Healthcare Regulator Clamps Down on Private Health Insurance Benefits in Abu Dhabi

Health Authority Abu Dhabi has announced a series of amendments to the Emirate’s health insurance programmes that kicked in from July 2016 onwards. They aim to increase the efficiency and gear up the system to meet changing healthcare demands.

‘Thiqa’ plan cardholders will now receive 80% coverage of the fees for treatment services availed at private healthcare facilities in the Emirate. They will, however, still be fully covered for treatment at local governmental healthcare facilities.

Outside of the Emirate, Thiqa will cover 50% unless the treatment at stake is unavailable within the country and is, therefore, eligible for 100% coverage. Orthodontic brace for those who are 18 years of age is now excluded unless medically required. Full coverage of IVF treatment is limited to governmental healthcare facilities and one attempt per year at a private medical facility in the Emirate.

Additionally, all prescriptions from private healthcare facilities will now only be dispensed at private pharmacies.

Meanwhile, expat employees above 40 years old and under the Abu Dhabi Basic Plan will have an optional co-payment of up to 50% of their own insurance policy’s premium. The agreement is to be decided between the employer and employee.

All employees will also be obligated to pay 50% of the insurance policy’s premium for their spouse and three children, depending on their dependents’ age. Other dependents such as father, mother and fourth child are to be fully covered by the individual. Childbirth costs are to be charged according to a separate scheme. Domestic workers at Emirati households are exempt from these changes until the necessary framework is in place to support this category.

“HAAD is working towards a more sustainable healthcare sector by encouraging competition and further improving the quality and breadth of the healthcare offering. These measures will further contribute to our ongoing efforts to increase efficiency, standardise operations and increase the sector’s financial viability – for the benefit of the patient, and the healthcare system as a whole,” explained Adeeb Al Zaabi, Manager of Corporate Communication department at HAAD.

Read full press release here.