Is Dermatology Covered by Health Insurance Policies?

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

Keeping yourself properly covered during winters to avoid flu or saving yourself from heatstroke in scorching summers of the gulf is not all that there is to staying healthy. There are several other small and big ailments that we tackle in our everyday lives.

One such ailment is the varied skin conditions. Skin diseases are some of the most commonly existing health conditions in the UAE, partly due to the extreme environmental conditions of the Gulf. Getting these conditions treated, however, can lead to huge medical bills.

Given the expenses, it is natural to seek cover for dermatology treatments in your Medical insurance policy. Let’s figure out if health insurance plans cover dermatology and what are the basic underlying terms and conditions for the coverage.

Does Health Insurance Cover Dermatology in the UAE?

In short, yes, health insurance does cover dermatology treatments on a case-by-case basis. In plain terms, while coverage exists, not all dermatology treatments are covered by health plans. As the base rule of health insurance policy goes, anything deemed medically necessary is covered by insurance under dermatology and skincare treatments. The exact terms of dermatology treatment coverage may differ for every provider and as per the type of network your plan is based on. The best way to figure out the exact benefits of dermatology treatments covered by your plan is by reading policy wordings or by talking to the service providers.

Do We Need Referral from a Dermatologist?

Since dermatologists are from the specialist category, many health insurance policies may require you to get a referral from your primary care physician. This generally applies when your health plan requires you to choose a facility from the list available with them as network doctors.

Even when you don’t have to choose a facility for your insurance policy, services and benefits related to dermatology may still need a referral from a primary care physician of your choice. This term is often highlighted in the policy wording of your plan as well. You will find it under the specialist consultation section.

What Kind of Health Insurance Plans Are Most Common Here in the UAE?

Primarily, two types of health insurance plans are available in the UAE — basic and comprehensive. If you opt for basic plans, you get access to only a General Practitioner. In this case, you will need a referral to consult a specialist. On the other hand, if you have semi-comprehensive or comprehensive plan, you get direct access to specialist consultation without any prior approval from your respective insurers.

Which is the Best Health Insurance Plan for Dermatology Treatment?

Both basic and comprehensive plans are a good choice depending on the requirements of the policyholder. If you need a budget insurance plan that covers all the basic benefits and emergency treatments, you can go for basic plans. Since they are more limited in coverage than other kinds of health plans, the price is relatively low as well.

For those who need more freedom to choose healthcare providers and doctors along with more benefits, comprehensive health insurance is more suitable. This type of Medical insurance costs a little more than basic plans but offers a better range of benefits and covers.

Compare health insurance in the UAE to find out a suitable plan from the category of your choice. When you compare plans, you must also take some time out to examine secondary factors such as claim process and customer service.

What are the General Dermatology Treatments Covered?

All medically necessary treatments can be covered by your health insurance policy when it comes to dermatology. Given below is the complete list:

Acne Treatment: Only covered if it caused by a severe infection that leads to a medical situation
Skin Cancer Treatment: Includes therapy sessions and pharmaceuticals taken orally to cure skin cancer
Skin Allergies: Can include several conditions like eczema, dermatitis, psoriasis, infections, rashes, keloid scars, warts, moles causing a health hazard
Skin Cancer Removal: Physical removal of cancerous skin cells by surgery
Skin Disfigurement Removal: Includes removal of potentially cancerous moles and other skin textures

What are the General Exclusions for Dermatology in Health Insurance?

The most common exclusions of dermatology treatments are cosmetic surgeries, procedures and treatments. Any dermatological procedure performed to improve aesthetics is categorized as a cosmetic treatment. Since the concerned skin condition is not affecting the health of the person directly or indirectly, the insurance companies do not cover them. A fine example here can be treatments taken for wrinkles, age spots, smile lines, Botox, tattoos (application and removal), chemical peels, microdermabrasion, etc.

How Can I File a Claim for My Dermatology Treatment?

Direct billing cashless claims are available for dermatology-related treatments. Keep in mind that a reimbursement claim is only allowed if the insured individual has availed of treatment outside their insurance network. It’s worth mentioning that reimbursement claims must be made within 90 days from the date of medical billing date.

The process is fairly straightforward — simply download the claim form from the provider’s website and complete the documentation. Contact the provider and avail of the treatment. Once done, the hospital will directly settle the bill with the respective provider.

Other Important Things to Keep in Mind

Just like any other health treatment, dermatology treatments are covered only if they are deemed medically necessary for you. You must obtain documented proof of the same to get the claim approved.
Co-payment and coinsurance apply to dermatology treatments generally. Read the terms and conditions of your plan carefully to find out exactly how much you have to pay out of pocket and manage finances accordingly.
Any treatment that can be categorized as cosmetic is generally not covered by health insurance plans.

In a Nutshell

Dermatology treatments are typically a part of your basic health insurance policy as long as they are medically necessary. Even the most comprehensive plans probably won’t cover cosmetic treatments and procedures unless specified otherwise. You must compare your options properly to get a hold of the best possible health policy for your needs. Use the online comparison platform of Policybazaar UAE to compare health insurance in the UAE ideally finding the perfect plan for your skin treatment and procedure. Make sure that you buy from authentic and safe sources only and give careful consideration to both price and features when choosing your health policy.