Dubai: If you are based in the Northern Emirates, and are looking for an affordable health insurance policy, consider the UAE’s federal Basic Health Insurance Scheme, also known as Workers Health Insurance (WHI).Here’s everything you need to know about this unique initiative, which brings affordable healthcare to employees in the UAE.How does health insurance work in the UAE?In Dubai, the Dubai Health Authority (DHA) mandates the health insurance sector through Law No. (11) of 2013 and Administrative Resolution No. (78) of 2022, whereby it oversees licensing of insurance companies, third-party administrators, brokers, and healthcare providers within the emirate. All residents in the city are expected to hold health insurance that meets or exceeds the DHA’s minimum benefit standards.Similarly, the Department of Health – Abu Dhabi regulates mandatory health insurance in the capital, under framework established in Law No. (23) of 2005. It enforces policy standards and penalties for non-compliance, and has introduced flexible insurance plans with tiered systems that allow companies to tailor packages based on geographical coverage or benefit levels.In the remaining five emirates, however, residents had no legal requirement to hold health insurance, and most people paid their medical bills out of pocket. This changed when the UAE introduced a federal scheme that ensured workers are able to access basic health insurance coverage for themselves and their families in all emirates.What is the Basic Health Insurance Scheme?On January 1, 2025, a UAE Cabinet Resolution extending mandatory health insurance coverage to all emirates came into effect. Called the Basic Health Insurance Scheme or Workers Health Insurance, the initiative was launched by the UAE Ministry of Human Resources and Emiratisation (MOHRE), in collaboration with the Federal Authority for Identity, Citizenship, Customs, and Port Security (ICP), and the Ministry of Health and Prevention (MOHAP).The Basic Health Insurance Scheme is the UAE government’s minimum coverage standard, and ensures employees in every emirate have access to essential medical care. It’s designed specifically for private sector employees and domestic workers, according to MOHRE.The Scheme extends to residents of Sharjah, Ajman, Ras Al Khaimah, Fujairah, and Umm Al Quwain, and is regulated by the Emirates Health Services (EHS) in these regions. It provides a standardised minimum-coverage option for two years, for residents of the Northern Emirates, including for lower-income earners. After two years, the insurance can be renewed. According to MOHRE, the Scheme’s objectives are:To support the well-being of workers by providing a comprehensive healthcare system.To enhance the competitiveness of the UAE labour market.To reduce financial burdens associated with medical treatment and unpaid sick leaves for uninsured workers.The package also helps reduce the financial burden on employers, by offering health insurance at a significantly lower cost, compared to covering medical expenses directly.Terms and conditionsThe Basic Health Insurance Scheme comes with certain conditions, so check the criteria below to ensure you are aware of the fine print, before applying. Here are the terms and conditions, as stated by the official Workers Health Insurance (WHI) website:The policy is available only to UAE citizens who are working in the Northern Emirates, and UAE residents holding a valid work visa status in the Northern Emirates.The maximum age of applicants is up to 64 years old. Members 65 years and older are subject to individual medical evaluations and acceptance is at the discretion of the insurer. The insurer may add a premium, or apply sub limits, or decline the application accordingly.Deductibles and any co-insurance amounts must be paid by the insured person.Premiums are per person for two years, and are payable fully in advance.Treatment within the DubaiCare Network in the Northern Emirates is settled on a direct billing basis.Musa Dayani, a Dubai-based public relations officer, clarified that Dubai and Abu Dhabi residents can also avail of this insurance scheme, subject to the policy and premium amount at the time of signing, and conditional to hospitals and clinics that are not affiliated with the DHA.What does the Basic Health Insurance Scheme cover?The plan covers day-to-day healthcare needs, and is based on a network model. This means policy holders must use approved hospitals and clinics within the specified DubaiCare Network. Treatment outside the network will not be covered by this insurance policy, except in emergencies.In general, the Scheme provides coverage for the following:Outpatient consultations: Specialist and general practitioner (GP) visits at network hospitals and clinics.Inpatient treatment: Hospitalisation, surgeries and emergency procedures.Emergency care: Serious medical emergencies, including ambulance services.Maternity care: Antenatal check-ups, delivery, and postnatal care, subject to limits outlined in the Scheme.Prescription medication: Essential medicines listed in the Scheme’s approved formulary.Diagnostic tests: Lab tests and radiology reports, like X-rays and ultrasounds, when clinically required.Chronic disease management: Basic care for conditions such as diabetes and hypertension.Mental health services: Outpatient psychiatric and psychological conditions, subject to limits outlined in the Scheme.Organ transplantation and kidney dialysis: Organ transplantation and kidney dialysis are covered at a minimum of