Health system profile - United arab Emirates - What is GIS - World ...

Health Systems Profile- UAE Regional Health Systems Observatory- EMRO
of Abu Dhabi has supported the treatment abroad of some 3,600 patients, mainly in the
USA! The Ministry of health has disbursed 19 million dirham in 1999 for the treatment of
its patients; it is estimated however that in excess of 100-150 million $ in spent by the
CPC of Abu Dhabi per year.
Patients who are sent for treatment abroad are predominantly nationals. The costs
incurred include the cost of medical care as well as travel, accommodation and generous
living expenses for the patient and one or more of his/her relatives.
Health insurance companies are likely to increase and widen the scope of their
operations. Arrangements, much like managed care programmes and health
maintenance organizations are apparently imminent, with some association and
affiliation with medical centers abroad (regional and international) as well. This may well
serve to promote cost sharing, particularly if the employers and employees were to
contribute to the premium.
Private insurance programs: trends, eligibility, benefits, contributions
One aspect of this market which does not appear to be standardized is whether the
insurance companies have associations with particular hospitals or clinics. In the case of
the insurer providing a listed network of facilities, each one on the list will normally have
been visited by the insurer, evaluated for quality and scope of services and treatment
rates and, in some cases, special arrangements and tariffs may have been agreed upon
whereby the medical facility offers reduced rates to the insured patient.
Both group and individual policies are available from insurers and all insurance providers
contacted were found to offer discounted premiums as an integral part of group
(corporate) policies. Most companies offer policies that cover treatment abroad if the
policy holder needs emergency attention whilst already out of the country; however
there are some policies which restrict this to certain regions or exclude coverage in
North America, for example. Similarly, if the patient is in the UAE but the treatment
required is not available locally then international treatment may be covered: this is case
specific. There are also exclusive policies offered by some insurance companies which
are by no means standard and may allow for global coverage at much higher premiums.
As well as the geographical restrictions of insurance policies, there are also treatment
exclusions that are often standard or may be company specific. Exclusions which are
found to exist in the mainstream (at least in the UAE) are, for example: pre-existing
conditions, AIDS related sicknesses, cosmetic surgery (other than re-constructive),
routine medical check-ups, congenital and hereditary conditions, dental treatment,
pregnancy and maternity and lastly, eye care. However some of these exclusions (e.g.
dental, optical and maternity) can be covered by insurance through additional
agreements that will incur additional premiums being paid by the policy holder. Despite
the availability of international treatment, due primarily to the strict conditions that apply
and secondly to the fact that the majority of conditions can be treated locally, a
maximum of about 10% of claimants have actually requested or received treatment
abroad.
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