Article 2 of the law stipulates
that the system shall, thereinafter, be applied on all foreign residents of Abu
Dhabi. Expatriates who are on parent-sponsored visit visa may also be covered by
the system.
According to article 3,
categories of people who are exempt from the provisions of the law include:
1.
Employees of the companies operating in the emirate which have their own
certified (approved) medical facilities, provided that exemption is sanctioned
by the Abu Dhabi General Authority for Health Services (GAHS)
2.
Foreign wife of UAE citizen.
3.
Children of national women married to foreigners.
4.
Visitors on tourist visa.
5.
Those who may be exempt following a resolution by GAHS which must be endorsed by
the executive council.
Unless otherwise stated in
articles 2 and 3, all foreign residents and their family members must
participate in the compulsory health insurance system. The system is, however,
optional for UAE citizens.
The law obliges employers to
participate in the health insurance system for all their employees. The employer
shall secure health insurance to each employee, along with wife and three
children under the age of 18. It is mandatory for the employees to secure health
insurance to the persons they sponsor, who are not covered by the employer.
The law links issuing of
residence visas to foreigners and their families with their compliance to the
provision of participating in the health insurance system.
Companies licensed by GAHS to
operate in health insurance shall provide services to resident foreigners, their
families and others who are willing to benefit from such services.
Health insurance companies shall
pay the cost of the insured treatment to the medical treatment providers.
The law states that health
insurance companies may not own, manage or co-manage treatment facilities or
offer in any form treatment services.
Treatment providers may not own,
manage or co-manage such companies.
Article 9 of the law stipulates
that public and private healthcare facilities shall provide medical treatment
services to the insured covered by the heath insurance system. Private providers
must obtain permission from GAH to offer such services.
Article 12 identifies medical
treatment services covered in the health insurance system, including: check up
and primary healthcare by general practisioners and specialist doctors at
clinics and health centres, laboratory tests and X-rays, in-patient treatment,
dental and gum treatment, excluding orthodontics and dentures and medicines.
Expenses of an escort in critical
cases GAHs has the right to add or delete any of the services if needed.
Article 13 specifies cases not covered by health insurance, such
as: self-inflicted injuries,
diseases caused by unprescribed dopes or tranquilisers, plastic surgeries,
unless necessitated by severe damage, comprehensive check ups, treatment of
pregnancy and delivery for women covered as single, recreational treatment and
physical fitness programmes, occupational diseases/accidents, venereal diseases
communicable through sexual intercourse, expenses of the period that follows
diagnosis of HIV, expenses of dentures and bridges and orthodontic surgeries,
visual and audio tests, unless ordered by treating doctor, expenses of
transporting the insured by means other than licensed ambulances, treatment of
hair falling, balding and wigs, psychiatric treatment, allergy tests, equipment,
drugs and hormone treatment for birth control and impotence, treatment of
deformation that existed before issuance of insurance policy, organ transplant
and cases that require treatment abroad.
The law mandates minister of
justice, in coordination with the chairman of GAHs to empower some of GAH
employees to search the facilities licenced to provide treatment under the
health insurance system.
Article 24 of the law states that
a penalty of no less than Dh300 shall be leveid on employers/sponsors who
refrain from taking part in the system or from renewing the policy.
Violators of the provisions of
this law shall pay a fine of no less than Dh5,000 and no more than Dh20,000.
The law shall be published in the
official gazette and shall go into effect four months after its publishing.
Deliberate
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