What is Comprehensive Health Insurance?

Comprehensive health insurance or comprehensive medical coverage refers to broad insurance plans that cover a wide range of medical services, treatments, and costs for policyholders. This type of insurance is designed to provide individuals and families with extensive coverage and financial protection against various medical expenses. ...read more

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The above plans and premiums are for AED 1,000,000 Sum insured for 1 Adult of 30 Years for Dubai city.

A remarkable benefit of comprehensive health insurance is that you can take benefit from the extensive coverage within a single policy, eliminating the need to purchase multiple or separate health insurance plans to cover medical expenses. In contrast to the basic health insurance plans, these health insurance plans cover more expensive procedures such as organ transplants and alternative treatment methods as well. 

Inclusions of Comprehensive Health Insurance Plans

Without further ado, let’s take a look at some of the coverages provided by comprehensive health insurance plans in the UAE – 

  • In-Patient Healthcare: Coverage for hospitalisation, surgeries, and treatments that require an overnight stay or admission to a medical facility
  • Out-Patient Care: Coverage for medical consultations, physiotherapies, diagnostic tests, and treatments that do not require hospitalisation or an overnight stay
  • Emergency Medical Services: Coverage for urgent medical situations, such as accidents or sudden illness, that need immediate medical attention
  • Prescribed Drugs and Medications: Reimbursement for prescribed medications deemed medically necessary by a healthcare professional
  • Preventive Care and Screenings: Coverage for routine health check-ups, immunisations, and early detection screenings to identify and manage potential health issues
  • Maternity and Newborn Care: Coverage for prenatal, postnatal, and childbirth services, as well as care for newborns, which may include paediatric consultations and vaccinations
  • Dental and Vision Care: Depending on the comprehensive medical coverage plan, dental and vision care may be included, covering services like routine dental check-ups, cleanings, eye exams, and corrective or contact lenses.
  • Organ Transplant: Some comprehensive health insurance plans cover organ transplantation expenses excluding any cost related to donor, acquisition, and organ cost. Some major organs covered are the lung, kidney, heart, pancreas, liver, and allogenic & autologous bone marrow.  
  • Treatment for Severe Illness:  Depending on the plan, you can also be covered against a range of common critical illnesses like cancer.
  • Alternative Treatments: Some plans may also cover alternative or complementary treatments, like chiropractic care, acupuncture, and homoeopathy if deemed medically necessary.
  • Emergency Ambulance: In some circumstances, such as medical emergencies, ambulance services may be required. With comprehensive medical coverage, you can also submit a claim to cover the expenses associated with emergency ambulance transportation.

Exclusions of Comprehensive Health Insurance Plans 

While comprehensive health insurance plans offer extensive coverage for a wide range of medical services and treatments, certain exclusions are typically not covered. While these exclusions may vary among different insurance providers and plans, some common exclusions include the following – 

  1. Cosmetic Procedures: Surgeries or treatments performed for cosmetic purposes rather than medical necessity are usually not covered.
  2. Experimental Or Unproven Treatments: Procedures or therapies considered experimental, investigational, or not medically proven may be excluded from comprehensive medical coverage.
  3. Self-Inflicted Injuries Or Conditions: Injuries or illnesses resulting from self-inflicted harm, substance abuse, or participation in illegal activities are typically excluded from coverage.
  4. Undeclared Pre-Existing Diseases: Most comprehensive health insurance plans do not cover pre-existing diseases which are not declared. 

Note: The scope of coverage and specific benefits can differ among insurance providers and plans in the UAE. Always review the policy details, inclusions, and exclusions to ensure that the comprehensive health insurance plan that you choose aligns with your individual requirements.

Difference Between Basic Health Insurance Plans and Comprehensive Health Insurance Plans

Tabled below is a quick overview of the difference between basic and comprehensive health insurance plans in the UAE. However, it is to be noted that the coverage may differ from one plan to the other.

Parameters

Basic / Standard Health Insurance Plans

Comprehensive Health Insurance Plans

Coverage

Limited, covers essential services

Extensive, covers a wide range of services and treatments

Inpatient Care

May cover solely basic hospitalisation

Covers hospitalisation, including surgeries and specialised treatments

Out-Patient Care

Limited or not covered

Covers consultations, physiotherapies, diagnostic tests, and treatments

Emergency Medical Services

Usually covered

Covered, including road and air ambulance services

Prescription Medications

Limited coverage

Covers most prescribed medications

Maternity and Newborn Care

Limited coverage

Covers in-patient and out-patient maternity services

Alternative Treatments

Generally not covered

May be included or available as additional benefits

High-cost Procedures (e.g., organ transplants)

Not covered or limited coverage

Typically covered, subject to policy terms

Policy Flexibility

Fewer options and customisations

Greater choice of coverage levels, deductibles, and additional benefits

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Benefits of Comprehensive Health Insurance

