Everything you need to know about the UAE's basic health insurance plan

Gulf Business

a day ago

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The UAE has officially implemented its Basic Health Insurance Plan for private sector employees and domestic workers across the Northern Emirates, marking a pivotal shift in the nation's approach to healthcare access and affordability.
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Effective since
Affordable healthcare now a reality for thousands
At the heart of the plan is a commitment to affordability. Under the new scheme, beneficiaries pay:
20 per cent co-payment for inpatient care, capped at Dhs500 per visit and Dhs1,000 annually
25 per cent co-payment for outpatient visits, with a maximum of Dhs100 per visit
30 per cent co-payment on medication, capped at Dhs1,500 annually
Follow-up consultations within seven days of the original appointment are exempt from co-payment, a move aimed at encouraging consistent medical follow-through.
The low-cost structure has been designed to lift a long-standing burden from domestic workers and laborers in the private sector, many of whom previously relied on out-of-pocket payments or informal arrangements.
New coverage brings a regulatory shift
The Basic Health Insurance Plan stems from a federal directive issued in 2024, requiring all private sector employers in Sharjah, Ajman, Fujairah, Ras Al Khaimah, and Umm Al Quwain to provide mandatory health insurance for their workers. The scheme, now fully in effect, complements existing laws in Dubai and Abu Dhabi.
Dubai's health insurance is governed by Law No. 11 of 2013 under the Dubai Health Authority (DHA), while Abu Dhabi follows Law No. 23 of 2005, enforced by the Department of Health (DoH). Both cities already mandate employer-sponsored insurance, including comprehensive benefits.
With the Northern Emirates now on board, the UAE's healthcare policy framework has moved significantly closer to universal coverage.
MOHRE and digital integration
The Ministry of Human Resources and Emiratisation (MOHRE) leads the implementation of the Basic Health Insurance Plan in collaboration with the Ministry of Health and Prevention and the Federal Authority for Identity, Citizenship, Customs and Port Security.
Insurance under the new scheme is administered via the Worker Health Insurance platform, managed by Dubai Insurance Company PSC, which also handles claims. The plan's data infrastructure is integrated with Riayati, the national digital health platform, and the National Unified Medical Record (NUMR)—a step that is streamlining patient care and bolstering public health analytics.
'This is not just about coverage; it's about systemic transformation,' said Anand Singh, Senior Counsel for Transport and Insurance at Al Tamimi & Company. 'We're witnessing a transition toward a data-driven, integrated health system that aligns with global best practices.'
Changing the game for pharmacies
The impact of the plan is already visible in the pharmaceutical sector. Over 44 pharmacies have joined the provider network, and more are expected to follow. These outlets report increased footfall from newly insured patients seeking both prescription medications and over-the-counter drugs.
Pharmacies are being urged to upgrade their IT systems to comply with the plan's digital requirements, including electronic prescriptions and automated claims submission. The result? Faster approvals, fewer errors, and a more efficient dispensing process.
This digital transformation is expected to reduce administrative delays and help create a seamless patient journey from diagnosis to treatment.
Visa requirements reinforce compliance
To ensure full enforcement, the UAE has made valid health insurance a mandatory requirement for residency visa issuance and renewal. Expatriates without proof of insurance coverage are ineligible for visa services, effectively closing the gap in enforcement that previously allowed some employers to bypass their obligations.
Golden Visa holders must present proof of long-term health insurance, prompting insurers to develop specialised packages that cater to high-net-worth individuals and long-term residents.
Strengths of the Basic Health Insurance plan
The launch of this plan has addressed several long-standing gaps in the UAE's healthcare ecosystem:
Greater access to healthcare: Thousands of low-wage workers now have access to essential services
Financial protection: Medical costs are reduced for workers and employers alike
Better public health outcomes: With increased access to early diagnosis and preventive care, the system is expected to reduce long-term treatment costs
Streamlined data: Integration with Riayati and NUMR improves coordination across providers and ensures continuity of care
Employers previously offering private coverage also benefit, as the Dhs320 plan offers a cost-effective alternative to more expensive insurance packages.
Increasing costs
The rollout of mandatory insurance arrives at a time when the UAE's healthcare industry is facing cost pressures across the board. Health insurance claims reached Dhs16.5 billion in 2024, an all-time high. Analysts warn that unless cost containment measures are introduced, both insurers and patients may face long-term challenges.
For hospitals and clinics, the sudden influx of insured patients has led to increased demand for medical staff, diagnostic services, and infrastructure upgrades. Without sufficient capacity expansion, patients may encounter longer wait times, reduced face time with doctors, and service delays.
Insurance sector reactions
Insurance companies are also recalibrating. High claim volumes are pushing firms to tighten approval processes and reconsider premium pricing models. Some providers are exploring bundling coverage or introducing tiered plans to manage risk.
The broader concern is sustainability. If costs continue to rise without corresponding revenue growth or efficiency improvements, insurers may be forced to raise premiums on other policies or reduce coverage options.
'This is where coordination between the government, healthcare providers, and the insurance industry becomes critical,' said Singh. 'You can't build a strong healthcare system without economic sustainability.'
A blueprint for the region?
Experts believe that the UAE's model could set a precedent for neighboring Gulf countries looking to reform their healthcare systems.
The combination of affordability, mandatory enforcement, and digital integration creates a blueprint that balances access with accountability. However, observers stress that continuous monitoring, stakeholder feedback, and policy refinement will be essential.
The road ahead
The successful implementation of the Basic Health Insurance Plan is just the beginning. Authorities are expected to monitor the plan's rollout closely in the coming months, with potential expansions in coverage — including maternity benefits — already under discussion.
As Singh put it, 'We've cleared the first major hurdle, but healthcare is a moving target. The next challenge is scaling up, closing the gaps, and making sure no one falls through the cracks.'
For now, the UAE's health sector enters a new chapter — one that promises a more inclusive, equitable, and digitally enabled future.