BASIC

MEDICAL INSURANCE
COMPARISON TABLE

AFIA Insurance Brokerage Services LLC Tel: +971 4 421 5819

19th and 24th Floors, Deyaar Tower (Al Ameri Building), Barsha Heights (TECOM) Fax: +971 4 421 5984
Main Reception on 19th floor Email: hello@afia.ae,
P.O. Box 26423, Dubai, United Arab Emirates askalfred@insurancemarket.ae
www.afia.ae, www.insurancemarket.ae
 FOR DEPENDENTS

Sponsor Salary up to Sponsor Salary above

4,000 4,000
(DMED)
Children - unmarried 587.90 788.65
Married females (18‐45yo) 587.90 1,770.40
Married females (66‐90yo) N/A 4,185.40
Husband & Other relatives (up to 64) 587.90 788.65
Husband & Other relatives (65+) N/A N/A
Parents/Grandparents (up to 64yo) 587.90
4,185.40 (up to 90 y/o)
Parents/Grandparents (65+) N/A

Enhanced Basic 1

Male (18‐64) / Single Female (up to 64) 905.1

Male/Female (below 18 y/o) 905.1
Married Females 2,137.80
Dependent Parents (up to 64yo) 905.1
Dependent Parents (65+) Requires Underwriting

Basic
Child Dependents ( 1‐ 17) - unmarried 790
Females 18‐45 Dependents 1,855
Females 46‐64 Dependents 790
Male 18‐64 Dependents 790
Parent (46‐59) 2048
Parent (60‐99) 4199

LSB‐ FOR EMPLOYEES EARNING UP TO 4,000aed

EMED

LSB Employee (up to 64 y/o) 587.90

LSB Employee (65+) N/A

Enhanced Basic 1

Male/Female (up to 64yo) 590.10

Male/Female (65+) N/A

Basic
LSB Employee (up to 64 y/o) 590
LSB Employee (66+) Requires Underwriting

FOR EMPLOYEES EARNING More than 4,000aed (HSB) / Investors/ Partners

IMED

HSB/Investor/Partner (up to 64 y/o) 917.80

HSB/Investor/Partner (65+) N/A

Enhanced Basic 1

Female (up to 64) 2,137.80

Male (up to 64) 905.1
Investors (65+) Requires Underwriting

Notes:
Basic * Newborns - for underwriting and
HSB ‐Employees (up to 64yo) 790
requires discharge summary
Female Investors (18‐45 y/o) 1,996 * Basic plans not applicable for
Female Investors (46‐64y/o) 804 medical facility staffs.
Male Investors (18‐64) 804
Male/Female Investors (66+) Requires Underwriting
 INSURANCE PROVIDER

PLAN NAME ORIENT DHA BASIC ENHANCED BASIC 1 DHA BASIC

TPA NEXTCARE AAFIYA/NEXTCARE SEHTEQ
ANNUAL CLAIM LIMIT AED 150,000 AED 150,000 AED 150,000
The UAE with minimal The UAE excluding Abu Dhabi The UAE excluding Abu Dhabi
REGIONS COVERED
coverage in Abu Dhabi and and Al Ain and Al Ain

