On a UAE health insurance plan, the co-pay (also called coinsurance, and sometimes “deductible”) is the share of each medical bill you pay yourself. On Dubai’s minimum plan that share is 20% of each outpatient visit and 20% of a hospital stay, capped at AED 500 per admission and AED 1,000 a year, under the Dubai Health Authority’s Essential Benefits Plan. What you actually pay depends on the type of care, any cap per visit, an annual cap, and the plan’s overall limits.
This guide explains each of those terms as UAE insurers use them, which is not always how they are used elsewhere. It sets out the official minimum co-pays in Dubai, Abu Dhabi and the Northern Emirates side by side, and works through real bills to show what you would pay. It also explains how to read the co-pay lines on your own Table of Benefits. For the rules on who must be insured and the penalties, see our guide to mandatory health insurance in the UAE.
Key Takeaways
- UAE health plans rarely use an annual deductible in the American sense. Most charge a percentage co-pay per visit or per admission, sometimes with a cap.
- Insurers use “co-pay”, “coinsurance” and “deductible” loosely. Daman calls its 30% medicines share a “deductible”, and the DHA calls the same mechanism “coinsurance”.
- Dubai minimum plan: 20% per outpatient visit, 20% of in-patient care capped at AED 500 per encounter and AED 1,000 a year, and 30% of each prescription. Medicines are covered up to AED 2,500 a year.
- Abu Dhabi basic plan: AED 200 per admission capped at AED 500 a year, 20% on diagnostics up to AED 50 per visit, and medicines at 70% cover up to AED 1,500.
- Northern Emirates AED 320 package: 25% per outpatient visit up to AED 100, and 20% in-patient up to AED 500 per visit and AED 1,000 a year.
- A follow-up visit within seven days carries no co-pay on the Dubai and Northern Emirates minimum plans.
Co-Pay, Coinsurance and Deductible: What Each Term Means in the UAE
In the UAE, all three words usually describe the same thing: the part of a covered bill that you pay at the clinic, hospital or pharmacy. The difference is whether it is a percentage or a fixed amount, and whether it is charged per visit or once a year. Read the figure and its unit on your Table of Benefits rather than relying on the label.
| Term | What it means | How it appears on a UAE Table of Benefits |
|---|---|---|
| Co-pay (co-payment) | Your share of a bill, as a percentage or a fixed amount | “20% co-pay per visit” or “AED 50 per consultation” |
| Coinsurance | A percentage share of each bill | The DHA’s word: “20% coinsurance payable by the insured per visit” |
| Deductible | Elsewhere, an amount you pay before cover starts. In the UAE, often just another word for a per-visit co-pay. | “Deductible AED 50 per outpatient visit”, or Daman’s “deductible of 30%” on medicines |
| Cap per visit or encounter | The most you pay for one visit or one admission | “Capped at AED 500 per encounter” |
| Annual out-of-pocket cap | The most you pay in co-pays in a policy year for that category of care | “Annual aggregate cap of AED 1,000”, after which the insurer pays 100% |
| Benefit limit (sub-limit) | The most the plan pays for a category, including your share. Above it you pay everything. | “Medicines up to AED 2,500 per year (including coinsurance)” |
| Annual aggregate limit | The most the plan pays in total in a year | AED 150,000 on Dubai’s minimum plan, AED 250,000 on Abu Dhabi’s basic plan |
The confusion is real, and it comes from the regulators and insurers themselves. Daman, the insurer that runs Abu Dhabi’s basic plan, describes medicines as “70% coverage … a deductible value of 30%”. On the Dubai minimum plan the DHA calls the equivalent 30% share on each prescription “coinsurance”. Both are a percentage of each bill, not an amount paid once before cover starts.
The two numbers that matter most
A cap protects you and a limit protects the insurer. Once you reach an out-of-pocket cap, the insurer pays 100% of further bills in that category. Once the plan reaches a benefit limit, it pays nothing more in that category and you pay 100%. Many people read “AED 1,500 medicines” as a ceiling on their own spending, when on most basic plans it is the ceiling on the insurer’s.
