Region's Leading Insurance Broker Advises Dubai Residents to Look for Gaps in Medical Insurance Coverage

Wellness/Routine Check-ups and Treatment of Congenital Conditions Excluded from Mandatory Requirements, warns Nexus Group

Dubai, United Arab Emirates: Dubai residents are being urged to read the fine print of their medical insurance policies to avoid facing a situation in which they are unable to finance their medical care, according to the region’s leading insurance broker, Nexus Group.

Although the Dubai Health Authority (DHA) has identified the minimum requirements for basic coverage that employers must offer their staff, this excludes certain forms of preventative care, such as cancer screenings, as well as treatment for congenital conditions.

“The DHA has taken a critical step to ensure everyone in Dubai has access to basic medical care, but residents must know that this does not include everything. For example, reconstructive/cosmetic procedures are only covered following an accident, or if deemed medically necessary by the insurance provider,” said Nathalie Youwakim, Head of Client Services, Corporate Solutions - Employee Benefits at Nexus Group.

“And if parents residing in Dubai were to have a child born with a congenital condition, treatment of that condition, regardless of whether or not it is life threatening, would also not be covered, as congenital conditions remain in the standard exclusions list. Other excluded benefits include dental care, optical care, and infertility treatment. Of course, all these are benefits that could be either added to or included in an insurance scheme depending on the policy purchased, but it is the onus of the member and the sponsor to do so.”

With the exception of regular screenings for diabetes after age 30 for the general population, and after age 18 for high-risk individuals, other forms of preventative care and screenings, such as those for cardiovascular disease or cancer, are also not included in the mandatory requirements. Rather, these could be part of an additional wellness package offered by the insurance company.

“While we urge residents to be fully aware of what their health insurance policy covers, we also equally advise employers to have a good understanding of their employees’ medical needs, and to provide them with comprehensive coverage with access to a good network of medical facilities,” N. Youwakim said.

Nexus also advises its corporate clients to select an insurance scheme that incorporates a co-payment/deductible, which patients will be required to contribute when visiting a medical facility. This will deter employees from misusing the plan, and will have a positive impact on the overall performance of the employer’s group policy.

“Unfortunately, the UAE market tends to be cost-oriented, and as a result many employers will choose a plan accordingly, despite what is better for their employees in the long-run,” added N. Youwakim.

“Employers should remember that by offering comprehensive coverage, with the right guidance and approach, they are investing in the wellbeing of their employees and giving them a sense of security, and this plays an important role in productivity and staff retention. I believe our most expensive asset is our health, which is priceless.”