How the changes in insurance coverage in Abu Dhabi will affect you

The changes announced by Health Authority Abu Dhabi on June 30 affect the Thiqa plan and the Abu Dhabi Basic Plan. Both are managed by Daman, the national insurance company.

Emiratis and expatriates in Abu Dhabi will have to pay more for health care at private facilities after changes to insurance cover were announced by the Health Authority Abu Dhabi (Haad) in June.

The changes in cover apply to the Thiqa plan for Emiratis, and for those expats and their families who are covered by Daman insurance’s Abu Dhabi Basic Plan, who seek treatment at private hospitals.

Changes to Thiqa plan:

• Thiqa cardholders will get 80 per cent coverage of treatment at private healthcare facilities in Abu Dhabi. Previously, they received full coverage at both private and public hospitals in Abu Dhabi.

• Outside Abu Dhabi, Thiqa will cover 50 per cent of the cost of treatment, a decrease from the 90 per cent coverage cardholders used to receive outside the emirate. Thiqa will cover treatment if service is unavailable in Abu Dhabi.

• Thiqa holders can get full coverage of IVF treatment at a governmental healthcare facility, in addition to one attempt per year at any private medical facility in Abu Dhabi. Previously, Emiratis could avail of three IVF treatments per year.

• Orthodontic braces for those above 18 years of age are no longer covered, unless they are a medical necessity.

• Medicines prescribed at a private healthcare facility can only be dispensed at a private pharmacy.

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Changes to Abu Dhabi Basic Plan:

• Abu Dhabi Basic Plan holders older than 40 will have an optional co-payment of up to 50 per cent of their own insurance policy’s premium.

• All employees under the Abu Dhabi Basic Plan will have to pay half of the insurance policy’s premium for their dependents (wife and three children).

• Childbirth costs will be charged according to a separate scheme.