Official Minimum Co-Pays by Emirate
Each emirate’s regulator sets a minimum plan, and its co-pays are the most an insurer may charge on that plan. Enhanced plans can charge less or nothing. The table compares the three official minimum plans as they stand in October 2026.
| Type of care | Dubai: Essential Benefits Plan (DHA) | Abu Dhabi: Basic Plan (DoH / Daman) | Northern Emirates: AED 320 package |
|---|---|---|---|
| Doctor visit (GP, specialist) | 20% per visit, no cap. 0% for a follow-up within 7 days. GP referral needed to see a specialist. | Not changed in the July 2024 update; check your policy | 25% per visit, max AED 100. 0% for a follow-up within 7 days. |
| Lab tests and radiology | 20% | 20%, max AED 50 per visit | Included in the outpatient co-pay |
| In-patient and day surgery | 20%, max AED 500 per encounter and AED 1,000 a year | AED 200 per admission, max AED 500 a year | 20%, max AED 500 per visit and AED 1,000 a year |
| Medicines | 30% of each prescription. Plan pays up to AED 2,500 a year including your share. | 30% your share; cover up to AED 1,500 a year | 30%, capped at AED 1,500 a year |
| Maternity | 10% on antenatal visits and delivery. Delivery covered to AED 10,000 including your share. | Covered; terms in the policy | Terms in the policy |
| Telehealth | Virtual consultations included at the outpatient rate | Check the policy | No co-pay, except for pharmacy |
| Annual limit (all care) | AED 150,000 | AED 250,000 | Set in the scheme policy |
The Dubai figures are from DHA circular GC 03/2024, the updated Essential Benefits Plan table in force from 1 January 2025. The DHA describes that table as “the minimum standard for ANY health insurance policy issued in the Emirate of Dubai”. The Abu Dhabi figures come from the Abu Dhabi Media Office announcement of the basic plan changes effective 1 July 2024 and Daman’s FAQ. The Northern Emirates figures are from MOHRE’s page on the Health Insurance Scheme, which covers private-sector and domestic workers in Sharjah, Ajman, Umm Al Quwain, Ras Al Khaimah and Fujairah.
Other Dubai minimum-plan co-pays worth knowing
- Mental health: outpatient counselling covered up to AED 800 a year, with 30% coinsurance per visit.
- Dental: covered up to AED 500 a year, with 30% coinsurance per visit.
- Physiotherapy: up to 6 sessions a year with prior approval, 20% per session.
- Dialysis and organ transplant (recipient): outpatient 20% per visit, within limits of AED 60,000 and AED 100,000.
- Pre-existing conditions: can be excluded for the first six months of your first UAE scheme only, and emergencies are covered even then.
Worked Examples: What You Actually Pay
The examples below apply the official minimum-plan rules to typical bills. Your own plan may be more generous, so use these to understand the mechanics and then check your Table of Benefits.
Dubai: a GP visit, a follow-up and a prescription
A GP consultation billed at AED 300 costs you 20%, which is AED 60. A follow-up for the same condition five days later costs AED 0, because there is no coinsurance on a follow-up within seven days. If the doctor then prescribes medicines costing AED 250, you pay 30%, which is AED 75, and that AED 250 counts toward the AED 2,500 annual medicines limit.
Dubai: two hospital admissions in one year
A first admission billed at AED 12,000 would be AED 2,400 at 20%, but the per-encounter cap limits your share to AED 500. A second admission later in the year billed at AED 4,000 would be AED 800 at 20%. It is capped at AED 500 per encounter, and the annual cap of AED 1,000 leaves only AED 500 available, so you pay AED 500. Any further admission that year costs you nothing in coinsurance.
Abu Dhabi: a scan and a day surgery
An MRI billed at AED 1,200 on the basic plan would be AED 240 at 20%, but diagnostics are capped at AED 50 per visit, so you pay AED 50. A day-surgery procedure costs a flat AED 200 per admission, and your total for admissions cannot pass AED 500 in the year.
