives coverage from the insurance provider directly. 
  • If the surgery you are about to get is not urgent, you will need to get a pre-approval from the provider. For that, you can submit the direct claim form to the provider yourself. They will send approval in a few days. Once you get the approval, you can get admitted and begin your treatment. 

Health Insurance Claim Form

AXA Health Insurance Claim Form oriental health insurance Claim Form Noor Takaful Health Insurance Claim Form
ADNIC Health Insurance Claim Form Daman Health Insurance Claim Form RAK Health Insurance Claim Form

Documents Required to Claim Abu Dhabi Medical Insurance

The documents you will need for your Abu Dhabi insurance claims depend on the kind of claim you need to make. Given below are two lists of documents for both direct and reimbursement claims:

Documents needed for reimbursement claims

  • The reimbursement form was obtained from the provider website. Duly filled and signed by the claimant. 
  • All medical invoices, bills, payment receipts, etc. This includes receipts for the expenses that you are looking to get reimbursed. 
  • All original lab tests and diagnostic reports from your treatment schedule. 
  • Health insurance documents.
  • Bank details of the claimant or the policyholder. 
  • Hospital admission and discharge papers along with a record from the doctor. 
  • A signed document from the doctor explaining the medical necessity of your treatment. 
  • Prescription for all the medicines included in reimbursement form. 

Documents required for direct claims 

Direct claims or cashless treatment does not require as many documents as reimbursement claims. You will need a direct claim form to be filled out and submitted at the hospital. The insurance department at the hospital will get approval from your provider and start the treatment. The coverage will be offered as the treatment proceeds. 

Government Established Guidelines for Abu Dhabi Health Insurance 

Health insurance is mandatory for all ex-pats currently present in the UAE. The government has taken a few steps to make it easier for all to find health insurance. As the law states, all employers in the emirate of Abu Dhabi are required to provide their employees with a proper health insurance plan. This rule is applicable in the emirate of Dubai as well. However, employers in the emirate of Abu Dhabi are also required to provide health insurance for dependents of their employees. Up to 4 dependents can be covered at one time. This includes 3 children and 1 spouse of the employees. People can opt for more than one Abu Dhabi medical insurance policy as well. If the employer-provided health insurance does not offer optimum coverage as per your individual needs, you can buy a personal health insurance plan as well. 

Are employers mandated to provide health insurance in Abu Dhabi to employees?

Yes, as the Abu Dhabi government has established, all employers are required by law to provide their employees with proper health insurance coverage.

Do dependents of employees also get health insurance coverage in Abu Dhabi?

Unlike Dubai, dependents of employees in Abu Dhabi also get health insurance coverage from employers in Abu Dhabi. It is mandated by the law.

Are preventive services covered in Abu Dhabi health insurance policies?

Depending on the coverage scope of your Abu Dhabi medical insurance, preventive services may be covered. This can include immunisation services like vaccination.

How many claims can I make in a year for my health insurance in Abu Dhabi?

You can make as many claims as you like in the tenure of your plan as long as your assured sum limit allows it.

Is maternity cover offered in Abu Dhabi medical insurance?

Yes, many Abu Dhabi medical insurance plans offer maternity coverage. There are even some special plans designed specifically for maternity benefits.

Are NEXTCARE, NAS and Mednet insurance companies in Abu Dhabi?

No, NEXTCARE and others mentioned are not insurance companies. These are medical network providers for many of the top Abu Dhabi health insurance companies.

Are pre-existing conditions covered in Abu Dhabi medical insurance plans?

Yes, as a generalised rule for all the emirates, all health insurance policies cover pre-existing conditions. 6 months to 2-year-long waiting period may apply before coverage for pre-existing conditions begins.

 

Are their special medical insurance plans offered by providers for Abu Dhabi residents only?

Yes, many health insurance providers offer special medical plans for Abu Dhabi residents only. These plans are often even named using ‘Abu Dhabi’ as a part of the name. You can also find specialised plans for Dubai and the northern emirates.

Do I get optical and dental cover in Abu Dhabi health insurance policies?

Depending on the coverage, you can find optical and dental coverage in Abu Dhabi medical insurance plans.

Is treatment in non-network hospitals and clinics covered in Abu Dhabi medical insurance plans?

Yes, some Abu Dhabi health insurance policies may cover treatment at non-network medical facilities as well.

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