Posted on Feb 06, 2015 by Alex Nellist  | Filed Under: Family medical insurance Dubai

Existing Pregnancies can no longer be excluded from cover by any Insurer

Existing Pregnancies Can No Longer Be Excluded From Cover By Any Insurer

In 2013, the Dubai Health Authority (DHA) announced that they would follow the Abu Dhabi model for ensuring that all residents have access to affordable health insurance to take care of all medical needs. “The fundamental basis of the law is to ensure that every national, resident and visitor in Dubai has essential health insurance coverage and access to essential health services. This stems from the government’s fundamental goal to provide happiness and security to the people of the country and is in line with Dubai Strategic Plan 2015.” 

All Dubai residents are required to have health insurance and resident visas will not be issued without a valid certificate of insurance. Beginning the 1st of January 2015 all new group and individual policies issued in Dubai must be compliant with DHA regulations concerning minimum benefits, underwriting terms and product structures.

There are now standardised rules that insurance companies must follow now, and one major change UMI has noted is that all pre-existing conditions have to be covered up to 150,000 aed (approx 40,000 USD, a moratorium of 6 months applied) and that pregnancy cannot be excluded from cover and will not be subject to a maternity waiting period.

Historically, insurance companies used maternity waiting periods to tie clients into a policy for more than one year, effectively spreading the maternity risk over two policy years and ensuring the portfolio of individual and family members would not be affected too badly by the high cost claims for maternity.

Like all medical treatment in Dubai, maternity related expenses are very high. For an expatriate in Dubai wanting to have treatment and delivery by an OBGYN in one of the high quality American and European hospitals the cost could range from anywhere between 5,000 to 15,000 USD for a normal delivery without any complications or NICU cover.

Another benefit is that residents of Dubai were mostly not aware of the waiting periods being applied to health insurance policies. Many customers only sought to purchase health insurance with maternity care only after finding out that they are pregnant. Before the DHA Reform these people would have an exclusion placed on the policy and receive no cover for the pregnancy. Within the DHA Reform this is no longer permissible and insurers have to offer cover for the pregnancy. 

Additionally, newborn cover must now be included. Prior to the DHA Reform, local insurance companies in the UAE did not guarantee cover for newborn infants. This is where many people were unknowingly under insured. A mother who was fully insured for maternity with a high benefit and the maternity waiting period completed still did not have the safety net that her newborn would be automatically covered in the event of premature birth or born with an existing medical condition. We have seen cases where families in Dubai have been hit with thousands of dollars in medical fees because the insurance companies would not pay for the treatment of the newborn baby. Newborns can be added to their mothers plan and any treatment required is covered as per the pre-existing benefit, however the insurer may apply premium loadings to do so. If the newborn’s condition is serious, the premium loading may be too high for a family to afford.

The minimum that insurance companies have to provide for expectant mothers is cover for medically necessary costs incurred during normal pregnancy and childbirth including pre and post natal checkups, including:

1. 8 visits to a Primary Healthcare obstetrician for low risk patients and a specialist obstetrician for high risk patients.
2. Initial investigations and testing to determine the mother and babies health
3. Inpatient maternity up to a maximum of $1,950 for normal pregnancy and $2,750 for C-Section per period of cover
4. 3 ante-natal ultrasound scans
5. Essential vaccinations and inoculations for newborns and children

Although number 5 is not a maternity benefit, it is worth highlighting as a very positive benefit of the DHA reforms. Vaccinations in Dubai are expensive, as they are in many countries. The standard clinic tariff is $200 for a consultation and extra for the vaccination. Prior to the Reform some insurers would cover vaccinations but at a very low limit of cover which meant that parents would have to pay high costs against child vaccinations.

The major benefit in relation to maternity of the Dubai Health Reform is that high numbers of women and families were previously taking the chance to self-insure their pregnancies. They either couldn’t get cover as they were already pregnant, did not want to wait ten or twelve months or did not want to pay the insurance companies high premium costs over a two year period. Instead preferring to self-insure but at the same time carrying a very high risk of incurring an unaffordable medical bill if the baby was born requiring urgent medical treatment.

In order to comply with the local regulations, the insurance companies who have traditionally offered International cover have re-adjusted their plans so they all include maternity cover. Most of them have kept the structure of the old plans which were available in the market prior to the reform and have added the benefits required to meet the minimum cover guidelines set out by the Health Authority.

It is interesting to note that some of the providers offer no waiting period for maternity regardless of where the member decides to receive maternity-related medical treatment. Some others have removed the waiting period for medical treatment received in the Emirate of Dubai but have kept the waiting period for maternity treatment received outside Dubai.

Over all the DHA Reform mandates increased benefits within health insurance policies in Dubai and contributes to the Dubai Government's aim “to provide happiness and security to the people of the country”.

If you would like more information on how the DHA reform affects your policies, or want to take advantage of the new regulations put in place by the authority, get in contact for a free insurance quote.