Health Insurance

The Ultimate Guide to Health Insurance: From Basics to Advanced

Health insurance is a topic that often seems complicated and overwhelming, yet it’s one of the most crucial aspects of modern life. Whether you’re dealing with a minor health issue or a major medical emergency, the quality of healthcare you receive can significantly impact your well-being and financial stability. But how do you navigate the labyrinth of terms, policies, and options available in the medical insurance marketplace? More importantly, how do you make sense of it all if you’re a complete beginner?

This comprehensive article aims to be your go-to guide for understanding health insurance in the United Arab Emirates. Designed to enlighten someone who has no prior knowledge of the subject, the article is divided into three main parts:

  1. Understanding the Basics of Health Insurance: This section will introduce you to what health insurance is, the different types of plans available, how it works, and why it’s important.
  2. Navigating the Health Insurance Marketplace: Here, we’ll delve into how to choose a plan, understand enrollment periods, and take advantage of government programs and subsidies.
  3. Advanced Topics and Future Trends: This final section will explore the rise of telehealth, global trends, and ethical considerations.

By the end of this article, you’ll have a well-rounded understanding of health insurance, empowering you to make informed decisions that can have a lasting impact on your health and financial security. So, let’s dive right into the first part to understand the basics of health insurance.

A complete guide to health insurance

Part 1: Understanding the Basics of Health Insurance

What is Health Insurance?

Health insurance, aka medical insurance, is a type of coverage that pays for medical, surgical, and sometimes dental expenses incurred by the insured. In most cases, the insurance company provides a financial safety net by reimbursing the insured for medical expenses or directly paying the healthcare provider. Medical insurance can also cover disability or long-term nursing care.

The concept of medical insurance dates back to the late 19th century but has evolved significantly over time. Initially, it was more akin to a “sickness fund” that workers contributed to. Today, it has become an intricate system involving various types of plans, coverages, and policies, designed to offer financial protection against high medical costs.

Types of Health Insurance Plans

Private vs. Public Health Insurance

  • Private Health Insurance: Provided by private companies, often offered as a benefit by employers.
  • Public Health Insurance: Government-provided insurance, such as the Thiqa program in the United Arab Emirates.

Common Types of Plans: The types of health insurance plans available in the UAE are diverse and cater to different needs. Here are some common types-

Individual Health Insurance

Individual health insurance plans are designed for a single policyholder. These plans offer financial protection against specific illnesses and provide benefits like access to network hospitals, cashless treatments, and coverage for pre and post-hospitalization needs.

Family Health Insurance

Family health insurance plans cover two or more family members under a single policy. These plans are cost-effective and offer similar benefits as individual plans but for multiple family members.

Employee or Group Health Insurance

Employers in Dubai and Abu Dhabi are legally required to provide group health insurance to their employees. These plans offer a range of healthcare services, including physician consultations, diagnostic tests, maternity benefits, and emergency hospital services.

Domestic Workers Health Insurance

This type of insurance is mandatory for domestic workers in Dubai and Abu Dhabi if their gross monthly salary is under AED 4000. It covers basic healthcare needs.

Northern Emirates Health Insurance

Specific plans are available for residents of the Northern Emirates. This includes the regions of Ajman, Fujairah, Ras Al-Khaimah, Sharjah, and Umm al-Quwain.

Basic Health Insurance

Basic medical insurance plans offer a predefined list of hospitals with full medical coverage. These are generally cheaper and are available in the Northern Emirates and Dubai.

Comprehensive Health Insurance

These plans offer more extensive coverage compared to basic plans.

Shariah Compliant Health Insurance

Also known as Takaful Insurance, these are plans that comply with Islamic law.

Health Insurance with Direct Access to Hospitals

These plans allow direct access to certain hospitals without the need for referrals.

Enhanced Medical Insurance

These plans offer more benefits and medical coverage compared to basic medical insurance.

Special Plans

Some insurance providers offer specially designed products for Northern Emirates visa holders, and there are also plans with various features like dental and optical coverages.

Plans for Specific Groups

There are also plans tailored for domestic workers, dependents, female spouses, and the elderly, with varying premiums based on the group.

It’s essential to compare different plans and consult with insurance professionals to choose the best plan that suits your needs.

How Does Health Insurance Work?

