Basic insurance packages that cover chronic diseases

Minister of State for Financial Affairs, Mohammed bin Hadi Al Husseini, confirmed that insurance companies licensed in the country provide many health insurance services, whether basic coverage in insurance documents in accordance with what is decided by health insurance bodies in the various emirates of the country, or additional benefits and coverage on those documents and in accordance with what is agreed upon between the insurance company and the beneficiaries of the insurance policy in exchange for additional premiums, which are agreed upon whether those policies are individual or group..

This came in response to a question from a member of the Federal National Council, Saeed Al-Kaabi, about some health insurance companies including exceptions in insurance documents that exclude coverage of some health conditions, such as congenital diseases with which a person is born, and chronic diseases such as diabetes, high blood pressure, asthma, and heart disease. What treatment can the Central Bank put in place, as the regulating body for the insurance sector, to ensure the provision of the required health care for patients with these diseases?

Al-Husseini said: “With regard to coverage of chronic diseases, it is one of the coverages available in many of the basic insurance packages available in the various emirates of the country, in Abu Dhabi, Dubai, and the Northern Emirates as well, including, but not limited to, the basic health insurance package for workers in the private sector and auxiliary workers in the Northern Emirates, which was approved at the beginning of this year, pointing out that even in cases where these diseases are not included in the basic coverage, they can be covered by insurance companies in accordance with what is agreed upon in this regard with the Beneficiaries.

He added: “As for congenital diseases that are born with humans, whether internal or external, His Excellency said that they are not considered among the mandatory basic benefits that must be provided within health insurance documents in accordance with the legislation issued by health authorities in the various emirates of the country, and in many cases they fall within the exceptions to health insurance coverage, like other exceptions contained in health insurance documents existing in the country, especially chronic hereditary diseases, due to the high costs of treatment resulting from them and to avoid the high prices of health insurance policies in the country, adding that it is necessary to review The terms of the health insurance policy for each individual case and the type of disease that the beneficiary suffers from, to ascertain the extent to which the policy covers this type of disease or not, the possibility of adding it to the policy and the premium to be paid to the company if this disease is covered..

For her part, a member of the Federal National Council, Sheikha Saeed Al Kaabi, commented that practical application still shows that excluding these groups and those suffering from chronic diseases from basic coverage, or linking them to conditions or additional costs, constitutes a real challenge that hinders the achievement of the principle of comprehensive health care, and imposes high financial burdens on many cases of citizens and residents. Global health experiences confirm that chronic diseases are not temporary exceptional cases, but rather represent a large percentage of ongoing health needs, which makes their inclusion within the basic package a necessity and is one of the most important reasons for long-term health spending. Range, which makes its inclusion in the basic package a necessity, not an exception, and not an option linked to special agreements with insurance companies..

She said: “The justifications for including this category in the basic package include, from a public health perspective, chronic diseases, as they are part of the community health system and not individual, transient cases, and their early coverage contributes to reducing the costs of late treatment on the entire health system. In terms of family financial stability, the high cost of treating chronic diseases compared to average income constitutes a threatening burden to the social and economic stability of families, and from the perspective of health justice, leaving coverage to the judgments of insurance companies or to individual spending leads to a large disparity between groups, and violates the principle Equal health opportunities.

Al-Kaabi stressed that, within the framework of compatibility with the state’s trends towards quality of life, the inclusion of chronic diseases within the basic package enhances the quality of life, and practically embodies health and well-being policies, as prevention and continuous medical follow-up have been scientifically proven to be much less expensive than delayed therapeutic intervention or treatment in critical cases. Here we see the importance of studying the issuance of a binding regulatory directive for insurance companies that guarantees the inclusion of chronic and congenital diseases within the basic package of health insurance for all categories, without requiring additional cost or exceptional coverage, in line with health legislation in the country. And internationally advanced standards of care.