Basic group health insurance plans in the UAE cover essential medical services, but they do not include every healthcare expense.
Benefits such as dental care, optical care, maternity, mental health support, and international coverage are often available only as optional add ons or through higher tier plans.
As a result, knowing these exclusions helps employers choose a policy that meets their employees’ needs.
Note: To identify the most common exclusions, we compared the benefits offered by several UAE group health insurance plans, including MetLife Care+, Allianz Care Corporate Group Schemes, and ADNIC’s DAFZ Health Insurance Program.
We reviewed their benefit tables, coverage options, and optional add ons to identify the features that are commonly excluded from standard group health insurance plans.
What’s not included in a basic group health insurance plan in the UAE
| ✅ Commonly Included in Basic Group Health Insurance | ❌ Usually Not Included in Basic Group Health Insurance |
| Doctor consultations | Dental treatment |
| Hospitalization and inpatient care | Optical care such as glasses and contact lenses |
| Outpatient treatment | Alternative treatments such as acupuncture and chiropractic care |
| Emergency medical treatment | Maternity benefits in many entry level plans |
| Diagnostic tests such as blood tests, X rays, and scans | Fertility treatment, including IVF |
| Prescription medicines (subject to policy limits) | Comprehensive mental health services |
| Surgery and specialist treatment | Home nursing and long term rehabilitation |
| Emergency ambulance services | Comprehensive annual health checkups |
| Coverage for chronic conditions (depending on the policy) | International medical coverage and medical evacuation |
| Access to the insurer’s approved hospital and clinic network | Treatment outside the insurer’s network without additional costs |
1. Dental Care
Many employees assume their company health insurance will cover routine dental care, only to find out it does not. Most basic group health insurance plans in the UAE exclude dental treatment unless the employer adds it as an optional benefit.
This means employees may have to pay for routine checkups, teeth cleaning, fillings, root canal treatment, crowns, and dentures themselves. Even when dental coverage is included, insurers usually set an annual claim limit and often exclude cosmetic treatments such as teeth whitening and veneers.
2. Optical Care
Eye care is another benefit that is often missing from basic group health insurance plans. Employees may have to pay for eye tests, prescription glasses, contact lenses, and other vision related expenses from their own pocket.
Some insurers offer optical cover as an optional benefit, but it usually comes with a fixed yearly allowance instead of covering the full cost of treatment or eyewear.
3. Alternative Treatments
Many people use treatments like acupuncture, chiropractic care, osteopathy, or homeopathy to manage pain and improve their overall health. However, these treatments are not commonly included in standard group health insurance plans.
If an employer wants to offer these benefits, they usually need to choose a higher plan or purchase additional coverage.
4. Maternity Benefits
Many employers believe maternity care is automatically included in every group health insurance plan, but that is not always the case.
Basic plans may provide limited maternity benefits or exclude pregnancy related care altogether. Even when maternity is covered, insurers often apply waiting periods and set separate limits for prenatal care, delivery, and postnatal treatment.
5. Mental Health Services
Mental health support has become an important part of employee wellbeing, but it is still limited in many basic health insurance plans.
Counseling, psychotherapy, and psychiatric treatment may have waiting periods, annual visit limits, or separate claim caps. Some entry level plans may not include these services at all.
For example, Orient Insurance PJSC’s policy covers psychiatry and psychotherapy, but it also states that a 10 month waiting period applies for inpatient and day care treatment.
6. Fertility Treatment
Employees who need fertility treatment are often surprised to learn that it is not included in most standard group health insurance plans.
Treatments such as IVF are usually available only through premium plans or optional benefits. Even then, insurers may apply long waiting periods, lifetime claim limits, and eligibility requirements before approving claims.
7. Treatment Outside the Provider Network
Many employees expect they can visit any hospital or clinic whenever they need medical care. In reality, most group health insurance plans only cover treatment within the insurer’s approved healthcare network.
If you choose a hospital or clinic outside that network, you may receive only partial reimbursement or have to pay the full bill yourself unless it is an emergency.
For example, Orient Insurance PJSC states that if you receive treatment within its provider network, the medical provider will handle the required pre-authorization directly with the insurer.
However, if you choose treatment outside the provider network, you must contact the insurer yourself to obtain the necessary pre authorization.
8. International Medical Coverage
Basic group health insurance plans are usually designed to cover treatment within the UAE. Medical expenses incurred while travelling or living abroad are often not included.
Companies with employees who travel frequently should check whether the policy includes worldwide medical cover, emergency treatment overseas, or medical evacuation before purchasing a plan.
9. Home Nursing and Rehabilitation
Medical care does not always end when a patient leaves the hospital. Some people need home nursing, physiotherapy, or rehabilitation to recover fully after surgery or a serious illness.
These services are commonly excluded from basic plans or covered only up to a limited amount. Insurers may also require pre approval before paying for rehabilitation or home based care.
10. Preventive Health Screenings
Many employees expect their insurance to include a full annual health checkup, but that is not always the case.
Basic plans often cover only a few preventive tests instead of a comprehensive health screening. Executive health packages and advanced diagnostic checkups usually require additional coverage or must be paid for separately.
Further Resources:
- What Happens to Group Health Insurance When You Open a Branch in a New Emirate?
- Factors To Consider Before Choosing Group Health Insurance
- Best Group Health Insurance Companies In UAE
Let Seven Insurance Brokers Help You Find the Right Group Health Insurance Plan
Choosing a group health insurance plan is about more than finding the lowest premium. You need a plan that protects your employees, meets UAE regulations, and fits your company’s budget without unnecessary extras.
That’s where Seven Insurance Brokers can help. More than 450 businesses trust Seven Insurance Brokers to manage benefits for 12,000+ lives. We compare plans from leading UAE insurers, negotiate competitive pricing, and provide end to end support, from policy setup and renewals to 24/7 claims assistance.
With experts who speak 10+ languages, we make the entire process simple for both your HR team and your employees.
👉 Read customer reviews about Seven Insurance Brokers