Financial Aspects

  • Premium: The amount you pay for your health insurance every month.
  • Deductible: The amount you pay for covered health care services before your insurance plan starts to pay.
  • Copayments: Your share of the costs of a covered healthcare service, usually a fixed amount.
  • Coinsurance: Your share of the costs of a covered healthcare service is calculated as a percent.

Network Considerations

  • In-network: Doctors, hospitals, and healthcare providers that have a contract with your health insurance.
  • Out-of-network: Providers that don’t have a contract with your health plan.

Pre-existing Conditions and Waiting Periods

Some insurance plans have waiting periods for pre-existing conditions, meaning they won’t cover costs related to these conditions for a certain period after you enroll.

Importance of Health Insurance

Having medical insurance is crucial for several reasons:

Financial Security

Medical treatments can be expensive. Health insurance protects you from high, unexpected costs by covering a significant portion of your medical expenses.

Access to a Broad Range of Healthcare Services

With health insurance, you have access to a wide array of services, from preventive care to emergency services, ensuring you get the comprehensive healthcare you need.

Preventive Care and Early Diagnosis

Many insurance plans offer free preventive services, encouraging early diagnosis and treatment of diseases, which can be more cost-effective and beneficial in the long run.

By understanding these basics, you lay the foundation for navigating the more complex aspects of health insurance, which we will explore in the subsequent parts of this article.

Part 2: Navigating the Health Insurance Marketplace

How to Choose a Health Insurance Plan

Choosing the right medical insurance plan is a critical decision that requires careful consideration of various factors. Here are some key aspects to keep in mind:


  • Premium: This is the monthly fee you’ll pay for your plan. Lower premiums often mean higher out-of-pocket costs when you receive medical care.
  • Deductible: Consider how much you can afford to pay out-of-pocket before the insurance kicks in.


  • Essential Benefits: Make sure the plan covers the services you need, such as hospitalization, prescription drugs, and maternity care.
  • Additional Benefits: Some plans offer extra services like mental health support and chiropractic care.


  • Doctors and Hospitals: Check if your preferred healthcare providers are in-network.
  • Geographical Coverage: If you travel frequently, you might want a plan that provides good coverage in multiple locations.

“Metal” Categories

Plans are often categorized into “metal” tiers: Bronze, Silver, Gold, and Platinum. These tiers indicate the cost-sharing ratio between you and the insurer, with Bronze having the highest out-of-pocket costs and Platinum the lowest.

Enrollment Periods and Qualifying Life Events

Open Enrollment

This is the specific period during which you can enroll in or change your health insurance plan. Missing this window often means waiting until the next open enrollment period.

Special Enrollment Periods

Certain life events, such as marriage, having a baby, or losing other health coverage, qualify you for a Special Enrollment Period where you can change your plan outside of the Open Enrollment.

Qualifying Life Events

Examples include:

  • Marriage or divorce
  • Birth or adoption of a child
  • Loss of other health coverage

Government Programs and Subsidies

  • Thiqa and Abu Dhabi Basic Plan: Government programs in the UAE for Emirati citizens and low-income expatriates, respectively

Health Insurance Subsidies in the UAE:

The UAE government provides various subsidies and programs to make health insurance more affordable for its residents.

Common Mistakes to Avoid

Not Reading the Fine Print

Always read the policy documents to understand what is and isn’t covered.

Ignoring Additional Costs

Apart from premiums, consider other costs like copayments and coinsurance.

Overlooking Network Restrictions

Make sure your preferred healthcare providers are in-network, or you could face higher out-of-pocket costs.

By understanding these aspects of the health insurance marketplace, you’ll be better equipped to choose a plan that meets your needs and budget. In the next part of this article, we’ll delve into advanced topics and future trends in health insurance.

Part 3: Advanced Topics and Future Trends

Health Insurance Taxes and Penalties

Navigating the intersection of health insurance and taxes can be complex but is crucial for financial planning.


Value Added Tax (VAT) is a type of tax that’s collected by business entities operating in the UAE on behalf of local tax authorities and is paid by the end consumers. Issued by the UAE Federal Tax Authority or FTA, there is a standard rate of 5% VAT for health insurance products for all UAE residents.

Penalties for Not Having Insurance

In the UAE, it is mandatory for employers to provide health insurance to their employees, and failure to do so can result in penalties.

