Understanding the Total Cost of Health Insurance

Here are the things you should know to understand the complete cost structure behind health insurance

Planning your health insurance

In today’s times of rising medical costs and lifestyle related illnesses, a medical emergency can happen to anyone at anytime, significantly impacting the individual both financially and emotionally. Therefore, it is wise to invest in a health insurance plan early on in life. Before zeroing-in on a plan, one has to consider the total cost of health insurance in Dubai. The premium is the most important component in overall cost, but other aspects have to be taken into account as well.

The major components of a medical policy that influence the cost of health insurance in Dubai are:

  • Premium: The fixed amount that you pay to purchase a health insurance policy irrespective of whether you receive medical treatment or not. The amount is charged on a yearly basis and doesn’t change whether the policy is acquired through a broker or from the insurance company directly.
  • Deductible: It is your share of medical expenses that must be paid before the insurance company starts paying. For example, let’s suppose that you have a health plan with a AED 50 deductible. If you go for a consultation and the cost of the visit turns out to be AED 300, you’d have to pay AED 50 and the insurance company would pay AED 250.

Deductibles are not applicable to every type of treatment. Certain treatments, especially in-patient ones, are covered in full which means that you wouldn’t have to pay anything out of pocket. The deductible amounts can vary between AED 25 and AED 75. Plans that have higher deductibles will generally be less expensive. The deductible amount will therefore influence the total cost of your health insurance policy.

  • Coinsurance: This is similar to deductibles, but your share of medical expenses are represented as a percentage of the cost. For example, if your policy specifies 10% coinsurance for maternity, and you have a bill of AED 1,000 for a consultation, then you must pay AED 100 and the insurance company will cover the rest. Coinsurance amounts are usually higher for prescription medications. As is the case with deductibles, the lower the coinsurance amounts, the more expensive the policy. When purchasing a policy, you have to take into account how coinsurance amounts would influence the total cost.
  • Expenses resulting from exclusions: Most health insurance policies have a long list of exclusions. It is imperative that you become familiar with theses exclusions to avoid unpleasant surprises. Hair loss for example is generally not covered. This means that if you go to dermatologist for a consultation about hair loss, the cost will be completely borne by you. To keep the total cost of your health insurance policy at bay, make sure that you stay away from excluded treatments that are not medically required.

Choosing a plan that suits your needs

The health insurance plans that may suit your colleagues or friends could not be the right fit for you. So before opting for the policies that they’ve purchased, take a step back to think about what your specific needs.

Here are a few of the key factors that you should consider while making this decision:

Basic healthcare plans only have the minimum benefits required by the Dubai Health Authority. The deductibles are higher for these plans but the premium are generally much lower. However, for most Essential Benefits Plans, the applicant must have a salary of AED 4,000 or lower.

  • Deductible vs. Coinsurance – which should you opt for?

The main differences between the two is how your share of medical costs would be calculated (fixed amount vs. percentage). Healthcare insurance plans may offer either only one of these or a combination of the two for different depending on the policy. Your decision to go for either or should depend on whether you think you’ll be using your policy for more expensive treatments or not.

  • How much are you willing to spend on a health insurance policy?

It is important to balance-out the cost and the comprehensiveness of the policy you purchase. Try to figure out how much you might spend on excluded treatments and accordingly decide how extensive your coverage should be (of course, it would be difficult to factor in emergency treatments as they are not possible to predict). You also have to consider whether you’ll have to add your spouse and children onto the plan.

  • Are the doctors and hospitals you usually go to in the network?

Insurance companies will provide you with a list of medical facilities that you can access without having to pay out of pocket depending on the plan that you choose.  Make sure that you choose a policy that has all (or most) of the healthcare providers that you usually use. Otherwise, you’ll have to pay for the consultation or treatment and get reimbursed. It usually takes a few weeks to do so and you end up getting back around 80% of your money back.

  • Do you need a plan that has worldwide coverage?

If you are a frequent traveler you need to ensure that your plan covers you in all geographic locations that you are usually in to make sure that you get reimbursed for the medical costs that you incur. Some policies also offer direct billing facilities abroad.

So remember, it is very important to take some time time to evaluate not only the healthcare plans available, but also your own needs. You can contact one of our insurance consultants or use our comparison platform to make an informed decision. Medical emergencies are not in your control, but a smart choice early on, can help you be prepared for one.


Related Articles

6 things to consider when selecting your group insurance plan in UAE

Why do 60% of companies in the UAE find it very challenging to manage benefits?

Did You Know the Health Insurance Network You Paid For Changes?