How can you boost your health insurance? Find out here

They say ‘health is wealth’, so find out how to better take care of yourself by enhancing your health insurance benefits

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Whether a sedentary lifestyle and nine-to-five desk job is taking its toll, or you’re highly active and fit, we often underestimate the importance of health insurance. From chronic health issues to medical emergencies, your health insurance could prove vital.

Health insurance, by definition, is a type of insurance coverage that pays for medical expenses.

Health insurance in Abu Dhabi is mandatory for all residents, with employers and sponsors tasked with making sure that they obtain coverage for their employees, and sometimes their families and dependents as well.

According to UAE law and the Health Authority – Abu Dhabi, employers are prohibited from ‘passing on the cost of providing health insurance to their employees’. This is considered a violation and may result in a penalty.

Given that health insurance coverage is required and readily provided the moment you land a job here, you may be restricted to a particular provider and plan, but do you know how to make the most of your insurance?

Common exclusions

Take note that coverage or medical services that can be availed by a person may vary depending on the insurance policy subscribed to you by your company.

While there are a number of services covered by the policy, there is also a list of common exclusions – including self-inflicted injuries, cancer treatment and psychiatric consultations – to keep in mind.

This is why it’s important to know the limitations of your coverage to avoid the unpleasant surprise of having to shell out cash.

“In markets where health insurance is mandatory, there is a minimum coverage set by the relevant authority, and anything beyond that is additional,” explains Yousif Alkhanjari, chief financial officer at the National Health Insurance Company, Daman.

“Nearly all common diseases and illnesses are covered. Generally, policies will stipulate what is not covered rather than what is.”

Coverage add-ons

While your plan covers particular conditions, it may be worth asking your employer if it’s possible to add specific conditions not covered in the original policy. Some employers, depending on budget, may be open to this and treat it as additional perks for the staff.

“We can do this for employers who want to add specific illnesses as a benefit for their employees, let’s say laser eye surgery for those with particular poor sight or specific screenings and check-ups,” Yousif explains.

There are other options as well such as availing personal insurance tailor-made to cover excluded conditions in the original plan, or you can ask your employer to pay at least a portion of the upgraded policy while you take care of the rest.

“Daman offers larger employers the opportunity to provide their employees with the option to upgrade their plans,” Yousif continues. “The employer would provide a comprehensive plan that is in line with legal requirements and the employee would pay just for the ‘extra’ bits.

“This is a more economical option as it saves employees from paying for the minimum coverage plus the extra one, which happens when you buy an entirely new policy.”

Most importantly, Yousif stresses the importance of having a thorough understanding of your insurance policy in order to avoid problems like unnecessary expenses and compromising your health in times of emergency.

“People need to make sure that they’ve read and understood their employer’s policies, and be open with their employers about their condition in case the employer would like to add this coverage or would be willing to partly participate in funding treatment out of compassion.

“If an individual is purchasing a policy, he or she must check if their conditions are covered and must declare them in advance when filling the medical evaluation sheet.”

Check list

Here are five basic points to be considered when checking a health insurance policy:

  • Annual limit of the policy This is the maximum amount of medical services that can be availed, as covered by the company.
  • Sub-limits The limits that apply to specific services. For example, while a policy might provide up to AED 250,000 in annual medical coverage, there may be a cap of AED 2,000 for dental services.
  • Applicable deductibles The fixed amount paid by the policy holder or member when accessing any covered services. Similarly, applicable coinsurance rates determine the member’s share of the cost of service or treatment.
  • Participating establishments The network of hospitals, clinics and pharmacies that are part of your policy. There are often restrictions on which facilities and hospitals you can visit depending on the policy, so check if your preferred facilities are included.
  • Provider’s unique services The special services given by the insurance firm such as customer service availability especially during weekends, late nights and holidays, and even online accessibility.
WORDS Ferdinand Godinez
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