UAE insurance glossary
22 terms from a UAE health insurance rate chart and table of benefits, defined in one sentence each. Co-pay, deductible and coinsurance are three different things; a network and a TPA are two more. Every definition here is written for a broker explaining it to a client, not for another insurer.
A
- Age bandAge bracket · Age group
- An age band is the range of ages a health insurance rate chart prices as a single row — 26–35, for example — so every member whose age falls inside that band takes the same base premium regardless of where in the band they sit.
- Annual aggregate limitAnnual limit · Aggregate limit
- The annual aggregate limit is the maximum a health insurance policy will pay for one member across an entire policy year, counting every claim together. Once it is exhausted the member pays everything until the policy renews.
B
- BASMAHBasmah
- BASMAH is the name printed on many UAE health insurance quotations for a small fixed levy charged per member per policy year, added to the premium alongside VAT. The same charge is labelled ICP on many insurers' own rate sheets.
C
- Chronic condition
- A chronic condition is a long-term illness requiring continuing treatment, monitoring or medication — diabetes, hypertension and asthma are the common UAE examples. Health plans frequently cover chronic conditions under a specific sub-limit rather than the full annual aggregate limit.
- Co-payCopay · Co-payment
- A co-pay is the share of each claim the member pays at the point of treatment — usually a percentage of the bill, sometimes a fixed amount — with the insurer paying the remainder. It applies per visit, not once a year.
- Coinsurance
- Coinsurance is the percentage share of a claim that the member pays after any deductible has been met, with the insurer paying the remaining percentage up to the annual aggregate limit. On most UAE policy wordings coinsurance and co-pay describe the same percentage share.
D
- DeductibleExcess
- A deductible is a fixed amount the member pays before the insurance policy begins to pay, normally once per policy year or once per condition. Unlike a co-pay, a deductible is not charged on every claim once it has been met.
- Direct billingCashless · Direct settlement
- Direct billing is the arrangement under which a healthcare provider invoices the insurer or TPA directly for treatment, so the member presents their card, pays only their co-pay or deductible, and never settles the full amount.
- Direct billing network
- A direct billing network is the set of providers that have an arrangement with the TPA to bill the insurer directly, so a member shows their card, pays only their co-pay or deductible, and never handles the full invoice.
E
- Essential Benefits PlanEBP
- The Essential Benefits Plan is the Dubai Health Authority's mandated minimum health insurance product for employees below a stated salary threshold, with a defined set of benefits, a restricted provider network and a capped annual limit.
I
- ICP
- ICP is the label many UAE insurers print on rate charts for a fixed per-member charge that is excluded from the quoted gross rates and added at quotation. The same charge frequently appears as BASMAH on the finished quotation document.
M
- MAFMedical application form · Health declaration
- A MAF, or medical application form, is the health declaration a UAE insurer requires from a proposed member before accepting them, listing medical history and current conditions so the insurer can underwrite, load or decline the risk.
- Married female rate
- A married female rate is a separate premium column that some UAE health insurance rate charts price for married women, higher than the single female rate at childbearing ages because maternity cover is expected to be used. The two rates converge and become identical at older ages.
N
- NetworkProvider network
- A network is the defined list of clinics, hospitals, pharmacies and laboratories that a UAE health insurance plan will pay for. Treatment inside the network is billed to the insurer directly; treatment outside it is normally paid by the member and may not be reimbursed at all.
P
- Pre-existing condition
- A pre-existing condition is a medical condition, illness or injury that existed before the health insurance policy started, whether or not it had been diagnosed. UAE plans differ on whether pre-existing conditions are covered from day one, covered after a waiting period, or excluded.
Q
- Quotable offering
- A quotable offering is one combination of plan variant, network tier and co-pay block — a single thing a client can actually buy and be priced for. A plan sold on three networks at two co-pay levels is six quotable offerings.
R
- Rate chartRate table · Gross rate table · Premium table
- A rate chart is the grid an insurer publishes giving the premium for a plan by age band and member category, usually split further by network and co-pay level. Every quote for that plan is read out of this grid.
- ReimbursementPay and claim
- Reimbursement is the claims route where the member pays the provider in full and then claims the amount back from the insurer, subject to the policy's limits, co-pay and any reimbursement scale. It applies wherever direct billing is not available.
S
- Salary band
- A salary band is the monthly pay range that determines which health insurance products a UAE employee may be enrolled on. The AED 4,000 threshold is the one that appears most often in insurer underwriting conditions and regulated minimum products.
T
- Table of benefitsTOB · Benefit schedule
- A table of benefits is the schedule an insurer publishes listing each benefit a health plan covers, the limit or sub-limit on it, and the co-pay that applies. It defines the product; the rate chart only prices it.
- TPAThird party administrator
- A TPA, or third party administrator, is the company that administers a UAE health insurance policy on the insurer's behalf — issuing cards, holding the provider network, approving treatment and settling claims — while the insurer carries the risk.
W
- Waiting periodQualifying period
- A waiting period is a stated number of days or months after a health insurance policy begins during which a specific benefit is not payable. Maternity and pre-existing conditions carry the most common waiting periods in UAE health insurance.
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