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Health Insurance in Ajman

Health insurance in simple terms is a policy that offers financial cover to its holder in the event of a huge medical bill arising from medical treatment or surgery. It protects families from bearing the huge burden associated with medical treatments, surgeries, post, and pre-medical expenses in Ajman and across UAE. The dept of the medical cover depends on the type of health insurance procured by the individual.

Health is very important for people in today’s circumstances. An unhealthy person will not have the strength to perform his/her daily work regimens. If a person is sick he/she could not attend work resulting in a loss of pay. This is the same case when one of the family members gets sick. The health care system across UAE is very expensive and for the average employee accessing quality, healthcare can put a dent in his/her savings. Having an appropriate insurance product can help save people from this financial misery.

Benefits of Health Insurance In Ajman

Health insurance products offered in Ajman and across the UAE comes with a wide variety of benefits. Some of the biggest benefits of buying health insurance products in Ajman comes with the following benefits:

Cashless treatment

All major health insurance providers in Ajman have a network of hospitals that collaborate with them, spread across the UAE. As an insurance holder, he/she could get admitted to one of these network hospitals and get treated without paying a penny. The insurance company will pay for the policyholder's treatment cost directly to the network hospital concerned. This process in a nutshell is called cashless treatment.

Coverage for Pre & Post Hospitalization

Certain medical insurance providers in Ajman does offer pre & post hospitalization coverages as part of the insurance package. The terms and conditions for the same would be mentioned in the policy document.

Medical Check-up

Many health insurance products in Ajman offer free medical check-ups at regular intervals. Some insurance companies offer free medical checkup options for people with fairly decent No Claim Bonuses

Transportation expenses

Transportation expense involves the ambulance cost involved in transporting the patient to the hospital. Certain insurance products offer it as part of the standard package and others as an add-on.

Room Charges

When the insurance holder is hospitalized naturally he/she will incur a room rent. Having a suitable insurance product can ensure that such expenses are covered under the policy(to the specified extent mentioned in the policy document).

No Claim Bonus

If the insurance holder has not undertaken any treatment during the policy period he/she will be rewarded with a no claim bonus. The NCB can be provided as a discount on the premium or as an increment to the sum assured

Third Party Administrators

TPAs manage a wide variety of functions on behalf of the insurance companies like claim settlement, premium collection, enrolment, to name a few. TPAs ensure standardization of service to their customers on behalf of the insurance providers.

Types of Medical Insurance Available in Ajman

Given below are the different types of health insurance products available in Ajman:

1
Individual Health Insurance Plans

Individual health insurance plans offer medical coverage to an individual policyholder. The purpose of the insurance is to hedge against the financial liability that might occur from the possible illness that might affect the policyholder during the policy tenure. Naturally, the policyholder can enjoy cashless and reimbursement benefits on medical expenses suffered by him/her during the policy tenure.
2
Family health Insurance Plans

Family health insurance plans are intended to insure an entire family rather than just an individual. Family health insurance plans cover the entire family under one roof, it is easily one of the most value for money insurance types available in the country. There is a restriction on the number of spouses and children that can be included in the plan. The sum assured is shared among the family members included in the plan.
3
Group/Employee Health insurance Plans

Employee Insurance plans as the name suggests is an insurance plan specifically designed for employees working in an enterprise. 50 percent of the contribution for the insurance comes from the employer and the rest comes from a percentage of employee salary or the sponsor. Employee health insurance also known as group health insurance plans usually comes with lower premiums due to the large pool of workers and low risk involved.
4
Senior citizen health insurance plans

Senior citizen health insurance plans are designed to offer quality health cover to people who are 60 and above. Very few insurance companies offer senior citizen health insurance plans in Ajman and the premium associated with such insurance plans are usually on the higher side. Certain insurance companies who offer this policy mandates their customers to produce a full body medical check-up report to assess the health condition of the individual to be insured, this is to help the insurance company to calculate the appropriate premium for the policy concerned.

Health Insurance Inclusions List

Health insurance lists consist of a set of items(inclusions) that are covered under the medical insurance policy. Please find below a general list of inclusions that are found common among the insurance policies issued across Ajman.

Ambulance fees
Pre-existing diseases and health illnesses
Pre & post hospitalization
In-patient hospitalization costs
Vaccinations & inoculations
Health check-ups
Daycare procedures
Hospital room cost
Vaccinations & inoculations
Newborn or maternity
Donor expenses in case of organ transplantation
Medication

Health Insurance Exclusion List

All the insurance products sold in the UAE come with an exclusion list. The exclusion list consists of expenses that are not covered under the current policy. Please find below a list of some of the most common exclusion items for health insurance policies sold in Ajman.

