You start a new job in Dubai or Abu Dhabi. HR hands you a shiny plastic card (or tells you to download the
app). You look at the “Network” list. Great! Mediclinic, Saudi German, Burjeel, King’s College…
they are all there. You feel safe.
Six months later, you visit a specialist for a nagging knee pain. The doctor orders an MRI and prescribes
some anti-inflammatories. You walk to the reception, card in hand, expecting to pay your usual AED 50.
The receptionist smiles and says: “That will be AED 850, please.”
You freeze. “But I have insurance! It’s VIP Network!”
The receptionist points to a small line on the screen: “20% Co-Insurance.”
This is the moment most UAE residents realize they never actually read their Table of Benefits. They confused
“Deductible” with “Co-Insurance.” And that confusion is the most expensive mistake you can make.
The Terminology Trap: Deductible vs. Co-Insurance
These two terms look similar but behave very differently.
1. The Deductible (The Good One)
This is a Fixed Amount you pay per visit. It is capped.
Example: “AED 50 per consultation.” No matter if the consultation costs AED 200 or AED 2,000,
you only pay AED 50. It is predictable.
2. Co-Insurance (The Dangerous One)
This is a Percentage of the total bill that YOU are responsible for.
Example: “20% Co-Insurance on Consumables and Radiology.” If the MRI costs AED 4,000, you pay
20% = AED 800.
The Trap: Many policies mix these. You might have a fixed deductible for the
doctor, but co-insurance for the tests and medicine.
Case Study: The “Free” Checkup That Wasn’t
Let’s follow Omar. Omar has a policy with “AED 50 Deductible” for Consultations, but “15% Co-Insurance” for
Diagnostics/Meds.
| Service | Total Cost | Omar Pays | Why? |
|---|---|---|---|
| Doctor Visit | AED 500 | AED 50 | Fixed Deductible |
| MRI Scan | AED 2,000 | AED 300 | 15% Co-Insurance |
| Blood Tests | AED 800 | AED 120 | 15% Co-Insurance |
| Pharmacy | AED 400 | AED 60 | 15% Co-Insurance |
| TOTAL | AED 3,700 | AED 530 | Surprise Bill |
Omar walked in expecting to pay AED 50. He walked out AED 530 poorer. If he had known about the Co-Insurance,
he might have asked the doctor: “Do I really need the MRI today?”
The “Tiered Network” Trick
But wait, it gets deeper. In the UAE, insurers often use Tiered Benefits.
Your card might say “Comprehensive,” but the co-insurance changes depending on the hospital.
- Network A (Clinics / General Hospitals): 0% Co-Insurance.
- Network B (Premium Hospitals): 20% Co-Insurance.
This means you can go to the 5-star hospital, but you are penalized for it. If you go to the clinic
down the road, it’s free. If you go to the luxury hospital for the same cold flu, you pay 20%.
The Pharmacy Limit (The Silent Cap)
Another overlooked detail is the Sub-Limit.
Your annual limit might be AED 1 Million. Immense.
But look for the line: “Pharmacy Limit.” It is often capped at AED 3,000 or AED 5,000 per
year for outpatient meds.
If you have a chronic condition (Diabetes, Hypertension) and your monthly meds cost AED 600:
- AED 600 x 12 months = AED 7,200.
- Limit: AED 3,000.
- Result: By month 6, your insurance rejects the pharmacy request. You pay 100% out of
pocket for the rest of the year.
Pro Tip: How to Spot the Co-Insurance
Open your policy PDF. Look at the column labeled “Member Share” or
“Deductible/Co-Pay”.
If you see a % symbol anywhere, that is a red flag.
If you see “Nil” or “0%”, you are golden.
If you see “AED 50”, that is standard.
FAQ: Paying Less
Q: Can I negotiate the Co-Insurance?
A: With the insurer? No. With the hospital? Sometimes! If you have a high bill, ask the hospital admin:
“My co-pay is high. can you give me a discount on the patient share?” Some hospitals will waive
part of it to keep your business.
Q: Does Co-Insurance have a maximum?
A: Only on good policies. Look for “Out of Pocket Maximum.” E.g., “20% Co-Pay, capped at
AED 1,000 per year.” Once you pay AED 1,000, it becomes 0%. If this line is missing, the sky is the limit.
time the doctor orders an expensive test, do the math first.