DEDUCTIBLES / EXCESS
PRE‐EXISTING and CHRONIC
CONDITIONS
KEY DIRECT BILLING HOSPITALS
MEDICINE
DIAGNOSTICS (X‐RAY, MRI, CT‐SCAN,
Lab test)
Vaccinations (up to 6yo as shown in
the MOH list at DHA facilities )
PHYSIOTHERAPY
MATERNITY (for Married Females)
Disclaimer: The rates quoted above are indicative and can go up based on the medical conditions that you declare, and government‐mandated fees or initiatives
for health insurance. Also, note that the insurance policy supersedes if there are changes, discrepancies, or omissions from the covers and current network list
provided. DHA standard benefit exclusions apply among all plans.
Al Ain
20% max 25aed on OP
20% Coinsurance 20% Coinsurance
consultation
Covered up to aggregate limit; Covered up to aggregate limit; Covered up to aggregate limit;
Subject to medical underwriting, 6 Subject to medical underwriting, 6 Subject to medical underwriting, 6
mos waiting period (waived if mos waiting period (waived if mos waiting period (waived if
coming from an existing DHA coming from an existing DHA coming from an existing DHA
insurance) insurance) insurance)
Outpatient: Outpatient: Outpatient:
*Nextcare PCP *Nextcare PCP/ Aafiya APN *Sehteq Basic
*Clinics Only *Clinics Only *Clinics Only
*GP Referral *GP Referral *GP Referral
Please refer to attached file. Please refer to attached file. Please refer to attached file.
Inpatient: Inpatient: Inpatient:
*Nextcare RN3 *Nextcare RN3/Aafiya APN *Sehteq Basic
*Hospitals *Hospitals *Hospitals
*Admissions and Emergency *Admissions and Emergency *Admissions and Emergency
* 20% max cap 500 with 1,000 * 20% max cap 500 with 1,000 * 20% max cap 500 with 1,000
annual aggregate cap annual aggregate cap annual aggregate cap
Please refer to attached file. Please refer to attached file. Please refer to attached file.
AED 1,500.00 with 30% co‐ AED 1,500.00 with 30% co‐ AED 1,500.00 with 30% co‐
insurance insurance insurance
20% coinsurance 20% coinsurance 20% coinsurance
Covered Covered Covered
Max 6 sessions with 20% co‐ Max 6 sessions with 20% co‐ Max 6 sessions with 20% co‐
insurance insurance insurance
Outpatient Outpatient Outpatient
‐8 visits ‐8 visits ‐8 visits
‐tests in accordance with DHA ‐tests in accordance with DHA ‐tests in accordance with DHA
Antenatal Care Protocol Antenatal Care Protocol Antenatal Care Protocol
‐10% coinsurance ‐10% coinsurance ‐10% coinsurance
Normal Delivery‐ AED 7,000 Normal Delivery‐ AED 7,000 Normal Delivery‐ AED 7,000
Medically Necessary C‐Section‐AED Medically Necessary C‐Section‐AED Medically Necessary C‐Section‐AED
10,000 for 10,000 for 10,000 for
with 10% Co‐Insurance with 10% Co‐Insurance with 10% Co‐Insurance
With 6 month waiting period if not With 6 month waiting period if not With 6 month waiting period if not
pregnant pregnant pregnant
with 6 months waiting period no waiting period with premium no waiting period with premium
plus premium loading if already loading upon underwriter review loading upon underwriter review
pregnant if already pregnant if already pregnant
 SEHTEQ CARE PLANS

CARE CARE PLUS

Male/Female (1‐17) 1,140 1,455

Males (18‐40) 1,086 1,276
Females (18‐40) 2,085 2,190
Male/Female (41‐50) 1,612 2,022
Male/Female (51‐64) 2,400 2,421
Male/Female (65+) Requires Underwriting Requires Underwriting

SEHTEQ EXECUTIVE PLANS

EXECUTIVE EXECUTIVE PLUS

Male/Female (1‐17) 2,100 2,730

Male/Female (18‐40) 2,310 3,045
Male/Female (41‐50) 2,940 3,675
Male/Female (51‐64) 3,465 4,410
Male/Female (65+) Requires Underwriting Requires Underwriting

Notes:

* Newborns - for underwriting and requires discharge summary

* Basic plans not applicable for medical facility staffs.
* Dependent parents are not eligible for Care and Enhanced Plans
 INSURANCE PROVIDER

