Health Insurance Law in Abu Dhabi

Considering the increase in demand for healthcare services, the UAE government ensured to regulate the healthcare sector further so that it becomes easily accessible to every other individual. 

In this regard, the Emirate of Abu Dhabi enacted Law 23 in 2005. The primary aim of implementing the health insurance law in Abu Dhabi was to ensure that all citizens of Abu Dhabi gain access to affordable and quality healthcare. 

If you are a resident of this Emirate or are planning to settle here, knowing about the legal health insurance requirements is a must. Read through the following sections to know more.

About health insurance law in Abu Dhabi

The journey of Abu Dhabi towards its mandatory health insurance law started in 2005. This law made it mandatory for all citizens and expats to have health insurance from June 1 2006. Consequently, the health insurance regulations featured two divisions -

1. HAAD (Health Authority Abu Dhabi), which is responsible for regulating the health sector
2. SEHA (Abu Dhabi Health Services Company), which is responsible for managing government-owned healthcare facilities in the Emirate

Under the basic health insurance plan, which comes under the management of HAAD, you get the option of two policies:

1. Thiqa Plan (only for Emiratis)
2. Abu Dhabi Basic Plan (expats)

The laws regarding health insurance law are particular and strict in Abu Dhabi. Keep reading to know more.

Applicability of health insurance law in Abu Dhabi

As per the provisions of the health insurance law, the health insurance scheme applies to all non-resident UAE nationals and their families in Abu Dhabi. This law also applies to UAE nationals staying in the country by a resolution of the Executive Council.

Furthermore, this law's regulations shall apply to all visitors who have sponsorship from their relatives.

Exemptions of health insurance law in Abu Dhabi

According to the law, the following categories are exempted from health insurance schemes:

• Establishments or companies operating in Abu Dhabi that have their own medical facilities, with proper licensing 
• Non-UAE national women who are married to UAE nationals
• Children of UAE national women who marry non-UAE nationals
• Individuals arriving in Abu Dhabi on a tourist visa
• Other exemptions by the authority after getting approval from the Executive Council

Inclusions and exclusions in a compulsory health insurance scheme

The compulsory health insurance scheme comes with the following inclusions:

• Medical exams, healthcare services provided in medical centres or clinics by specialist doctors and general physicians
• X-rays and lab tests
• Hospital treatment and in-patient stay
• Dental treatment
• Treatment to cure a case
• Accommodation charges for an accompaniment in case of serious illness

These inclusions are indicative and can be changed by the Executive Council if necessary.

Having said that, these compulsory medical policies do not provide coverage for the following healthcare services:

• Injuries that are self-inflicted
• Diseases caused by tranquilisers, non-prescribed drugs/medicines, or due to the consumption of alcohol, drugs, etc.
• Plastic surgery
• Pregnancy and followed-up surgery if the woman is unmarried
• Expenses related to dental implants, fixtures and more
• Audiometric and optometric testing
• Transport expenses other than local ambulance services
• Hair fall treatment
• Psychiatric treatment
• Hormone treatment
• Organ transplants

These exclusions are indicative and might change by the Executive Council if needed.

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Types of compulsory health insurance policies in Abu Dhabi

As per health insurance law in Abu Dhabi, individuals get the option to choose from three types of health insurance plans. Find about them below:

Basic health insurance policy

This plan is applicable for individuals with lower income and their dependents who receive salaries of:

1. AED 3,000 with accommodation
2. AED 4,000 with accommodation

It is also applicable for expats who do not have coverage from their Employer's health insurance.

Health insurance policy for urgent cases

This type of policy is available to individuals entering Abu Dhabi on a visit visa. Additionally, children who have sponsorship from their father/mother do not have any plans of staying in the Emirates. However, you will have to submit relevant documents to avail of this plan.

Enhanced health insurance plan

This type of medical insurance policy is available to all categories. Ensure to keep all needed documents handy to avail of this policy.

Points to keep in mind regarding health insurance law in Abu Dhabi

Following are a few points you should keep in mind regarding the mandatory health insurance law in Abu Dhabi:

• The maximum coverage amount you can get is around AED 150,000 – AED 250,000. You can also get extensive coverage by paying more premiums.
• You can avail of health insurance in Abu Dhabi up to the age of 65. 
• If a woman is already pregnant before availing of a health insurance plan, the premium amount can be significant.
• The newborn baby is covered for 30 days from the date of birth.

With this health insurance law in Abu Dhabi, availing of healthcare services becomes accessible for everyone staying in the Emirates. Consider educating yourself on the different kinds of policies and the legal requirements associated with them before availing of a medical insurance plan.