Listed below are the advantages of comprehensive health insurance plans in UAE – 

  1. Legal Requirement: The UAE government has mandated that all residents residing in Dubai and Abu Dhabi, including expatriates, must have at least a basic level of health insurance coverage. 
  2. Extensive Coverage: As the name suggests, comprehensive health insurance plans offer extensive coverage for various health concerns including unexpected accidents, costs associated with hospital stays, daycare procedures, treatments for severe, life-threatening illnesses, and more. Additionally, these policies provide higher sum insured options.
  3. High Cost Of Healthcare: Healthcare costs in the UAE can be quite high, especially for private hospitals and clinics. With a comprehensive health insurance plan, however, your financial burden can be reduced as the plan can cover these expenses.
  4. Access to Quality Healthcare: Comprehensive health insurance plans provide access to a wide network of healthcare providers, ensuring that individuals receive quality medical care when needed. This includes coverage for treatments, diagnostics, tests, and medications.
  5. Family Coverage: Comprehensive medical coverage protects you and your family under a single policy, with the coverage typically including spouses, children, and parents. 
  6. Coverage for Pre-Existing Diseases:  Generally, comprehensive medical coverage in the UAE covers pre-existing conditions so that individuals with chronic illnesses or ongoing health issues can still access the care they need without incurring significant out-of-pocket expenses.

Note: It’s crucial to declare existing diseases and health conditions at the time of applying for a health insurance plan in the UAE.

  1. Peace Of Mind: Having a comprehensive health insurance plan provides peace of mind, as you would know that you and your family are protected in case of illness or accidents. This reduces stress and allows you to focus on your work and personal life without worrying about potential medical expenses.

List of Comprehensive Health Insurance Plans in UAE

Given below are some of the top comprehensive health insurance plans in UAE along with their features and benefits – 

Comprehensive Health Insurance Plan

Features and Benefits

Orient Silk Road – Family Care

  • Medical coverage of up to AED 1,000,000
  • Pharmacy limit – Up to medical cover
  • Network list is as below – 
  • In-patient and emergency services- Mednet- Silk Road
  • Out-patient – Mednet- Silk Road
  • Newborn cover of up to 30 days in line with DHA guidelines
  • Out-patient treatment limited to clinics
  • Both out-patient and in-patient maternity coverage included
  • Medication coverage up to the policy's annual limit
  • Physiotherapy treatment for up to 15 sessions per year
  • Dental & gum treatment as well as hearing & visions aids are included in the policy as per the terms

Takaful Emarat Gold

  • Medical coverage of up to AED 1,000,000
  • Pharmacy limit – Up to AED 7,500
  • Hearing and vision aids, and vision correction by laser or surgeries, subjected to 20% co-insurance
  • Physiotherapy treatment of up to 15 sessions per member per annum
  • Repatriation of mortal remains to home country coverage
  • Coverage of home nursing on reimbursement
  • Vaccination coverage
  • Pre-existing and chronic diseases cover up to AED 150,000 limit per member per year

Al Sagr Steel

  • Medical coverage of up to AED 150,000
  • Pharmacy limit cover of up to AED 1,500
  • Insurance coverage for Dubai visa holders
  • Pre-existing diseases coverage with 6 months waiting period
  • The network list is as follows – 
  • In-patient and emergency services – Nextcare – RN3
  • Out-patient services – Nextcare – PCP
  • Laboratory tests, radiology diagnostic, physiotherapy treatment, and emergency treatment are included
  • Medication coverage with a maximum limit of up to AED 1,500 

Dubai National Insurance Pearl

  • Medical coverage of up to AED 1,000,000
  • Pharmacy limit – Up to medical cover
  • Maternity coverage up to a sub-limit of AED 10,000 for normal delivery and necessary caesarean section
  • Dental and gum treatment coverage with a sub-limit of AED 3,500 and co-insurance of 20%
  • Hearing and vision aids cover emergency cases
  • Physiotherapy 15 sessions per member every year, included
  • Network list – Pearl
  • Vaccination services are included at designated clinics once per annum, as per DHA guidelines

Cigna Healthcare Regional General

  • Medical coverage of up to AED 2,750,000
  • Pharmacy limit – Up to medical cover
  • Network – General
  • Home nursing cover up to AED 9,000
  • Coverage for cancer treatment
  • Local road and ambulance services cover
  • Emergency dental and gum treatments covered
  • Chinese medicine, Ayurveda, and Homoeopathy covered
  • Fees for consultants, surgeons, and anaesthetists covered
  • 30 visits coverage for physiotherapy treatment

Alliance Limited Plan

  • Medical coverage of up to AED 150,000
  • Pharmacy limit of up to AED 3,000
  • Out-patient maternity service coverage with 9 months waiting period for non-working married females and no waiting period for working females
  • Coverage for the UAE, Arab World, Indian Sub-Continent, Sri Lanka, Korea, and the Philippines
  • Network list is as follows – 
  • In-patient and emergency services – Nextcare – RN 2
  • Out-patient services – Nextcare – RN2
  • Radiology diagnostic, laboratory tests, physiotherapy treatment, and emergency treatment are included
  • Medication limit of up to AED 3,000

How Much Does Comprehensive Health Insurance Cost?