PLAN NAME CARE CARE PLUS EXECUTIVE EXECUTIVE PLUS

TPA SEHTEQ SEHTEQ SEHTEQ SEHTEQ
ANNUAL CLAIM LIMIT AED 150,000 AED 150,000 AED 150,000 AED 150,000
The UAE excluding Abu Dhabi The UAE excluding Abu Dhabi The UAE excluding Abu Dhabi The UAE excluding Abu Dhabi
REGIONS COVERED
and Al Ain and Al Ain and Al Ain and Al Ain
20% max 25aed on OP 10% max 25aed on OP 10% max 25aed on OP NIL coinsurance on OP
DEDUCTIBLES / EXCESS
consultation consultation consultation consultation
Covered up to aggregate limit; Covered up to aggregate limit; Covered up to aggregate limit; Covered up to aggregate limit;
Subject to medical underwriting, Subject to medical underwriting, Subject to medical underwriting, Subject to medical underwriting,
PRE‐EXISTING and CHRONIC
6 mos waiting period (waived if 6 mos waiting period (waived if 6 mos waiting period (waived if 6 mos waiting period (waived if
CONDITIONS
coming from an existing DHA coming from an existing DHA coming from an existing DHA coming from an existing DHA
insurance) insurance) insurance) insurance)
Outpatient: Outpatient: Outpatient: Outpatient:
*Sehteq RN3 *Sehteq RN3 *Sehteq RN2 *Sehteq RN2
*Clinics, Medical Centres, some *Clinics, Medical Centres, some *Clinics, Medical Centres, some *Clinics, Medical Centres, some
Hospitals Hospitals Hospitals Hospitals
*Direct access to specialist *Direct access to specialist *Direct access to specialist *Direct access to specialist
Please refer to attached file. Please refer to attached file. Please refer to attached file. Please refer to attached file.
KEY DIRECT BILLING HOSPITALS Inpatient: Inpatient: Inpatient: Inpatient:
*Sehteq RN3 *Sehteq RN3 *Sehteq RN2 *Sehteq RN2
*Hospitals *Hospitals *Hospitals *Hospitals
*Admissions and Emergency *Admissions and Emergency *Admissions and Emergency *Admissions and Emergency
* 20% max cap 500 with 1,000 * 20% max cap 500 with 1,000 * 20% max cap 500 with 1,000 * 20% max cap 500 with 1,000
annual aggregate cap annual aggregate cap annual aggregate cap annual aggregate cap
Please refer to attached file. Please refer to attached file. Please refer to attached file. Please refer to attached file.
AED 3,000.00 with 20% co‐ AED 5,000.00 with 10% co‐ AED 10,000.00 with 10% co‐ AED 10,000.00 with NIL
MEDICINE
insurance insurance insurance co‐insurance
DIAGNOSTICS (X‐RAY, MRI, CT‐
20% coinsurance 10% coinsurance 10% coinsurance NIL coinsurance
SCAN, Lab test)
Vaccinations (up to 6yo as shown in the
Covered Covered Covered Covered
MOH list at DHA facilities )
Max 6 sessions with 10% co‐ Max 6 sessions with 10% co‐ Max 6 sessions with 10% co‐ Max 6 sessions with NIL co‐
PHYSIOTHERAPY
insurance insurance insurance insurance
Outpatient Outpatient Outpatient Outpatient
‐8 visits ‐8 visits ‐8 visits ‐8 visits
‐tests in accordance with DHA ‐tests in accordance with DHA ‐tests in accordance with DHA ‐tests in accordance with DHA
Antenatal Care Protocol Antenatal Care Protocol Antenatal Care Protocol Antenatal Care Protocol
‐10% coinsurance ‐10% coinsurance ‐10% coinsurance ‐10% coinsurance
Normal Delivery‐ AED 7,000 Normal Delivery‐ AED 7,000 Normal Delivery‐ AED 7,000 Normal Delivery‐ AED 7,000
Medically Necessary C‐Section‐ Medically Necessary C‐Section‐ Medically Necessary C‐Section‐ Medically Necessary C‐Section‐
MATERNITY (for Married
AED 10,000 for AED 10,000 for AED 10,000 for AED 10,000 for
Females)
with 10% Co‐Insurance with 10% Co‐Insurance with 10% Co‐Insurance with 10% Co‐Insurance
With 6 month waiting period if With 6 month waiting period if With 6 month waiting period if With 6 month waiting period if
not pregnant not pregnant not pregnant not pregnant

no waiting period with premium no waiting period with premium no waiting period with premium no waiting period with premium
loading upon underwriter review loading upon underwriter review loading upon underwriter review loading upon underwriter review
if already pregnant if already pregnant if already pregnant if already pregnant

Disclaimer: The rates quoted above are indicative and can go up based on the medical conditions that you declare, and government‐mandated fees or initiatives
for health insurance. Also, note that the insurance policy supersedes if there are changes, discrepancies, or omissions from the covers and current network list
provided. DHA standard benefit exclusions apply among all plans.