Dh100,000 and Dh60,000 respectively, with a maximum co-payment of 20%.Which hospitals or clinics can I visit?Under the WHI, the insured employee is covered in more than 380 healthcare providers across several emirates, according to MOHRE. The network is called DubaiCare N5 NE (Northern Emirates) Network and you can access the full list of hospitals, clinics, pharmacies, and laboratories at dubins.ae/networks/dubai-care.Follow these steps to do so:Visit DubaiCare Network’s website at dubins.ae/networks/dubai-care.In the Search bar on the left, enter your ‘Emirate’.Next, enter the ‘Network type’, which would be either ‘N5 OP’ (outpatient) or ‘N5 IP’ (in-patient).Next, enter the ‘Category’, which includes treatment locations like ‘Hospital’, ‘Pharmacy’, and more.Click ‘Find’. Once you do, a map will appear with the locations and you can click on each one to see its name, telephone number or address. You can toggle between ‘Map’ and ‘List’ views for easier access to all relevant locations.What are the available plans?There are two comprehensive plans under the WHI or Basic Health Insurance Scheme.WHI Basic PlanAnnual policy limit: Dh50,000 (in-patient), Dh10,000 (outpatient).Geographical scope: Northern Emirates (Sharjah, Ajman, Fujairah, Ras Al Khaimah, Umm Al Quwain).Network: DubaiCare N5 NE Network. Outpatient restricted to clinics.Pre-existing conditions: No waiting period.Premium/Cost: Starting from Dh320 per person per year.WHI Enhanced PlanAnnual policy limit: Dh100,000 (in-patient and outpatient).Geographical scope: Northern Emirates (Sharjah, Ajman, Fujairah, Ras Al Khaimah, Umm Al Quwain).Network: DubaiCare N5 NE Restricted Network. Outpatient restricted to clinics.Pre-existing conditions: No waiting period.Premium/Cost: Starting from Dh440 per person per year.Required documentsAccording to the WHI website, the following requirements are mandated for policy issuance:Employees are required to present a valid work permit.For dependents, applicants must provide:Medical application form for cases that require medical declaration (such as age over 64 years), as well as recent medical reports and prescriptions.Passport copy with visa page.Emirates ID of the insured and their sponsor.A copy of the current health insurance card.In case of group insurance for companies, Dubai Insurance Company will provide an Excel sheet containing all the mandatory details required. The company must submit this sheet when requesting insurance coverage.Insurance benefitsHere are some benefits you can expect under the Scheme:Inpatient services: Covered with 20% co-insurance, capped at Dh500 per encounter (annual cap Dh 1,000).Outpatient services: 25% co-insurance per visit (max Dh100 per visit).Laboratory tests: Covered with 25% co-insurance.Physiotherapy: Up to six sessions per year with 25% co-insurance (prior approval required).Medicines: Covered up to Dh1,500 with 30% co-insurance.Telehealth: Free consultation and lab services via Novitas Healthcare (800 200800) or ISON Healthcare (800 4766).How to registerDomestic worker employers, as well as individuals looking to register their dependents, parents or parents-in-law, can register for WHI on the official website: whi.ae. For private sector employees, their company is responsible for signing them up, using the same portal.Follow these steps to do so:Visit whi.ae and click on ‘Subscribe/Renew Here’. Select what kind of user you are (for instance, if you are signing up your children’s nanny for insurance, you can click on ‘Domestic Employer’).Enter the company code, if you are subscribing your employees. Then enter your Emirates ID number.Choose the mobile number and email address via which, you would like to receive the one-time password (OTP). Click ‘Request OTP’.Validate your contact information by entering the four-digit security code received in the OTP notification.Next, choose the preferred method (email or SMS) via which, you would like to receive notifications from WHI.If you’re a company registering private employees, you can add the organisation’s tax registration number (TRN) at this point and click ‘Save Changes’.Next, pick a plan that’s suitable for you – Basic or Enhanced.Upon selecting the plan, companies can go ahead and select the employees they want to add to the plan, and then add their employees’ personal information, including their mobile number, email, and visa file number, so that their details are successfully reflected in the systems of MOHRE and the ICP.If an employee is above 64 years old, the system will automatically alert you to fill in a medical application form for the employee. This is a mandatory form, as the premium for this employee would be calculated based on their medical history.Once you have completed entering personal information, select ‘I confirm details are correct’ and click on ‘Pay Now’. The amount paid is for a two-year coverage policy.Next, you will gain access to WHI’s terms and conditions, based on your chosen plan. Once you have carefully read it, select ‘Accept’.On your dashboard, you can view the certificate of insurance and the related electronic card, and download copies of it, by clicking on ‘Download’. The process is complete.Cancellation policyIf you need to cancel your insurance at any point, note the following conditions for doing so:The first year’s premium is non-refundable.Upon cancellation of the policy within the first 12 months, only the second-year premium will be eligible for refund.Upon cancellation of the policy during the second year, the premium is non-refundable.
