Understanding the costs associated with your medical insurance can feel extremely overwhelming. However, it’s important you understand your obligation for payments and copay before you use your benefits to avoid racking up a large and expensive bill. Let’s take a look at the basic principles involved in understanding your health insurance costs and charges.

 

Speaking the Same Language as Your Insurance Provider

The first step in understanding health care costs is understanding the key terms, such as cost, charge/price, and reimbursement.

  • Cost is broken down into three categories, for providers, payers, and patients. For providers, cost is the expense incurred to deliver healthcare services to their patients. For the payer or insurance company, cost is the amount they pay to providers for services provided. For the patient, cost is the amount they pay out-of pocket for health care services.
  • Charge or price is the amount asked by the medical provider for a health care service, which appears on the medical bill.
  • Reimbursement is a payment made by a third party to a medical provider for medical services provided.

 

What Do Patients Actually Pay?

In Dubai, all residents are required to have health insurance by law. As such, they will only be required to pay a specific portion of their medical expenses (a fixed payment referred to as a copay), with the remaining balance being paid per the conditions of their health insurance policy coverage limits. This can be challenging for patients looking to know the exact cost of their service bill. Even when your doctor knows the charge, they will not know your required copay amount. While some clinics and doctors will call your insurance company on your behalf to determine your copay requirements, many will not. In this case, you’ll have to call your insurance provider to see what your policy copay is.

The amount a patient will owe is also based on their deductibles. With health insurance, the deductible is the amount paid out of pocket by the policyholder before an insurance provider will pay any expenses. For example, if you have an insurance policy with an AED 100 deductible, you will be required to pay the first AED 100 before your policy will start making payments for your care. Once your deductible is met, you will only be required to pay your copay for covered services. You will also be required to pay in full for any services not covered within your policy. 

 

understanding medical insurance costs and charges

 

How Much Will My Yearly Health Insurance Costs be?

The cost of your yearly health insurance premium will be based on the amount of health insurance you use in the year. It will also be based on the amount of coverage you require (including dependents), and type of coverage you need. For example, your policy will cost more if you are planning on starting a family and adding maternity coverage to your health insurance policy. 

If you end up using a great deal of your benefits throughout the year, you may end up having a larger payment when you renew your policy the following year. For this reason, it’s important to only use your benefits coverage when you need them. Just because a policy may cost AED10000 doesn’t mean it should be used to the maximum or more. On the contrary, if you use more than your allotted amount, you will pay higher premiums in the years to come. 

 

The Difference Between Private & Public care

As per a 2021 UAE Healthcare Report, 20% of healthcare usage in the UAE is through the public system. The remaining 80% is through the private system. While both offer access to world-class medical care, many people prefer to use private over public facilities. Before you use private healthcare facilities, it’s essential to make sure they accept your medical insurance and that your services are covered within the scope of your policy benefits. This starts with getting the best health insurance coverage within your budget. Luckily, getting an insurance quote has never been easier! You can compare insurance quotes for the best coverage rates by taking advantage of Petra’s fast and efficient insurance quote portal. Gain access to quotes in as little as thirty seconds!

 

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Life is full of unexpected mishaps. It’s better to be safe than sorry with insurance that works to protect your future. As Dubai’s premier car, health, and travel insurance providers, we’ll not only protect your financial investment, but we’ll also protect your peace of mind.

If you’re interested in learning more about our insurance policy offerings, contact a member of our team to learn more. Better yet, get your 30 second insurance quote today!

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rebecca gigi medical insurance coordinator at petra insurance

Ms. Rebecca Gigi

Medical Insurance Coordinator
The Challenge of Understanding Medical Insurance Costs and ChargesThe Challenge of Understanding Medical Insurance Costs and Charges