The changes are being made in line with the ongoing efforts to ensure that all community members receive continued access to the highest quality of care. The changes will also enhance efficiency in the delivery of healthcare services within the emirate, in accordance with best practices and international standards.
Out-of-pocket expense is now AED 200 per encounter with an annual aggregate Out-of-pocket limit of AED 500.
The coverage for medicines and pharmaceutical products remains the same, equal to 70% coverage within the policy’s network providers list, a deductible value of 30%, and a total coverage value of AED 1,500.
Previously, there was a deductible of AED 10 for lab tests and AED 10 for diagnostics. Now, there will be a 20% co-pay with a maximum amount of AED 50, including radiology.
The changes will take effect on the 1st of July 2024.
These changes aim to ensure the sustainability of the programme and the continuity of the coverage for all the eligible categories and age groups, while maintaining access to quality care, which aligns with the evolving needs of individuals and families living in Abu Dhabi.
There is no changes in the current Basic Network. Policyholders can continue to access services from the existing network providers which comprises over 1,250 providers offering outpatient, inpatient, and emergency services in the various regions of the emirate of Abu Dhabi.
Access to quality healthcare providers remains unchanged through this update; however, Daman and the Department of Health constantly update the network as part of their regular network review.
The coverage for medicines and pharmaceutical products remains the same equaling a 70% coverage within the network providers list of the policy with a deductible value of 30%, and a total coverage value of AED 1,500.