Health expenses for the elderly expected to drop

Dubai - Compulsory insurance for all in Dubai by June 2016; medical services may be de-subsidised after that.

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Asma Ali Zain

Published: Wed 12 Aug 2015, 12:00 AM

Last updated: Thu 13 Aug 2015, 9:00 AM

Insurance premiums for the elderly are expected to drop once the Dubai health insurance scheme is in place, making medical treatment affordable for them.
Dr Haider Al Yousaf, Director of Health Funding at the Dubai Health Authority (DHA) said: "Insurance companies normally underwrite very high premiums for people who are above 60 because the risks are much higher, but now when everyone will be insured, risks will normalise and premiums will drop.
In an interview with Khaleej Times, Al Yousaf said once the whole of the Dubai population is insured by June 2016, prices of medical services are expected to be de-subsidised. "This means that cash payers (non-insured patients) who visit Dubai's government hospitals from other emirates will not get the services at the current prices which are subsidised," he explained. He said the current rates are not the actual cost of the service.
However, emergency services will remain free of cost until the patient stabilises following which arrangements will be made to recover the payments.
"Anybody with insurance can use the DHA facilities even if they reside in any emirate," he added. He also said that DHA did not expect any burden on its facilities even with an increase in the number of insured patients.
Though there is no start date for the roll out of each the insurance phases, the deadline of June 2016 has to be met by all residents.
Starting August 1, companies with more than 100 employees are no longer able to sponsor visas for their employees until they have presented the Health Insurance Certificate to the immigration department.
The new enforcement system issued through collaboration of the DHA and the General Directorate of Residency and Foreigners Affairs (GDRFA), has been set in place to ensure that all employers and sponsors comply with their responsibilities.
At least 2.7 million people are now covered by Dubai's insurance scheme since its launch. In November 2013 when the health insurance scheme was first introduced, the insured population in Dubai was just 1.1 million.
Dr Haider also said that most of the companies in the first two phases have complied and have insured their employees except for a few.
"Only a small number of companies have not complied with the regulation but they should know that the fine amount that they will be charged for non-compliance will be more than the cost of insurance," he said.
The DHA will soon start taking action against such companies, he said, adding that the legal responsibility lies with the sponsor.
Speaking about Sa'ada, the insurance scheme for Emiratis that was introduced in June, Dr Haider said that around 60,000 of the 130,000 Emiratis in Dubai had enrolled for the scheme.
asma@khaleejtimes.com

 All you need to know about the new law

The new Health Insurance Law for Dubai (Insurance Law No11) will be implemented in phases through to 2016, based on company size as follows;
> For employers with employees numbering 1,000 or more: October 31, 2014;
> For employers with 100-999 employees: July 31, 2015;
> For employers with less than 100 employees: June 30, 2016;
> For spouses, dependents and domestic workers: June 30, 2016.
What are the minimum requirements?
All new policies whether group or individual, issued on or after January 1, 2015, must comply with the standards of the Essential Benefits Plan. This means that by the final implementation deadline of June 30, 2016, all insured members will have benefits that meet the minimum standards.
Is this health insurance coverage mandatory for visa and ID cards (PIC) application and renewal?
Yes, it is mandatory as of January 2015.
What is the minimum premium and basic coverage promised to each person? What is the maximum?
The minimum standards must meet the Essential Benefits Plan (EBP). The annual premium per employee varies between Dh500 to Dh700
What will happen in case of an emergency? Who will pay for the costs?
All emergency cases will also be covered by the insurance within the territorial limit specified in the policy. In fact, any emergency procedure will not require a pre-authorisation. If a patient happens to be in an emergency situation and is taken to a hospital that is not covered by their insurance, the patient will still be taken there and emergency treatment will be carried out. Only after the patient's condition stablises can a hospital shift the patient to a hospital that is under the insurance coverage.
What about chronic and pre-existing illnesses? Will the co-insurance amount to be picked up by the individual be higher?
Under the Essential Benefits Plan (EBP) there is a six month waiting period for pre-existing conditions, covered subject to policy terms and conditions.
Nationals
UAE nationals shall receive insurance cards to replace those of Dubai Health Authority (DHA) to cover healthcare services and preventive care. These services shall include all current services provided by DHA and various private healthcare providers.
Residents
The health insurance law sets forth the employers' responsibility to secure insurance to cover residents' basic healthcare needs. Depending on the contractual agreement between employer and employee, the employer may offer enhanced insurance coverage.
These packages shall be provided through licensed insurance companies operating in the Emirate and shall be monitored by the DHA.
Visitors
The goal is that all visitors coming to the emirate shall have valid medical insurance coverage to cover at least accident and emergency expenses. Roll out details will be communicated in the coming months.
 

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Asma Ali Zain

Published: Wed 12 Aug 2015, 12:00 AM

Last updated: Thu 13 Aug 2015, 9:00 AM

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