HEALTH INSURRANCE
WHAT IS HEALTH INSURANCE?
Health Insurance is one of the most essential aspects of an individual’s life. It enables the insured to lessen the substantial risks linked with illness and treatment. Also provides financial coverage for all medical and surgical expenses incurred during hospitalization by the insured. Sharjah has some of the best public hospitals in the United Arab Emirates. The Sharjah Health Authority does a fantastic job of ensuring that Sharjah’s hospitals rigorously adhere to the high medical standards established by the authority.
WHY CHOOSE MERAK TAX CONSULTANT?
Purchasing health insurance coverage online is one of the finest ways to do so. Merak Tax Consultant is likely one of the simplest and most secure methods to purchase individual, family, senior, and employee health insurance coverage.
Merak Tax Consultant employs a unique algorithm to offer numerous insurance policies that meet the needs of customers based on their inputs. The ability to assess alternative programs unavoidably confers decision-making authority to the consumer. Through Merak Tax Consultant, a consumer might select the policy that best meets his or her needs.
FEATURES & BENEFITS OF HEALTH INSURANCE IN SHARJAH
In most cases, the comprehensive health insurance coverage will cover daycare hospitalization in addition to pre-and post-hospitalization benefits. Almost all medical insurance plans in Sharjah include cashless hospitalization and reimbursement options. All of a policyholder’s medical expenses are either paid directly to the hospital (in the case of cashless hospitalization) or reimbursed to the policyholder upon submission of reimbursement claims.
The following are the various characteristics and advantages of medical insurance in Sharjah:
CASHLESS TREATMENT
Cashless services provided by insurance companies allow policyholders to receive medical care without paying cash at the hospital cash register. In this instance, the insurer will reimburse the hospitals for the cost of treatment on behalf of the policyholder. The policyholder must supply the policy number at the time of admission; the hospital will handle all other matters on behalf of the insurance company.
However, if the insured’s medical bills surpass the insured amount, the insured will be responsible for the difference. The insurance company will not pay for damages over the amounts insured.
REIMBURSEMENT
Cashless therapy is only available at hospitals with insurance partnerships. For non-partner hospitals, the policyholder must utilize the insurance company’s reimbursement option. If the policyholder is admitted to a non-network hospital, the policyholder will initially be responsible for the expense of hospitalization. After receiving treatment, the policyholder can submit all original receipts and supporting documentation to the insurer for reimbursement. The amount reimbursed cannot exceed the amount insured under the health insurance policy.
COVERAGE FOR PRE & POST HOSPITALIZATION
In Sharjah, health insurance covers pre-and post-hospitalization charges. Typically, the coverage is limited to a set number of days, during which all pre-and post-hospitalization charges are covered. In the policy paper, the exact number of days will be specified.
MEDICAL CHECK-UP
Medical insurance policyholders in Sharjah typically receive free checkups at regular periods. The frequency of these medical examinations can vary between insurance providers. It is interesting to note that a small number of medical insurance carriers in the United Arab Emirates offer free medical checkups based on past medical records and no-claim bonuses. The frequency of free medical checkups provided varies from insurer to insurer.
TRANSPORTATION EXPENSES
In the event of hospitalization, the insurance coverage will cover the cost of transportation (ambulance charge) from home to hospital and back. Typically, it is an add-on to the existing coverage, and the buyer of the health insurance policy must opt for it at the time of purchase.
NO CLAIM BONUS (NCB)
The policyholder will be eligible for the No Claim Bonus if he or she does not file a claim during the policy year. No-Claim Bonus is often awarded as a premium decrease or an increase to the sum guaranteed. Typically, the benefits are reflected at insurance renewal.
THIRD-PARTY ADMINISTRATORS (TPAS)
The majority of Health Insurance providers in Sharjah and throughout the United Arab Emirates employ Third Party Administrators (TPA) to manage their sales and other services. These TPAs oversee a multitude of services, including claim settlement, enrollment, premium collecting, etc. While purchasing medical insurance in Sharjah, the applicant should conduct the necessary research to select the most dependable and easily accessible TPAs on the market. Identifying and choosing the finest medical insurance and Third-Party Administrators is essential for the greatest possible experience.
ROOM RENT
Room Rent Having health insurance will assist the policyholder in covering all room rent costs incurred during hospitalization. In the health insurance policy agreement, the maximum amount of room rent reimbursed by the policy will be specified.
TYPES OF HEALTH INSURANCE IN SHARJAH AND ACROSS UAE
There are primarily two types of health insurance policies available to satisfy the policyholder’s individual needs:
Individual health insurance policies cover hospitalization costs for a single insured. The policy’s cashless and reimbursement options for pre-and post-hospitalization expenses cover the cost of illness or hospitalization for a single individual.
