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Individual Medical Insurance is cover for Individuals & their dependants against sickness and illness.
Members who wish to have a Comprehensive Global Medical Insurance Plan with extensive benefits
As per the law, the responsibility lies with Sponsor (for dependants) & Employer (for Domestic Help). DHA encourages Employers to provide medical insurance for the spouse or dependants of its employees. However, its mandatory that if an employer does not provide cover, then sponsor will need to arrange cover for Dependants or Domestic Help.
Yes. EBP is the Minimum specified benefits as prescribed by DHA and all should meet those requirements.
Employer/Sponsor can provide insurance which gives benefits more than the basic requirements, but these additional benefits will normally attract higher premium.
Yes, but such conditions can be subject to a waiting period of 6 months. If there is cover continuity, then the waiting period can be waived off. Premium gets loaded based on severity of the declared conditions.
Coinsurance is a percentage of the costs of Consultations, Treatment, Tests, Drugs and Medicines that must be borne by the Insured member during each visit. A deductible is a fixed amount that the member pays regardless of the overall cost of treatment. Both are used as a means of keeping down the costs of medical insurance.
YES, it is covered as mandatory benefit under EBP. However, it is Insurers’ discretion to load the premium or apply waiting period as appropriate.
LSB (Lower salary band) member should be insured with a DHA approved Participating Insurer (PI) only.
HSB / NLSB (Higher Salary Band or Non-Lower Salary Band) members can opt to avail cover from any Registered insurer.