Dental & optical care
Medical treatments for obesity
AIDS, terminal illnesses, and diseases of similar nature
Non-allopathic treatment
Plastic/cosmetic surgery, sex change, hormone replacement, etc
Injuries caused due to war, terrorism, suicide attempt, and or nuclear activity
Diagnostic tests, treatment as well as post-medical care procedures

How to file a claim for health insurance in Ajman?

There are mainly two ways to claim insurance from the insurance company, one is the cashless process (for network hospitals) and the other is the reimbursement method( for non-network hospitals).

Cashless Process

If the policyholder is admitted to the network hospital (a hospital that is part of the hospital network developed by the insurance company), he/she can opt for this method. Under this method the money spent on the policyholder will be paid by the insurance company to the network hospital, the payment will be made up to the agreed-upon policy limit specified in the policy document.
Reimbursement

Reimbursement scheme is used for hospitals that are outside the network hospital list. In this case, the policyholder pays for the cost of the treatment and submit the reimbursement claim documents along with all the other necessary documents specified by the insurance company. Once the reimbursement claim form along with the supporting document is received the insurance company evaluates the claim application and the reimbursement payments are made to the policyholder's bank account.

How to Buy the Right Medical Insurance Plan in Ajman?

Finding the right insurance that suits your requirement is of utmost importance. Given below is a set of guidelines that can help individuals buy the right insurance product.

The first step to buy the right health insurance product is to identify the purpose of the insurance product. Are you looking for individual insurance or family insurance, or are you looking for a product to insure your employees, and so on. Defining the purpose of taking the insurance is one of the most important steps for finding the right insurance product.

Once the type of insurance policy is identified the next step is to prepare a budget allocation for the same. How much is the maximum you are willing to spend on the insurance including the addons has to be identified and make sure you do not out-spend the same.

Now the research face starts, use the internet and find out the different insurance products available under your desired category. You could also ask your friends and peers about the products that they are using and get recommendations from them as well.

Once you have identified a few insurance products that perfectly fit your requirements the next step is to compare the policies. Do a SWOT analysis of the same. Alternatively, you could go to a policy aggregator like Policyhouse.com to compare the different insurance products and come to a meaningful conclusion.

Then once you have found the right insurance product of your choice, go ahead and pay the premium. Secure your life for the future.

How to Buy Health Insurance Online via Policyhouse.com?

Buying medical insurance policy from Policyhouse.com is as easy as shopping online for clothes, electronic goods, and so on. The process mainly consists of four steps.

Select the Type of Insurance - The first step is to select the type of insurance. In the case of health insurance is it corporate or individual insurance.

Enter Your Details - The second step involves entering the personal details like the city of residents, the type of visa, name, age, and so on.

Compare Health Insurance Products - Screen through the variety of insurance products available in the market and compare the same. Check out the customization options and add-ons offered by the insurance company as well.

Pay Premium Online - The last step is to pay the premium of insurance that you have selected and secure your life from all the possible financial burdens arising from medical bills for the insurance period.

FAQs on Medical Insurance in Ajman

Is family plans the most affordable form of insurance available in Ajman?

Yes, family insurance is easily considered the most affordable insurance product available in Ajman at the moment. In some cases, the insurer might opt for add-ons to make the insurance policy better suit the purpose, in such cases, the price might increase.
Should I declare my pre-existing conditions at the time of insurance purchase?

The policyholder should disclose all pre-existing conditions before the purchase of the insurance policy because this information is vital for the insurance company to calculate the premium. No disclosure of vital information can result in the policy agreement being null and void.
What is the scope of coverage for medical insurance in Ajman?

The scope of coverage of medical insurance in Ajman will be mentioned in the policy document. Check the inclusions and exclusion list along with the policy document as a whole to understand the scope of the health insurance policy bought in Ajman.
Is maternity covered under a health insurance plan?

Yes, maternity plans are available for women who purchase health insurance plans from Ajman. The policyholder can have 8 prenatal visits and enjoy 7,000 AED of child delivery benefits as part of the package. Most health insurance policies have maternity benefits offered as an inclusion. Check out if any of these policies have a cooling period.
Do I get policy renewal benefits at the time of renewal from the same insurance provider?

Yes, almost all insurance companies offer loyalty benefits at the time of insurance renewal. The benefit can come as a premium discount or increase in sum insured value.
Is optical & dental covered under the basic health insurance plan?

No, not really, the basic insurance policies do not cover optical & dental expenses. Optical and dental covers usually come as an add-on to the existing insurance product.
In the case of an employee health insurance plan does the employee have to contribute a share to the insurance premium?

In the case of employee health insurance plans, the employer offers 50 percent of the premium and the rest is taken from the salary of the employee or his/her sponsor.
Will I be covered for pre-existing and chronic conditions with my existing insurance plan?

Yes, if the policyholder at the time of buying the policy has informed the insurance provider of the same he/she will be covered for pre-existing and chronic conditions. There might be a cooling period for first-time insurance buyers but for insurance renewals, this is not applicable.