Essential benefits plans (EBP) Health Insurance in Dubai

The above plans and premiums are for AED 1,000,000 Sum insured for 1 Adult of 30 Years for Dubai city.

Among these, the Essential Benefits Plan (EBP) plays a pivotal role by offering a cost-effective solution that fulfills the minimum requirements for basic healthcare coverage. The EBP Dubai is specifically tailored for low-income earners, which provides them access to essential medical services while ensuring compliance with UAE law.

To dive deeper into how EBP works and why it is a foundation of Dubai’s healthcare framework, keep reading!

What is an Essential Benefit Health Insurance?

The Essential Benefits Plan (EBP) is a plan introduced under the Dubai Health Insurance Law to provide basic healthcare coverage for all residents. It is specifically for individuals earning less than AED 4,000 per month, providing them with affordable and essential medical services while meeting legal requirements.

Some of the key features of Essential Benefit Health Insurance are —

Affordable Coverage: EBP offers cost-effective health coverage, with premiums starting from AED 690 (approx.) annually
Inclusive Benefits: Covers emergencies, surgeries, medical tests, medications, outpatient and inpatient treatments, and maternity care
Limits and Co-insurance: Includes annual claim limits of up to AED 150,000 and coinsurance requirements like 20% for basic healthcare services
Newborn and Maternity Care: Coverage includes maternity expenses and newborn care for the first 30 days under the mother's policy

What is Included in Essential Benefit Health Insurance?

The Essential Benefits Plan (EBP) offers comprehensive yet affordable health insurance coverage tailored for low-income residents in Dubai. Here are the key services covered under the plan—

Service	Inclusions
Emergency Medical Services	Coverage across the UAE for emergency treatments and ambulance services
Inpatient Services	Hospital stays, including: Tests, diagnosis, and necessary surgeries Room accommodation (shared rooms) Coverage for organ transplants (up to AED 100,000) Emergency treatments with prior insurer approval within 24 hours of admission Dialysis treatments (up to AED 60,000 annually)
Outpatient Services	General practitioner (GP) consultations and specialist referrals Diagnostic tests like blood tests, X-rays, and scans Physiotherapy sessions (up to 6 or 8 per year, depending on the plan)
Prescriptions and Medications	Annual medication cost limit with co-insurance applicable on each prescription
Maternity Services	Doctor visits, including necessary lab tests and ultrasounds Coverage for normal deliveries (up to AED 10,000) or medically necessary C-sections Newborn coverage for the first 30 days under the mother’s policy
Preventive Services	Vaccinations for newborns and children as per UAE Ministry of Health guidelines Regular screenings, including diabetes and cancer checks
Dental Services	Basic dental emergency treatments such as chipped or broken teeth, knocked-out teeth, and soft-tissue injuries

Who is Eligible for Essential Benefit Health Insurance?

The Essential Benefits Plan (EBP) is a mandatory health insurance plan that offers affordable healthcare for specific groups of residents in Dubai. Eligibility criteria are clearly defined to focus on individuals with limited income and dependents.

Listed below are the key eligibility points —

Low-income Employees: Individuals earning AED 4,000 or less per month are eligible to apply for the EBP
Dependents of Employees: Dependents such as spouses and children of eligible low-income earners can also be covered under the EBP
Domestic Workers: Housemaids, nannies, and other household staff fall under this eligibility criterion
Dubai Residents Only: The plan is strictly for residents living and working in Dubai — it ensures compliance with the Dubai Health Authority (DHA) regulations
Pre-existing Conditions: Individuals with pre-existing or chronic conditions are eligible, although coverage for the same may begin after a waiting period of 6 months

How Much Does Essential Benefit Health Insurance Cost?

The Essential Benefits Plan (EBP) premiums (per annum) start from around AED 690.

However, the actual cost can vary based on several key factors that insurers consider while tailoring the plan to individual needs.

Age of the Policyholder: Older individuals tend to have higher premiums due to increased health risks
Medical History: A history of chronic illnesses or pre-existing conditions may result in higher premium costs
Lifestyle Choices: Smokers and individuals with high BMI (Body Mass Index) often face higher premiums due to associated health risks
Coverage and Benefits Selected: Adding extra coverage, like dental cover, can increase the overall cost of the plan
Insurance Provider and Network: The choice of insurer and the range of hospitals, clinics, and pharmacies in the network can influence the premium

Does the Essential Benefit Health Insurance Provide Maternity Coverage?