Family health insurance policies cover the medical costs of an insured family’s entire household. Prospective clients deem family health insurance plans to be a good value due to their affordability and coverage capabilities.
The main disadvantage of this policy is that the number of policyholders is limited to one spouse and a certain number of children. Typically, the sum promised in family health insurance plans is divided among the family members covered by the policy.
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Employers typically purchase group health insurance plans for their employees. The most important characteristic of employee health insurance plans is the employer’s capacity to include or exclude employees as they join or depart the organization. Due to the low-risk nature of the policy, employee health insurance plans typically have low premiums.
Plans for senior citizens’ health insurance are tailored exclusively for those aged 60 and older. The likelihood that an elderly citizen may become ill is deemed to be high, resulting in typically higher rates. Very few health insurance companies in Sharjah offer health insurance plans for senior adults; the majority of insurance plans include required health examinations. The health examination report will be utilized as a factor in determining whether or not to sell the client an insurance policy.
Health insurance policies in Sharjah comply with a set of provisions that define the depth and breadth of the policyholder’s health insurance coverage. The below-listed benefits are common for all health insurance policies sold in Sharjah.
Standard health insurance coverage includes the following:
- Pre- and post-hospitalization costs
- Medication
- Costs of hospitalization as an inpatient
- Pre-existing ailments and health conditions
- Newborn or Maternity
- Ambulance expenses
- Health examinations
- Hospital room cost
- Vaccinations and immunizations
- Daycare procedures
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HEALTH INSURANCE EXCLUSIONS
Health insurance exclusions are a list of medical procedures and treatments that are not covered by health insurance in Sharjah. Listed below are some of the most typical exclusions from health insurance:
UNNECESSARY OPERATIONS
Medical insurance in Sharjah will not cover the expense of procedures deemed unnecessary to the policyholder’s health and welfare.
AESTHETIC TREATMENTS
It is quite rare to locate a medical insurance company that includes the cost of cosmetic treatments in its policy coverage.
OBESITY
The majority of medical insurance providers in Sharjah do not cover treatments for obesity.
DENTAL AND OPTICAL TREATMENT
Dental and optical care are typically not covered by Sharjah’s medical insurance carriers. A small number of medical insurance companies offer emergency dental and optical care coverage to policyholders. The majority of medical insurance policies in Sharjah provide clients the option to purchase maternity coverage as an add-on (by paying an additional premium).
WAITING PERIODS
Certain medical insurance plan benefits become effective once the policyholder has been a policyholder for a predetermined period. This is referred to as a waiting time. Included among the benefits requiring a waiting period are maternity coverage, coverage for pre-existing conditions, and coverage for chronic conditions, among others. Typically, policy renewals do not include a waiting period.
CANCELED POLICIES
In Sharjah, medical insurance policies include the “right to terminate” Due to the policyholder’s direct action, the health insurance policy can become null and void. Indulging in unlawful activities (such as gambling), committing self-harm or suicide, failing to pay the medical insurance premium on time, etc., are examples of conduct that could render an insurance policy void.
Canceled Policies
Waiting Periods
Dental & Optical Treatments
Obesity
Aesthetic Treatment
Health Insurance Exclusion
HOW TO FILE A CLAIM FOR HEALTH INSURANCE IN SHARJAH?
The process for filing a health insurance claim can vary depending on the hospital where the policyholder receives treatment. If the hospital is what is often referred to as a network hospital (hospitals with which the insurance provider has partnerships), the insurance claim process comprises a specific series of steps. If the hospital is an out-of-network hospital (one with which the insurance provider has no affiliation), a different procedure must be followed.
The two most common ways for members of a health insurance coverage to file claims are described here.
- Within the hospital network
United Arab Emirates (UAE) health insurance companies typically have close business ties with hospitals and clinics around the country. When a policyholder gets care at one of these network hospitals, he or she is eligible for a cashless claim settlement. The hospital will be compensated by the insurance company for the cost of treatment. In this aspect, the policymaker is not obligated to make any compensation. The cashless claim is only valid if the treatment received by the policyholder falls within the policy maximum.
- Outside the hospital network
In this circumstance, the policyholder is responsible for paying for treatment received at a non-network hospital. The insurance provider will repay the claim amount expended by the policyholder based on the policyholder’s submission of original bills and other supporting documentation. Typically, reimbursements are subject to policy eligibility and the insurance provider’s stipulated restrictions. Merak Tax Consultant, one of the largest insurance brokers in Sharjah, can help you cut through the clutter; contact our helpful customer service department for more information.