Essential Benefits Plan: Your Minimum Coverage Benchmark
The Essential Benefits Plan (EBP) is the basic health insurance package mandated in Dubai, especially for individuals earning below AED 4,000 per month. It provides essential medical services such as emergency care, outpatient visits, maternity benefits, and prescribed medications. Designed to ensure every resident has access to fundamental healthcare, the EBP serves as the starting point for medical protection in the UAE.
The infographic above illustrates the different health insurance options available. It highlights how important it is to understand your coverage choices. Choosing the right plan is key to ensuring adequate medical protection.
Understanding the Essential Benefits Plan (EBP) is particularly important, especially for those earning less than AED 4,000 per month. This plan serves as the foundation for health insurance in Dubai.
What Does the EBP Cover?
The EBP offers coverage for a variety of necessary medical services. This includes essential medical care when you need it most.
- Emergency care: Immediate medical attention in critical situations.
- Outpatient visits: Doctor consultations for non-emergency medical issues.
- Maternity benefits: Prenatal, delivery, and postnatal care for both mother and newborn.
- Prescription medications: Coverage for necessary prescribed drugs.
The EBP also extends coverage to dependents. This includes coverage for your spouse, children, and domestic staff.
New residents arriving in Abu Dhabi on a resident visa have 14 days to obtain health insurance coverage. Existing residents and policyholders should renew their policies before they expire.
Understanding Coverage Limits and Exclusions
It's important to be aware that the EBP has coverage limits and some exclusions. The plan covers up to AED 150,000 for all claims, but co-payments apply for various services.
There is a 20% co-pay for inpatient and non-emergency treatments. This co-pay is capped at AED 500 per visit and AED 1,000 annually. There's also a 30% co-pay for medications, with an annual limit of AED 1,500.
Pre-existing conditions have a six-month waiting period. Carefully review your policy documents for specific details and limitations.
Beyond the Basics: Supplementing Your EBP
While the EBP provides a minimum standard of coverage, you have the option to increase your protection. Consider supplementing your plan with optional add-ons or upgrading to a more comprehensive policy. This allows you to personalize your healthcare coverage.
The following table provides a comparison of coverage elements across different insurance tiers, including the EBP:
Essential Benefits Plan Coverage Comparison This table compares key coverage elements across different insurance tiers including the mandatory minimum Essential Benefits Plan.
| Coverage Element | Essential Benefits Plan | Enhanced Plans | Premium Plans |
| Emergency Care | Yes | Yes | Yes |
| Outpatient Visits | Limited | Higher Limits | Higher Limits & Wider Network |
| Maternity Benefits | Basic | Enhanced Benefits (e.g., private rooms) | Comprehensive Coverage & Choice of Doctors |
| Prescription Medications | Limited Formulary & Co-pay | Wider Formulary & Lower Co-pay | Extensive Formulary & Minimal Co-pay |
| Pre-existing Conditions | 6-month waiting period | Reduced waiting periods or waivers | Coverage from day one |
| Annual Coverage Limit | AED 150,000 | Higher Limits (e.g., AED 500,000) | Significantly Higher Limits (e.g., AED 1,000,000+) |
This table shows how Enhanced and Premium plans build upon the foundation of the EBP. They offer higher coverage limits, broader networks, and additional benefits
