UAE’s Workers Health Insurance Scheme: Essential Coverage Starting at Dh320 for Northern Emirates Residents

The UAE’s Workers Health Insurance (WHI) scheme provides mandatory health coverage for employees and domestic workers in the Northern Emirates, including Sharjah, Ajman, Fujairah, Ras Al Khaimah, and Umm Al Quwain. This initiative aims to ensure that all workers have access to essential healthcare services at an affordable cost.

Understanding Health Insurance in the UAE

In Dubai, health insurance is regulated by the Dubai Health Authority (DHA) under Law No. (11) of 2013 and Administrative Resolution No. (78) of 2022. These regulations mandate that all residents possess health insurance that meets or exceeds the DHA’s minimum benefit standards. Similarly, the Department of Health in Abu Dhabi governs health insurance in the capital, enforcing compliance through Law No. (23) of 2005.

Prior to the introduction of the WHI scheme, residents in the Northern Emirates were not legally required to hold health insurance, often resulting in out-of-pocket medical expenses. The federal scheme now provides a safety net, ensuring that workers can access basic health insurance coverage for themselves and their families across all emirates.

Overview of the Basic Health Insurance Scheme

Effective January 1, 2025, the Basic Health Insurance Scheme, also known as Workers Health Insurance, 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). This scheme establishes a minimum coverage standard, specifically designed for private sector employees and domestic workers.

The WHI scheme is regulated by Emirates Health Services (EHS) in the Northern Emirates and offers standardized coverage for two years, which can be renewed thereafter. It aims to support the well-being of workers, enhance the competitiveness of the UAE labor market, and alleviate the financial burdens associated with medical treatment for uninsured individuals.

Key Terms and Conditions

The WHI scheme has specific eligibility criteria:

• Available to UAE citizens and residents with a valid work visa in the Northern Emirates.
• Applicants must be 64 years old or younger; those aged 65 and above require individual medical evaluations.
• Deductibles and co-insurance amounts are the responsibility of the insured.
• Premiums are paid in advance for a two-year coverage period.

Musa Dayani, a public relations officer based in Dubai, noted that residents of Dubai and Abu Dhabi can also access this insurance scheme, subject to specific conditions regarding policy and premium amounts.

Coverage Details

The WHI plan covers essential healthcare needs through a network model, meaning policyholders must use approved hospitals and clinics within the DubaiCare Network. Coverage includes:

• Outpatient Consultations: Visits to specialists and general practitioners at network facilities.
• Inpatient Treatment: Hospitalization, surgeries, and emergency procedures.
• Emergency Care: Coverage for serious medical emergencies, including ambulance services.
• Maternity Care: Antenatal check-ups, delivery, and postnatal care within specified limits.
• Prescription Medication: Essential medicines listed in the approved formulary.
• Diagnostic Tests: Lab tests and radiology services as clinically required.
• Chronic Disease Management: Basic care for conditions such as diabetes and hypertension.
• Mental Health Services: Outpatient psychiatric and psychological care, subject to limits.
• Organ Transplantation and Kidney Dialysis: Coverage for organ transplantation and kidney dialysis with specific financial limits.

Network of Healthcare Providers

The WHI scheme covers more than 380 healthcare providers across multiple emirates. The network, known as the DubaiCare N5 NE (Northern Emirates) Network, allows insured individuals to access a comprehensive list of hospitals, clinics, pharmacies, and laboratories. For a complete list, individuals can visit the DubaiCare Network’s website.

Available Plans

The WHI offers two plans:

WHI Basic Plan

• Annual Policy Limit: Dh50,000 (in-patient), Dh10,000 (outpatient).
• Geographical Scope: Northern Emirates.
• Network: DubaiCare N5 NE Network, with outpatient services restricted to clinics.
• Pre-existing Conditions: No waiting period.
• Premium: Starting from Dh320 per person per year.

WHI Enhanced Plan

• Annual Policy Limit: Dh100,000 (in-patient and outpatient).
• Geographical Scope: Northern Emirates.
• Network: DubaiCare N5 NE Restricted Network, with outpatient services restricted to clinics.
• Pre-existing Conditions: No waiting period.
• Premium: Starting from Dh440 per person per year.

Required Documentation

To obtain coverage under the WHI scheme, employees must provide a valid work permit. For dependents, additional documentation is required, including:

• Medical application forms for cases requiring medical declarations.
• Passport copies with visa pages.
• Emirates ID of the insured and their sponsor.
• A copy of the current health insurance card.

For group insurance, companies must submit an Excel sheet detailing all mandatory information.

Insurance Benefits

The WHI scheme provides various benefits, including:

• Inpatient Services: Covered with 20% co-insurance, capped at Dh500 per encounter (annual cap Dh1,000).
• Outpatient Services: 25% co-insurance per visit (maximum Dh100).
• 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 Services: Free consultations via Novitas Healthcare or ISON Healthcare.

Registration Process

Employers of domestic workers and individuals wishing to register dependents can do so through the official WHI website. Private sector employees will be registered by their companies. The registration process involves selecting the appropriate user type, entering required information, and choosing a suitable plan.

Cancellation Policy

If cancellation is necessary, the following conditions apply:

• The first year’s premium is non-refundable.
• If canceled within the first 12 months, only the second-year premium is eligible for a refund.
• Cancellations during the second year result in a non-refundable premium.

For more detailed information, visit the official WHI website.

Source: www.emirates247.com

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Published on 2026-06-19 11:34:00 • By the Editorial Desk