The cost of comprehensive health insurance can vary widely as per several factors. Listed below are some key elements that can influence the cost of a comprehensive health insurance plan:

  • Policy Type: Individual policies may have different premium costs than family or group policies, depending on the number of people covered and their specific needs.
  • Coverage Level: Plans with more extensive coverage, including a wider range of treatments, services, and higher limits, generally cost more than those with limited benefits.
  • Deductibles, Co-payments, and Co-insurance: Policies with higher deductibles, co-payments, or co-insurance will usually have lower premiums, as policyholders will be responsible for a larger portion of their healthcare expenses.
  • Age: Older individuals or those with pre-existing medical conditions may get health insurance at relatively higher premiums, as they are often considered at a higher risk for developing health issues requiring medical treatment.
  • Provider Network: Plans with larger provider networks, offering more choice and flexibility in terms of healthcare providers, may have higher premiums than those with smaller networks.

The price of comprehensive health insurance plans generally starts at around AED 5,313 per annum and may go up to AED 48,077 per annum.

Understanding the Financial Aspects of Comprehensive Health Insurance: Premiums, Deductibles, and Out-of-Pocket Expenses and More

Now that we have understood the intricacies of comprehensive health insurance, let’s take a look at the financial components of comprehensive medical coverage and what they mean – 

  • Premiums: It is the amount that you have to pay periodically (usually monthly or annually) to an insurance company to maintain your health insurance coverage. This payment is necessary to ensure that your policy remains active, and the insurer will cover the agreed-upon health care expenses as detailed in the policy.
  • Deductibles: You are required to pay some amount out of your pocket for covered healthcare services before the insurance company starts to pay for any expenses. Once you have paid the deductible for the service, the insurance company will cover a percentage of the remaining health care costs according to the policy terms. 

Generally, policies with higher deductibles have lower premium costs, while those with lower deductibles have higher premium costs.

  • Out-of-Pocket Expenses: These are the costs that you must pay for health care services not covered by your insurance policy or the costs incurred before meeting the policy's deductible. These costs can include deductibles, co-payments, co-insurance, and other expenses for services not covered by the insurance plan. 
  • Co-Payment: A co-payment, or co-pay, is a fixed amount that you are required to pay for a specific health care service or prescription medication, as outlined in your insurance policy. 

Co-payments are typically paid at the time of service and are meant to share the cost of healthcare services between the policyholder and the insurance company. The amount of the co-payment can vary depending on factors such as the type of service received, the specific healthcare provider, and the terms of the insurance policy. 

Tips for Choosing and Purchasing a Comprehensive Health Insurance Plan

Choosing and purchasing a comprehensive health insurance plan in the UAE can be a crucial decision for ensuring adequate coverage for yourself and your family. Here are some tips to help you make the right choice:

  • Before purchasing a plan, consider your individual and family healthcare requirements. Consider factors such as age, current health status, pre-existing conditions, and the type of coverage that you require (e.g., maternity, dental, vision, or coverage for specific treatments).
  • Research and compare various health insurance providers and the plans that they offer. Look for the scope of coverage, inclusions, exclusions, and any waiting periods. Additionally,  make sure to consider the network of hospitals and clinics covered by the plan and the ease of the claims process.
  • Evaluate the costs associated with each plan, including premiums, deductibles, and co-payments. Opt for a plan with a deductible and premium that suits your budget without compromising the coverage you need.
  • Some health insurance policies have limits on specific benefits or treatments. Review these limits and ensure that they align with your needs and expectations.
  • Be aware of exclusions or limitations in the policy (if any) such as treatments, medications, or pre-existing conditions that may not be covered.
  • Depending on your needs, you can also purchase additional coverage, like critical illness and disability covers, to enhance your overall protection.
  • If you're unsure about which plan to choose, consider seeking advice from one of the experts of Policybazaar.ae, who can help you navigate the options and recommend a suitable plan based on your needs and budget. You can also compare the top health insurance plans on this site.
  • Before purchasing a plan, carefully read the policy document, including the terms and conditions. Make sure you understand the coverage, limitations, and exclusions before signing up.

Refer to the next section of the article for more deets on comprehensive health insurance.

Frequently Asked Questions (FAQs)

Q1. Can I choose my own healthcare provider under a comprehensive health insurance plan in the UAE?

Ans: Yes, you can choose your comprehensive health insurance plan depending on your needs and budget. You can visit policybazaar.ae, the official website of Policybazaar UAE, and apply for suitable comprehensive medical coverage. 

Q2. Are pre-existing conditions covered under comprehensive health insurance plans in the UAE?

Ans: Coverage for pre-existing conditions varies among insurance providers and plans. Some plans may cover pre-existing conditions after a waiting period, while others may exclude them entirely or charge an additional premium. For this reason, reviewing the terms and conditions of your comprehensive health insurance plan to understand your coverage options is crucial.

Q3. Does comprehensive health insurance cover dental and vision care in the UAE?

Ans: Dental and vision care coverage varies among comprehensive health insurance plans in the UAE. Some comprehensive health insurance plans may include basic dental and vision care, while others may require the purchase of additional coverage or riders. 

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