Yes, the Essential Benefits Plan (EBP) in Dubai includes maternity coverage for both outpatient and inpatient care. The coverage ensures that expectant mothers have access to critical medical services throughout their pregnancy, childbirth, and postpartum period.

Find below the key details about the maternity benefits offered under EBP plans —

Outpatient Maternity Services

Antenatal Care: Includes routine doctor consultations, up to 8 visits to a primary healthcare center or specialist
Screening Tests: Coverage for initial investigations such as:
- FBC (Full Blood Count) and Platelets
- Blood group, Rhesus status, and antibodies
- Rubella serology
- Urinalysis (MSU)
- Glucose Tolerance Test (GTT) for high-risk cases
- 3 antenatal ultrasounds
Co-insurance: A 10% or more co-payment is applicable for all outpatient maternity services

Inpatient Maternity Services

Normal Delivery: Covered up to a sub-limit of AED 7,500 or AED 10,000 (depending on the policy)
Caesarean Section: Medically necessary C-section expenses are also covered, up to a sub-limit of AED 10,000
Maternity-related Emergencies: If a condition becomes an emergency, coverage can extend up to AED 150,000, provided prior approval or notification within 24 hours is made
Newborn Coverage: Newborns are covered for the first 30 days after birth under the mother's policy, with expenses aligned to the DHA's guidelines

Additional Points to Note

Waiting Period: Some EBP plans impose waiting periods of 6 months for the first scheme membership — this is the case for new entrants to the UAE or those without continuity of cover (COC)
Pre-existing Conditions: Pregnancy declared during the application process is subject to medical underwriting — undeclared pregnancies may not be covered during the policy period
Emergency Coverage: Emergency maternity treatments must be reported within 24 hours to the insurer to qualify for coverage

How to Buy Essential Benefit Health Insurance in Dubai?

Step 1

Visit the Policybazaar.ae Website

On Policybazaar.ae, navigate to the ‘health insurance’ section

Step 2

Start Your Journey

Fill in personal details like residency, salary, and contact details to proceed further

Step 3

Explore Insurance Quotes

You’ll be redirected to the quotes page listing health insurance plans

Step 4

Filter Coverage Options

Use filters to refine by coverage type, such as ‘Clinic Only’ plans for EBP

Step 5

Compare and Purchase

Review plan features, compare premiums, and select the one best suited for you

Best Essential Benefit Health Insurance Plans

Some of the best EBP plans in Dubai are given in the table along with their key features —

Name of the Plan	Key Coverages
Takaful Emarat APN	Annual Limit: AED 150,000 for overall coverage, including maternity, outpatient, and inpatient care Pharmacy Cover: Prescription medicines covered up to AED 7,500 with a 20% co-pay Maternity Services: Covers 8 visits, 4 antenatal ultrasounds, and delivery (normal or C-section) up to AED 10,000 Pre-existing Conditions: Covered after medical underwriting, with no waiting period for declared conditions Newborn Coverage: Included for 30 days from birth, with vaccinations and screenings as per DHA guidelines Additional Benefits: Includes dental emergencies, physiotherapy (8 sessions/year), and mental health outpatient care (AED 800)
Takaful Emarat Ecare Blue	Annual Limit: AED 150,000 for overall coverage, including outpatient and inpatient care Pharmacy Cover: Medicines covered up to AED 6,500 with a 10% coinsurance Maternity Services: Covers 8 visits, 3 antenatal ultrasounds, and delivery (normal or C-section) up to AED 10,000 Pre-existing Conditions: Covered with no waiting period if declared during the application Newborn Coverage: Coverage for 30 days from birth, including vaccinations and neonatal screenings Additional Benefits: Includes mental health support (AED 800), dental (up to AED 500), and physiotherapy (6 sessions/year)
Watania Takaful NAS Plan 5	Annual Limit: AED 1 million for overall coverage, including inpatient and outpatient care Pharmacy Cover: Prescription medicines covered up to AED 5,000 with a 15% co-insurance Maternity Services: Normal delivery covered up to AED 7,500 and C-section up to AED 10,000 Pre-existing Conditions: Covered up to AED 150,000 after a 6-month waiting period if required Newborn Coverage: Expenses for newborns covered for the first 30 days under the mother's policy Additional Benefits: Includes 8 physiotherapy sessions/year, vaccinations, and diagnostics with 10% co-pay
Orient E-Med	Annual Limit: AED 150,000 covering inpatient and outpatient services Pharmacy Cover: Medications covered up to AED 2,500 with a 30% co-insurance Maternity Services: Covers 8 visits, 3 antenatal ultrasounds, and delivery (normal or C-section) up to AED 10,000 Pre-existing Conditions: Excluded for the first 6 months, covered afterward up to the annual limit Newborn Coverage: Includes coverage for 30 days post-birth, with vaccinations and screenings Additional Benefits: Includes dialysis (AED 60,000), organ transplant (AED 100,000), and physiotherapy (6 sessions/year)
DubaiCare Next N5 (Dubai Insurance)	Annual Limit: AED 1 million for inpatient and outpatient services, with global coverage Pharmacy Cover: Medications covered up to AED 5,000 with up to 20% co-insurance Maternity Services: Covers 10 visits, 4 antenatal ultrasounds, and delivery up to AED 10,000 Pre-existing Conditions: Covered up to AED 150,000 after a 6-month waiting period (if applicable) Newborn Coverage: Includes expenses for 30 days post-birth under the mother's policy Additional Benefits: Includes physiotherapy (8 sessions/year), mental health support (AED 10,000), and dialysis (AED 60,000)
Dubai Insurance Ecare Blue	Annual Limit: AED 1 million for overall coverage, including outpatient and inpatient care Pharmacy Cover: Medications covered up to AED 5,000 with a 10% co-insurance Maternity Services: Covers 3 antenatal ultrasounds, 8 visits, and delivery up to AED 10,000 Pre-existing Conditions: Covered up to AED 150,000 with no waiting period for declared conditions Newborn Coverage: Expenses covered for the first 30 days under the mother’s policy Additional Benefits: Includes physiotherapy (8 sessions/year), dialysis (AED 60,000), and organ transplant (AED 100,000).

