Abu Dhabi's Basic Health Insurance Plan has been updated with revised co-payment rules set to take effect on July 1, 2024. The National Health Insurance Company – Daman, operating under regulations from the Department of Health – Abu Dhabi (DoH), is implementing the changes to rationalise co-payment policies for all residents covered under the plan.
What's Changing in the Basic Health Insurance Plan
The revised guidelines focus on four areas: diagnostic services, inpatient care, medication coverage, and annual premiums for domestic helpers.
Diagnostic Services: Plan holders will pay a 20% co-payment on consultation charges and non-insured diagnostic services — including laboratory tests and radiology — with a maximum of Dh50 per visit.
Inpatient Services and One-Day Procedures: A co-payment of Dh200 applies per inpatient service or same-day procedure, capped at Dh500 per calendar year.
Medication Coverage: The plan provides Dh1,500 annually per account towards medication costs. Plan holders are required to pay 30% of the cost of medication directly to healthcare providers.
Domestic Helper Premiums: For domestic helpers under 60 years of age sponsored by UAE nationals, the regulated annual premium is fixed at Dh750.
Core Benefits That Remain Unchanged
While the co-payment structure has been updated, the plan's core benefits stay in place. The annual insurance limit remains Dh250,000, covering healthcare and emergency services at more than 1,250 facilities across Abu Dhabi, Al Ain, and Al Dhafra.
Coverage also extends to Abu Dhabi's Centres of Excellence (CoEs), which include:
- Cleveland Clinic Abu Dhabi – designated CoE for adult cardiac surgery and stroke - Sheikh Shakhbout Medical City (SSMC) – CoE for stroke care - Sheikh Khalifa Medical City (SKMC) – CoE for paediatric cardiac surgery
Additional services such as physiotherapy, ambulance, maternity care, and other circuit services continue to be available to plan holders under the updated plan.
