Health Insurance in Ajman

Overview of Health Insurance in Ajman

*For reference only — actual premiums may vary as per your age, health conditions, and more

What is Health Insurance in Ajman?

Health insurance in Ajman is a financial protection plan that covers the cost of medical treatment when you fall ill, get injured, or require routine healthcare. Instead of paying the entire bill yourself, the insurance company pays part or all of the expenses according to the policy you’ve chosen.

A health insurance plan in Ajman works in partnership with a network of approved hospitals, clinics and pharmacies. When you visit one of these network providers, your treatment is either billed directly to the insurer (cashless service) or reimbursed to you after you submit the receipts.

Is Health Insurance Mandatory in Ajman?

Yes. As of 2025, medical insurance is mandatory for all residents of Ajman. This includes UAE nationals, expatriates and their dependents. The regulation, aligned with the Northern Emirates health insurance framework, requires every resident to have at least a basic medical insurance plan that covers essential healthcare needs.

The rule applies across different resident categories — 

1. Employees – Employers must provide at least a basic health plan for their staff. This is part of the employment package and must be arranged before the visa process is completed.
2. Dependents – Sponsors (such as employees, investors or residents) are responsible for arranging health insurance for their spouse, children and any other dependents they sponsor.
3. Domestic Workers – Household staff, including drivers, nannies, and maids, must be covered under a valid health insurance policy in Ajman provided by their sponsor.
4. Self-Sponsored Residents – Investors, freelancers or anyone holding their own visa must buy individual health insurance in Ajman that meets the basic coverage requirements.

Types of Health Insurance Plans in Ajman

Health insurance plans in Ajman generally fall into three main categories. The right one for you will depend on your healthcare needs, budget and whether you prefer just the legal minimum or broader protection for your family.

1. Basic Plans: Basic health insurance in Ajman meets the mandatory coverage requirement and is designed for residents who want affordable protection for essential healthcare needs.
2. Semi-Comprehensive Plans: These plans go beyond the basic requirements, offering a mix of inpatient, outpatient and maternity benefits without reaching the cost of full premium coverage. Ideal for families or individuals who want more day-to-day medical access at an affordable rate.
3. Comprehensive Plans: These health plans in Ajman provide the highest level of protection, often chosen by families who want wide coverage, minimal restrictions and access to top hospitals in and outside the UAE.

Key Features and Benefits of Health Insurance in Ajman

Some of the key features and benefits of health insurance in Ajman are given below — 

1. Wide Choice of Plans: Health insurance in Ajman comes in different categories to suit every budget and requirement. You can choose from basic plans starting at around AED 4 per day, which meet the legal minimum, to premium policies that provide multi-million dirham coverage and worldwide benefits.
2. High Annual Coverage Limits: Even the most affordable basic plans offer substantial coverage, usually starting from AED 60,000 per year. Comprehensive plans can go as high as AED 7.5 million annually, covering complex surgeries, critical illness treatment and extended hospital stays. 
3. Direct Billing in Medical Networks: Most plans include access to a network of approved hospitals, clinics and pharmacies where treatment costs are settled directly by the insurer. This cashless process means you only pay the required co-pay, if applicable, while the rest is handled between the medical provider and the insurance company. It makes seeking care quick and stress-free.
4. Extra Hospital Stay Comforts: Additional benefits in some health insurance in Ajman plans include covering accommodation for a parent when a child is hospitalised, providing a daily cash benefit if you do not claim hospital costs and allowing a companion to stay in the hospital when medically necessary.
5. Coverage for Pre-Existing Conditions: Declared pre-existing and chronic medical conditions are covered after a set waiting period, usually between six and twelve months. Higher-tier plans offer larger sub-limits for these conditions, which makes it easier for residents with ongoing health needs to get the treatment they require without bearing the full financial burden.
6. Maternity and Newborn Benefits: Many health insurance plans in Ajman include maternity care after a waiting period. Benefits may cover prenatal check-ups, delivery costs for both normal and caesarean births and immediate newborn care. 
7. Access to Specialists and Outpatient Care: Semi-comprehensive and comprehensive plans cover outpatient consultations, diagnostic tests and follow-up care. This includes visits to general practitioners and specialists, with some policies allowing direct specialist access without a referral. Such coverage is essential for timely diagnosis and treatment.
8. Emergency Medical Cover: All plans provide emergency medical services throughout the UAE, including ambulance transport and urgent hospital admission. Some also extend emergency coverage to other GCC countries and selected regions abroad.

