Understanding Dubai's Essential Benefits Plan (EBP)
The Essential Benefits Plan (EBP) was created by the Dubai Health Authority (DHA) to ensure that every resident—regardless of income level—has guaranteed access to essential medical services, inpatient care, emergency treatments, and generic pharmaceuticals.
EBP policies are offered exclusively by participating insurance companies approved by DHA to underwrite basic schemes. Premiums and statutory benefit limits are strictly standardized by the government to prevent predatory pricing while guaranteeing sustainable healthcare access.
Key Benefits and Coverage Slabs
- Annual Policy Maximum: Up to AED 150,000 per person per policy year for covered medical treatments.
- Inpatient Hospital Treatment: Covered at 80% with a 20% co-payment, capped at a maximum patient co-pay of AED 500 per hospital admission, and AED 1,000 annual cumulative co-pay maximum.
- Outpatient Doctor Consultations: 20% co-insurance, capped at a maximum of AED 20 per visit at approved clinics and medical centers within the designated basic network.
- Pharmaceuticals & Medication: Up to AED 1,500 per year for generic and essential medications, subject to a 30% co-pay per prescription.
- Maternity Care: Outpatient antenatal services include routine doctor visits, basic blood tests, and 3 ultrasound scans. Inpatient normal delivery is covered up to AED 7,000, and medically necessary Caesarean section is covered up to AED 10,000 (both subject to 10% co-pay).
- Emergency Medical Care: Covered at 100% at any authorized hospital in the UAE until the medical condition is medically stabilized.
Eligibility Criteria
To qualify for an Essential Benefits Plan policy, the applicant must fall into one of the following regulated categories:
- Low-Salary Employees: Workers whose total monthly compensation (basic salary plus regular allowances as reflected on their registered MOHRE contract) is AED 4,000 or lower.
- Domestic Service Workers: Housemaids, private chauffeurs, nannies, cooks, and gardeners sponsored directly by individuals.
- Non-Working Dependents: Non-employed spouses, children, and elderly parents sponsored on a family residence visa.
Authorized EBP Underwriters
Only DHA-licensed "Participating Insurers" are authorized to issue compliant EBP policies in Dubai. These include designated national and international underwriters such as Dubai Insurance Company, Orient Insurance, National General Insurance (NGI), Takaful Emarat, and Oman Insurance (Sukoon).