Disclaimer: This is not a complete list of Essential Benefits Plans (EBP) available in Dubai. To explore the full range of plans and their detailed features, visit Policybazaar.ae and compare options tailored to your needs.

What is the Claim Process of Essential Benefit Health Insurance?

Given below is the claim process of EBP in Dubai —

Within Network Providers

Most EBP plans offer direct billing for covered services when visiting in-network providers.

Present your insurance card at the healthcare facility
Pay the applicable coinsurance or deductible at the time of the visit
The insurer directly settles the remaining amount with the healthcare provider

Outside Network Providers

For treatments received outside the insurer’s network, you will need to file a reimbursement claim.

Collect and retain the following —
- Original receipts and invoices
- Detailed medical reports and prescriptions
- Proof of payment (such as receipts)
Submit a reimbursement claim form to the insurer along with the supporting documents
Reimbursement is generally processed at 80% to 100% of the insurer’s network rates, depending on the policy terms

Emergency Treatments

Notify the insurer within 24 hours of admission to a hospital
Provide relevant medical documents and bills for claim settlement
Emergency care costs are usually covered up to the annual limit, subject to policy guidelines

Maternity and Newborn Claims

The process is fairly straightforward — notify the insurer in case of any emergency complications and follow the instructions to file a claim.

Prior approval is required for inpatient maternity services like delivery and C-sections
Newborn expenses are covered under the mother’s policy for 30 days post-delivery

Pre-Authorisation

Pre-approval is required for certain services like:

Surgeries
Physiotherapy
Diagnostic imaging (MRI, CT scans, and more)

You need to submit pre-authorisation requests through the healthcare provider to get coverage.

Claim Settlement Timeline

Insurers settle claims within 14 to 30 days of receiving complete documentation
Delays may occur if documents are incomplete or require further review

Health Insurance Popular Searches

Yes, most insurers allow policyholders to upgrade their plan to include additional benefits such as hospital networks or higher maternity coverage. However, the upgrade may require a revised premium and approval from the insurer.

Dental and vision services are generally limited to emergency cases under EBP. For example, dental emergencies like chipped or broken teeth are covered, but routine check-ups and cosmetic treatments are excluded. Vision-related emergencies, such as sudden loss of sight, are also included.

Yes, many Essential Benefits Plans include outpatient counseling sessions for mental health, usually up to a set limit (e.g., AED 800 annually) along with a co-insurance. Inpatient mental health care may not be covered unless specified as an emergency.

Failure to pay your premium on time can lead to policy suspension or cancellation. While insurers provide a grace period for payments, it is advisable to keep premium payments up to date to maintain uninterrupted coverage.

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