Essential Benefit Plan (EBP) in Dubai – Complete Guide for UAE Residents

What Is the Essential Benefit Plan (EBP)?

The Essential Benefit Plan (EBP) is a Dubai Health Authority (DHA)-mandated basic health insurance plan that ensures affordable access to essential medical services for residents, especially low-income earners and their dependents. The plan’s purpose is to make health insurance in Dubai accessible without excessive costs.

Who Is Eligible for the Essential Benefits Plan?

The EBP is designed primarily for:

• Employees earning AED 4,000 or less per month

• Dependents sponsored under a Dubai visa

• Domestic workers, drivers, nannies, and other low-income earners

In many cases, proof of income or employment may be required by the insurer to confirm eligibility.

Key Features of the Essential Benefit Plan

1. Annual Coverage Limit

EBP provides a generous annual claims limit of AED 150,000, which includes inpatient, outpatient, and emergency healthcare costs.

2. Geographic Scope

• Primary coverage is within Dubai.

• Some insurers may extend benefits across the entire UAE.

• Emergency medical treatment and ambulance services are generally covered across all emirates.

3. Provider Network

Policyholders get access to a wide but cost-effective network of hospitals, clinics, and pharmacies. Coverage ensures residents can access healthcare close to home or work.

4. Pre-Existing Conditions

• EBP cannot deny coverage solely due to pre-existing conditions.

• Coverage for chronic conditions typically begins after a six-month waiting period with the first UAE insurer.

• Emergency cases arising during the waiting period are covered up to the annual limit.

What the EBP Covers

Inpatient Treatment

• Essential hospital stays including tests, diagnostics, and necessary surgeries

• Shared room accommodation

• Emergency hospital admission (notify insurer within 24 hours)

• Medical transport services

• Organ transplant support (up to AED 100,000)

• Dialysis treatment coverage (up to AED 60,000 annually)

Outpatient Services

Covered services include:

• Doctor consultations and follow-ups

• Diagnostic tests, lab services, and radiology

• Physiotherapy sessions (with annual limits)

• Prescription medications under an annual drug limit

• Vaccines and immunisations (incl. DHA-recommended shots)

• Preventive screenings like diabetes, hepatitis, and cancer tests

Maternity Coverage

EBP includes maternity benefits:

• Outpatient visits for antenatal care

• Inpatient delivery costs with specified limits

• Newborn coverage for the first 30 days under the mother’s policy

Additional Benefits

• Mental health outpatient support

• Basic dental care (extractions, fillings, scaling)

• Repatriation costs in the event of death

Coinsurance and Limits

EBP typically requires coinsurance payments (e.g., 20% of outpatient costs, some medicines may involve 30% coinsurance). Some services also have per visit and annual caps, after which coverage increases to 100%.

What Is Not Covered

EBP excludes non-essential or elective services such as:

• Cosmetic procedures

• Vision/hearing aids (unless emergency)

• Long-term care

• Alternative or experimental treatments

• Some chronic and specialist services without referral

Always check policy exclusions closely before buying.

EBP vs Other Health Insurance Plans

While the EBP meets the mandatory health insurance minimum in Dubai, it is basic by design. For broader coverage — like international benefits, lower co-payments, private hospital rooms, or specialist care — consider enhanced or comprehensive health insurance plans.

Tips to Make the Most of Your EBP Coverage

✔ Carefully review the provider network of your insurer.
✔ Seek pre-approval for non-urgent diagnostics or surgeries.
✔ Follow referral protocols if specialist care is needed.
✔ Track your annual limits and coinsurance costs.
✔ Compare plans on InsurancePolicy.ae to decide if an enhanced plan suits your needs better.