Best Health Insurance Plans in Ajman

Some of the best health insurance plans in Ajman are given in the table below —

Disclaimer: This is not a complete list of all health insurance plans available in Ajman. The plans shown above are selected examples based on currently available information as of 2025. Coverage details, premiums and benefits may change at any time.

Inclusions & Exclusions of Health Insurance in Ajman

The following table highlights what is included and what is not included in health insurance plans in Ajman —

What is the Cost of Health Insurance in Ajman?

In Ajman, basic medical insurance plans start from around AED 4 per day, which is roughly AED 1,460 per year. This makes it possible for residents to meet the legal insurance requirement without a heavy financial burden. However, the actual cost of your health insurance will depend on several factors that insurers consider when calculating premiums.

Key factors that affect the cost of health insurance in Ajman include — 

1. Type of Plan Chosen – Basic plans are the most affordable, while semi-comprehensive and comprehensive policies with higher limits and more benefits cost more.
2. Age of the Insured Person – Premiums usually increase with age, as the likelihood of needing medical care is higher.
3. Health Status and Medical History – Individuals with pre-existing medical conditions may pay more or face waiting periods before certain treatments are covered.
4. Coverage Limits and Benefits – Plans with higher annual coverage limits, wider geographic coverage and additional benefits like dental or optical will have higher premiums.
5. Network of Hospitals and Clinics – Plans that include a broader network or premium medical facilities may come at a higher price.

Claim Process for Health Insurance in Ajman

Making a health insurance claim in Ajman is a simple process, and in most cases, it depends on whether you are receiving treatment inside or outside your insurer’s network of hospitals and clinics.

Cashless Claims

If you visit a network provider (a hospital, clinic, or pharmacy that has a direct billing agreement with your insurer), the process is almost effortless. You simply present your insurance card at the reception desk. The medical provider will verify your eligibility and obtain approval from the insurer for the required treatment. Once approved, you receive the treatment without paying the full cost upfront — you may only need to pay a small co-pay or deductible as per your policy terms. This is known as the cashless claim process and is the most common way claims are handled.

Reimbursement Claims

If you use a non-network provider, you will need to pay for the treatment yourself and then apply for reimbursement. In this case, you must keep all receipts, medical reports and prescriptions. Once you have the necessary documents, you can submit a claim form to your insurance company, either online or at their branch office. Most insurers in Ajman, including GIG Gulf, Dubai Insurance and Hayah Ecare, process reimbursement claims within 7 to 15 working days, provided all paperwork is in order.

The following documents are required for a reimbursement claim —

1. Completed claim form
2. Original medical bills and payment receipts
3. Medical reports and test results
4. Prescriptions for medicines purchased
5. Copy of your Emirates ID and insurance card

Emergency cases are handled quickly, even at non-network facilities. In such situations, you should inform your insurer as soon as possible, ideally within 24 to 48 hours, so they can approve and process the claim without delays.

How to Find the Right Health Insurance Plan with Policybazaar.ae?

Policybazaar.ae brings together multiple health insurers and plans in one place, so you can compare benefits, costs and coverage before making a decision. The process is quick, transparent and can be done entirely online.

Here’s how to use Policybazaar.ae to choose the right plan —

1. Enter Your Details – Visit the health insurance section of Policybazaar.ae and provide basic information such as age, nationality, emirate of residence and which cover you want.
2. Compare Plans Side-by-Side – Instantly view plans from various insurers in Ajman, along with their premiums, annual coverage limits and main benefits. You can filter options based on your needs too. 
3. Check the Fine Print – Each plan comes with detailed policy documents and benefit tables. Reviewing these helps you understand inclusions, exclusions and co-payments before you commit.
4. Get Expert Assistance – Policybazaar’s advisors can guide you through the process, answer your questions and help you understand the best value options for your situation.
5. Apply Online – Once you choose a plan, you can submit your application and required documents.

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