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Health Insurance in Fujairah

Health insurance provides financial coverage for medical and surgical expenses when the person under the insurance is hospitalized. A health insurance policy can be taken for an individual and or his/her family as a whole. When health insurance is taken for a family as a whole it protects the entire family from the ever-increasing cost of health care services in Fujairah.

Benefits of Health Insurance in Fujairah

The driving force for many Fujairah residents to buy a quality Health insurance product for themselves and their family is certainly the perks that come along with the insurance policy. Some of the most important features and benefits of health insurance in Fujairah are listed below:

Cashless Treatment

All major insurance companies in UAE have a network of hospitals that offers cashless claims. Naturally, their network will consist of hospitals located in Fujairah as well. As a prospective buyer, it is the duty of the individual to do extensive research about the network hospitals offered by each insurer. The policyholder can avail of this service only when he/she is admitted to one of the network hospitals. Once admitted to the hospital (network hospital) the policyholder is required to offer the policy number at the designated department and the rest is taken care of by the insurance provider and the hospital concerned. When the patient is availing the cashless treatment claim he/she need not pay anything for the medical treatments and allied services as long as it is covered under the policy. However, if the medical cost exceeds the pre-specified cost(as per the insurance contract) he/she will have to pay the difference.

No Claim Bonus (NCB)

No claim bonuses are rewarded for policyholders who have not made any claims during a policy year. The benefit can be availed by the customer at the time of renewal of the insurance contract. The rewards can be provided as a discount on the premium (cost of the premium) or as an increment in the sum assured

Coverage for Pre & Post Hospitalization

Certain medical insurances cover pre and post-hospitalization expenses as part of their policy. The insurance covers all expenses from a specific number of days before and after the hospitalization date. But, it is up to the prospective clients to research and identify policies that offer these benefits. Policyhouse.com can help individuals buy tailor-made insurance plans that suit their requirements the best.

Transportation Expenses

If the insurance policy covers the transportation expense, the insurance will cover the ambulance cost of transporting the patient to the hospital. This is usually an add-on for most insurance products but some insurance policies do have a transportation expenses clause built into the insurance contract. Having ambulance costs covered in the insurance contract is very important in today's scenario as the cost of medical services that include ambulance charges are rising dramatically these days.

Room Rent

There are medical insurance policies available today that covers the room rent of the hospital while the policyholder is hospitalized. When the hospital room rent is covered by the insurance, the patient can opt for a room that satisfies the daily rent limit specified by the insurance policy.

Medical Check-Up

Most insurance plans come with regular body check-ups(infrequent intervals), this is usually the case with most insurers but certainly not a mandatory rule. Some medical insurance providers even ask their clients to take a mandatory health check-up at the clients' cost before issuing the insuring policy. There is no hard and fast rule in this regard. Unfortunately, the rules differ from company to company, policy to policy. Having a nonclaim bonus is certainly an advantage though.

Third-Party Administrators (TPA)

Most medical insurance companies use the help of TPAs to handle certain functions on their behalf. Some of the common functions handled by TPAs include enrolment, premium collection, claim settlement, to name a few. It is the responsibility of the policyholder to identify a TPA that is both reliable and easily accessible at the same time.

Types of Health Insurance

Unlike other countries in the region, UAE has a matured insurance market. Listed below are some of the most common types of health insurance products available in the country.

1
Individual Health Insurance Plans

Individual health insurance plans are plans that cover a single person. The policy is usually offered for a year and the individual can renew the policy to his/her liking. The individual under the policy (policyholder) will have all the aspects of health and medical covers stipulated under the policy document. All the benefits associated with the policy can only be enjoyed by a single individual.
2
Family health Insurance Plans

Medical expenses are skyrocketing in price day by day. The expenses have risen to the point where a single hospital case can derail the entire financial position of the family. This is where family health insurance plans come into play. Family health insurance can help cover the entire family from the possible medical and financial expenses that might occur during the policy period. The policy documents do offer clear insight on the fixed number of spouses and children that can be covered under the medical insurance policy. The sum assured in the case of family medical insurance is shared among the individuals of the family covered under policy insurance.
3
Group/Employee Health insurance Plans

Group health insurance plans or employee health insurance plans as it is commonly known in the emirates are typically suitable for business. This particular form of insurance plan gives its customers the much-required flexibility to add and exclude employees as and when they join and leave the company. Employee health insurance plans usually come with relatively low premiums as it comes with very low risk.
4
Senior citizen health insurance plans

Senior citizens' health insurance plans as the name suggests are specially designed policies for individuals who are 60 years and above. Very few insurance companies deal with senior citizens' insurance plans. Out of which a large percentage of insurance companies require their clients to produce health checkup reports before committing to the policy. Furthermore, the cost of insurance in the case of senior citizen health plans is usually higher than the normal policy rate, this is due to the higher probability for senior citizens to get sick when compared to young policyholders.

What is Covered under Health Insurance in Fujairah?

Health insurance policies usually come with an inclusion list, this list helps define the scope of insurance cover offered by the policy. The inclusion list varies from one policy to the other. Listed below are some of the most commonly found inclusions:

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

What is Not Covered under Health Insurance in Fujairah?