Telehealth and Digital Health Services

What is Telehealth or Telemedicine?

Telehealth or Telemedicine refers to the use of digital technology to access healthcare services remotely. This can include video consultations, remote monitoring, and digital prescriptions.

Coverage for Telehealth Services

Doctor for every citizen

In December 2019, Dubai Health Authority (DHA) had launched a smart service titled, ‘Doctor for Every Citizen’ (PDF, 500 KB). Under this service, one can avail of free consultation through voice and video calls, 24/7. The service covers initial consultation and follow-ups with DHA-certified physicians. The physician can request for laboratory and radiology tests and issue electronic prescriptions.

When launched, this service was for Emiratis only. However, after the spread of COVID-19, this service was extended to all residents of the emirate of Dubai, and consultations on matters related to COVID-19 were included.

You can get the ‘Doctor for Every Citizen’ service through the DHA app available on App Store and Google Play

For more information, contact ‘Doctor for Every Citizen’ on DHA’s toll-free hotline 800 342.

The DOH RemoteCare app

The Department of Health – Abu Dhabi launched the DOH RemoteCare app through which people can receive healthcare at their own homes, without visiting a hospital or clinic physically. The app has a tool for examining symptoms, diagnosing non-emergency cases, booking appointments, and getting tele-consultations with doctors via voice or video calls or text messages.

The Future of Digital Health in Insurance Plans

Wearable devices that monitor vital signs, AI-powered diagnostic tools, and blockchain for secure patient records are some of the future trends that could become standard features in medical insurance plans.

Global Health Insurance Trends

Universal Healthcare Systems

Countries like Canada and the United Kingdom offer universal healthcare, where the government provides basic health services to all citizens, funded by taxes.

Private Health Insurance in Other Countries

In countries with universal healthcare, private insurance often exists as a supplementary option, providing faster access to specialists or more comfortable hospital amenities.

Future Trends in Health Insurance Globally

As healthcare costs rise globally, there is a growing trend towards value-based insurance models that focus on patient outcomes rather than services rendered.

Ethical and Policy Considerations

Ethical Dilemmas in Health Insurance

Issues such as coverage denial for pre-existing conditions or high premiums for older adults raise ethical questions about fairness and discrimination.

Policy Debates and Legislation

The future of health insurance is a hot topic in political debates globally, with discussions ranging from the expansion of public healthcare to the regulation of private insurance companies.

The Future of Health Insurance in the UAE

US$ 16 Billion is the total UAE Healthcare Expenditure
Source: WAM, KPMG

With ongoing healthcare reform and technological advancements in the field of telemedicine, robotics, AI, ML, etc., along with the willingness of the country’s leaders to embrace all those scientific advances, the landscape of health insurance and the overall healthcare industry in the United Arab Emirates is likely to undergo significant positive changes in the coming years.

By exploring these advanced topics and future trends, you’ll gain a deeper understanding of the complexities and ongoing developments in the world of health insurance. This knowledge will empower you to make more informed decisions and prepare for future changes in the healthcare landscape.


Navigating the world of health insurance can be a daunting task, especially for those who are new to the subject. However, understanding this complex system is crucial for both your physical well-being and financial stability. Throughout this comprehensive guide, we’ve explored the basics of what medical insurance is, how to navigate the marketplace, and delved into advanced topics and future trends that are shaping the industry.

The importance of being well-informed about your health insurance options cannot be overstated. From choosing the right plan that suits your needs to understanding the financial implications and tax benefits, every aspect plays a significant role in your overall health and quality of life.

As healthcare continues to evolve, staying updated on the latest trends and policy changes is essential. Whether it’s the rise of telehealth services, the ongoing debates about healthcare reform, or the ethical dilemmas that the industry faces, being knowledgeable empowers you to make decisions that are in your best interest.

In conclusion, health insurance is more than just a financial safety net; it’s a tool that provides you access to essential healthcare services, offering peace of mind in times of need. As you move forward, use this guide as a resource to help you make informed choices and take control of your healthcare journey.

Thank you for investing the time to educate yourself on this vital topic. Your health is your most valuable asset, and understanding how to protect it through effective health insurance coverage is a step in the right direction.

Read an in-depth guide on ‘What Is Insurance?