FAQ: Essential Benefits Plan (EBP) & Dependent Medical:

Why did Dubai introduce compulsory medical insurance?

His Highness Sheikh Mohammed bin Rashid Al Maktoum, Vice President and Prime Minister of the UAE and Ruler of Dubai, stated that Dubai must have a world class healthcare system that provides qualityand access to care.Compulsory health insurance ensures that all Dubai residents will be eligible to access healthcare. There is a minimum level of cover in place, called the Essential Benefits Plan (EBP) has been established by the Dubai Health Authority (DHA) which comprises the minimum level of coverage that must be offered by all employers.

What does the compulsory medical insurance mean for me?

If you work for a Dubai registered employer, your employer must provide you with health insurance. This also applies to sponsors who must provide health coverage for their spouses, dependents and domestic workers.

The implementation deadlines for the law were as follows:

  • Workers at companies employing more than 1000 employees must have coverage in place by end October 2014;
  • Workers at companies employing between 1000 and 100 employees must have coverage in place by end July 2015;
  • All other workers (including domestic staff), spouses and dependents must be covered by end of March 2017.

Can I obtain a visa without having medical insurance?

The visa renewal process has already been linked to medical insurance and activated from January 1 2017. To obtain a new visa or renewal through the General Directorate of Residency and Foreigners Affairs (GDRFA), you must have medical insurance. You can buy your medical insurance online at or over the telephoneuson +971 42115800. Alternatively, you can walk into any one of our branches or head office and purchase your policy.

Once you have paid for your policy you will immediately receive an auto-generated certificate of health insurance (this can be presented to obtain your visa – either renewal of existing visa or new visa).Your Emirates ID will be activated in place of your medical card(not applicable in Al Ain and Abu Dhabi) and you can start to avail medical services / treatment within 24 hours from receipt of purchase.

When will financial penalties / fines be applicable and calculated from?

All employees and sponsors will have to pay fines if they fail to provide insurance employees by March 31, 2017 and coverage for visitors by December 31, 2017 asper the Dubai Executive Council’s resolution. Dubai residents who fail to have the minimum coverage levels in place will face a fine of AED500 for each month that they are without insurance coverage. In addition, no existing visa will be renewed or new visa issued.

I am a domestic worker. How will I benefit from the compulsory health insurance?

If you are working for a family, for example, as a driver, maid, nanny etc. it will be your sponsor’s responsibility to provide you with medical insurance in line with the DHA’s plan.

I am on my spouse’s visa but not employed. Do I need to be covered?

If your spouse’s employer does not provide cover, your sponsor is responsible for making sure you have medical insurance.

What is the definition of “dependents”?

This is limited to your dependent children, parents andspouse who are on your sponsorship.

What is the eligibility criteria for the EBP?

This plan covers all those earning a gross salary of AED 4,000 or below, no matter what their pre-existing / chronic medical conditions are, they will pay the premium which has been approved by the DHA and coverage must be provided that meets the EBP minimum levels of cover.

What is covered under the EBP?

The basic cover includes emergencies, outpatient consultancy at clinics, referrals to specialist, diagnostic investigations, medications, maternity and inpatient treatment. Please refer to your policy and table of benefits for a full detailed breakdown of coverage.

What is the difference between a Third Party Administrator (TPA) and Insurance company?

The TPA is a company that the insurance company appoints to provide service to its insured members.

Who is the Third Party Administrator?

NGI has outsourced the service capability for the EBP through either FMC and / or NextCare. The TPA ensures the insured member receives all medical treatment in line with medical claims, cards and approvals.

Any medical claims / medical approvals made by the insured member will be processed and managed by the TPA. The medical facilities that you have access to are appointed by the TPA and the TPA has a contract with each of these facilities. The medical provider will provide you with the relevant medical treatment, as per medical necessity and as per the terms and condition of your policy.

Where can I receive treatment?

You will receive a list of medical facilities that are covered as part of the plan you have chosen, along with a copy of your table of benefits and the exclusion list highlighting what is excluded from coverage Please also contact the TPA directly to find out which medical facilities you can use.

What is a coinsurance?

Coinsurance is a percentage of the costs of outpatient treatment (such as consultations, diagnostics etc) that you are responsible for.For example, if you have 10% coinsurance and your bill comes to AED 100, you are responsible for AED 10.

What is a deductible?

A deductible is a fixed amount that you are responsible for.

I submitted a claim for reimbursement – but I received less than what I had claimed for?

As per the terms and conditions of your policy, you will be reimbursedfor the incurred expenses subject to coinsurance, deductible and reasonable and customary charges.

You may also have received a lesser amount because you visited a clinic / doctor / hospitaloutside our network of approved providers. To benefit from the medical specialties and provider network that we have created especially for you, we recommend you visit any clinic / doctor / hospital.

If I earn more than AED 4,000, what are my choices?

These employees can be provided with the Enhanced Product.

Will my Pre-existing / Chronic Conditions be covered?

You plan will cover pre-existing and chronic conditions with no waiting period for members who were previously insured, this will be subject to evidence of previous medical insurance cover. Otherwise a 6 months waiting period will apply.

Does my plan cover medical treatment in all Emirates?

You are covered for medical treatment in all Emirates except Abu Dhabi and Al Ain whereservices are covered on emergency basis only.

How do I access my provider network to avail direct billing?

This is a list of providersclinics, hospitals, pharmacies etc that you can access on direct billing. This means that you can present your Emirates ID in all Emirates (excluding Abu Dhabi and Al Ain) and you receive treatment on a cashless basis – minus any deductions relevant to your plan.

What is the difference between emergency treatment and elective treatment?

Emergency treatment is for a sudden sickness or injury whose acute symptoms raised a legitimate concern including but not limited to severe pain are of such severity thatabsence of immediate treatment at medical facility is medically expected to constitute a threat to life, : Life; and/or Health; and/or Body function; and/or Organ of the patient.

Elective treatment is medically necessary, but which is not required as an emergency.

What are the cancellation charges?

This plan is non-refundable. Please refer to your policy wording for a full explanation on the cancellation clause.

How do I make a complaint?

Please go to to follow the full complaints process. Alternatively, you can file a complaint on your membership portal / mobile phone application, email to r telephoneuson +971 42115800 and speak to a member of our customer service team.