An exclusion list gives you an idea of things not covered under your policy. Each policy has its unique exclusion list. Mentioned below are the common items found in the exclusion list:

Dental & optical care
Medical treatments for obesity
Non-allopathic treatments
Plastic/cosmetic surgery, hormone replacement, sex change, etc
Injuries caused by war/terrorism/nuclear activity/suicide attempt
Diagnostic tests/treatment as well as post-medical care procedures
AIDS, terminal illnesses, and diseases of a similar nature
Coverage of pre-existing diseases or critical illnesses is subject to a waiting period of around 2-4 years
Straightforward exclusion of expenses incurred for maternity unless a maternity rider has been added to the medical insurance policy

How to file a claim for health insurance in Fujairah?

The health insurance claim process defer from network hospital to non-network hospital. In the case of network hospitals that are listed in the insurance policy, the policyholder can opt for a cashless payment option. As part of the cashless payment process, the policyholder need not pay any money for the treatment as long as it is within the limit set by the policy contract

In the case of non-network hospitals, the policyholder has to pay for all the hospital expenses incurred and then use the reimbursement process to get back the money spent from the insurer. The policyholder has to submit expense bills and other document proofs to avail the spend money from the insurer. The money reimbursed will be subjected to the eligibility limit set by the policy.

Within the hospital network

Health insurance agencies in UAE generally collaborates with various medical clinics and hospitals. These joined forces let the policyholder avail their medical coverage plan benefits without making any installment using cash.
Outside the hospital network

The policyholders will be req pay for any clinical treatment that is outside a medical coverage strategy's system of hospitals. In any case, this sum can be repaid by introducing the medical coverage supplier with treatment subtleties, unique bills and other report confirmations as mentioned by them. The repayment sum is dependent upon clinical protection strategy qualification and to the furthest reaches that have been gone ahead by the insurance provider.

FAQs on UAE Health Insurance

Is it important to declare pre-existing conditions while purchasing health insurance policies?

The policyholder at the time of taking the policy is mandated to share the medical history with the insurance provider to evaluate the premium for your insurance. This information can also help the insurance companies to identify the best insurance policy that will suit your requirements. In case of discrepancies in the medical history shared, worst case scenario the policy agreement will remain null and void.
Can I cancel my medical insurance plan without charge any time I want?

No, Most insurance companies in the country offer a grace period, the customer can cancel their policy during this grace period. If the customer cancels the policy during the grace period he/she can in most cases receive their insurance amount back in full. This offer is valid for people who have not made any claim.
What is the scope of medical insurance coverage?

The scope of coverage is restricted by the geographical boundaries it serves. The details of which can be found in the policy contract. For Example: if the insurance policy purchased by a customer has a scope defined as “Applicable within the Fujairah” in such cases the reimbursement for medical treatments within Fujairah will only be honored.
Is family insurance plans the cheapest health insurance in the country?

Yes, family plans are the most affordable solutions to get insured in tohe emirates. Family plans usually come with some of the cheapest premiums in the insurance industry. Although it has to be noted that the number of spouses and children that can be added t the family insurance plan is limited as per the policy contract.
Why do I need health insurance in Fujairah?

The cost of medical treatments in Fujairah is increasing daily. A single incident with the doctor can sometimes derail your monthly or yearly budget. Health insurance protects the policyholders from such unexpected huge costs. It is always best to have health insurance to mitigate the risk of hospitalization.
Does my insurance policy cover medical emergencies arising while insured members are traveling abroad?

Yes, but it depends on the policy the policyholder has purchased. Most insurance companies offer this as an add-on to the existing insurance product.
What is deductible and how does it apply?

Deductibles are a percentage of the insurance or a certain preset amount that the policyholder pays to the hospitals and or allied services. The insurance company usually pays the rest of the amount on behalf of the policyholder. Higher the deductibles, lower the premium, and vice versa.
It is mentioned in the quote that a 30% co-insurance/Co-payment on all outpatient services. What does this mean?

It means the policyholder will pay 30 percent of all the costs regarding the treatment. The rest will be paid by the insurance company. Higher the co-payment lower the premium and vice versa.
Will my insurance cover any pre-existing and chronic conditions?

For individuals who are new to the country, there is usually a cooling period(no claim period). Treatments for pre-existing chronic conditions will not be eligible for a refund during this cooling period. Once the cooling period is over the policyholder can start claiming for the expense. The policyholder needs to declare about the same while applying the policy. There is no cooling period of policy renewables.
What can be done if a policyholder does not carry his medical card to avail of medical service at a health care provider?

Give your emirates ID, all basic health policies are linked with emirates ID and if that does not work, you can always look for a reimbursement option. Make sure you submit all your original bills and medical documents to get your reimbursement money.
Is Maternity covered in the health insurance policy?

Maternity cover is available for married women. Most insurance providers offer maternity cover as an add on to the existing health insurance, please read the policy document to check if there is a cooling period for the same.
How many claims are usually allowed during a health insurance plan period?

There is no limitation in the number of claims that can be made during the policy period but the sum issued as mentioned in the policy document can be the highest limit for medical insurance claims.