Abu Dhabi private health centers at risk of closure due to new insurance scheme
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Abu Dhabi private health centers at risk of closure due to new insurance scheme

By IHS Markit Life Sciences Expert 02 Sep 2016 (Last Updated November 2nd, 2021 03:28) |   Powered by GlobalData

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Abu Dhabi private health centers at risk of closure due to new insurance scheme

A number of healthcare centers in Abu Dhabi are at risk of sudden closure. Reports published on the Health Authority of Abu Dhabi (HAAD) in August suggest that some healthcare centers in the region are likely to have to reduce their work force in a drive to cut costs. This follows the modification of a co-payment scheme for Emiratis. The new insurance scheme may have negative effects for critically ill-patient groups.

Thiqa is a health scheme for UAE Nationals and those of similar status in the Emirate of Abu Dhabi. The Thiqa scheme is covered by the National Health Insurance Company Daman, which was nominated to manage the insurance scheme on behalf of the government of Abu Dhabi. Recent changes to the scheme have become effective since 1 July 2016. There was previously 100% coverage in private healthcare facilities prior to these changes being implemented. The situation now means that there is only 80% coverage for any treatment. As a result, patients in private healthcare facilities are now obliged to pay for 20% of their treatment.

There has been a reported increase in the number of complaints received by the Health Authority of Abu Dhabi (HAAD) alleging that patients can no longer afford new insurance fees. There is also emerging evidence that the increase in co-payments is placing the finances of private healthcare centers under pressure and may lead to the possible closure of some of these facilities in the future months and years.

The situation appears to be the most critical for patients with chronic diseases, since the cost of covering 20% of treatment expenses is potentially financially ruinous. Furthermore, Daman notified private healthcare companies that the insurance scheme will be cancelled in the event that co-payment fees are not collected. Local reports indicate that some patients have been requested to pay up to AED2800 (USD732) per day for nursing care. Patients who are unable to cover these costs are reported to have lost homecare providers.

Another critical aspect of the changes is that in future all prescriptions issued from private healthcare facilities can only be dispensed at private pharmacies. In addition, employees are required to pay AED8000 for dependents under the age of 18 years, as well as AED1,500 for those between 18 and 40 years. There is also a mandatory additional cost of AED750 for every child birth, while orthodontic services for those who are over the age of 18 years are no longer covered unless there is a medical necessity.

Demographic changes over the previous decade have prompted the UAE government to encourage growth in the private healthcare sector. Most of the country’s long-term healthcare scheme belong to the the public health insurance which is provided by Damn under Thiqa scheme for the UAE nationals. The latest changes are likely to have deep and lasting effect in terms of patient access to treatment. There are currently no indications that the HAAD is likely to reconsider or reverse the changes in the health insurance system in order to alleviate the situation for chronic disease patients.

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