Northern Emirates: a specialist visit
A specialist visit billed at AED 600 on the AED 320 package would be AED 150 at 25%, but the per-visit maximum is AED 100, so you pay AED 100. A follow-up within seven days is free.
When the medicines limit runs out
A Dubai minimum-plan member with a chronic condition whose prescriptions cost AED 350 a month pays AED 105 a month at 30%. The insurer pays AED 245. After about seven months the total reaches AED 2,500, and from then until renewal the member pays the full price. This is the most common way people on minimum plans meet large unexpected bills, and it is why medicine limits matter more than the co-pay percentage for anyone on long-term treatment.
How Enhanced Plans Differ
Plans above the minimum compete mainly on three things: lower or zero co-pays, higher medicine and annual limits, and a wider network. Employer group plans for professional staff often have no co-pay at all, or a fixed amount per outpatient visit. Some also offer a “nil co-pay” option at a higher premium.
The co-pay can also change with the hospital you use. Many enhanced plans set network tiers, with lower co-pays at clinics in the cheaper tier and higher ones at premium hospitals. Some plans apply a different co-pay to care you pay for upfront and claim back (reimbursement) than to direct billing inside the network. Check both columns on your Table of Benefits before choosing where to go.
If your plan has a co-pay, the clinic collects it at the desk when your Emirates ID is scanned. The rest of the bill goes directly to the insurer. You do not pay the full amount and claim it back unless you use a provider outside the network.
How to Read the Co-Pay Lines on Your Table of Benefits
Your policy documents include a Table of Benefits (sometimes called a “schedule of benefits”), and your insurer’s app usually shows it too. Use these questions to read it:
- Is the co-pay a percentage or a fixed amount? “20%” scales with the bill and “AED 50” does not.
- Is there a cap per visit? Without one, a 20% co-pay on an expensive specialist visit or scan has no ceiling.
- Is there an annual out-of-pocket cap, and for which categories? In-patient caps are common. Outpatient caps are less common.
- What are the sub-limits? Medicines, maternity, dental, physiotherapy and mental health each tend to carry their own limit.
- Does a referral or prior approval apply? Seeing a specialist without a GP referral on Dubai’s minimum plan means the insurer pays nothing, whatever the co-pay.
- Does the co-pay change by network tier or for reimbursement claims?
If you are comparing renewal quotes, the co-pay structure is often where an insurer recovers a premium cut. Our guide to health insurance premium increases at renewal covers what an insurer can change and what it cannot, and our comparison of UAE health insurers shows the main plan types.
FAQ
What is a co-pay in UAE health insurance?
It is the share of a covered medical bill that you pay yourself at the clinic, hospital or pharmacy. It is usually a percentage per visit, such as 20%, sometimes with a cap per visit. On Dubai’s minimum plan it is 20% for doctor visits and 30% for each prescription.
Is a deductible the same as a co-pay in the UAE?
Usually, yes. UAE insurers often use “deductible” for a per-visit co-pay rather than an annual amount paid before cover starts. Daman even describes its 30% share of medicine costs as a “deductible”. Check whether your figure is per visit, per admission or per year.
How much is the co-pay on Dubai’s basic health insurance?
Under the Essential Benefits Plan in force since 1 January 2025, you pay 20% of each outpatient visit, lab test and scan. In-patient care is 20%, capped at AED 500 per encounter and AED 1,000 a year. Prescriptions are 30% each, maternity is 10%, and a follow-up visit within seven days is free.
What is the co-pay on the Abu Dhabi basic plan?
Since 1 July 2024, in-patient and day-care treatment costs AED 200 per admission, capped at AED 500 a year. Diagnostics and lab tests cost 20% up to AED 50 per visit, and medicines are covered at 70% up to AED 1,500 a year.
What is the co-pay on the AED 320 Northern Emirates health insurance package?
25% per outpatient visit up to AED 100, nothing for a follow-up within seven days, and 20% for in-patient care up to AED 500 per visit and AED 1,000 a year. Medicines carry a 30% co-pay capped at AED 1,500 a year, and telehealth consultations have no co-pay.
Do I pay a co-pay on a follow-up visit?
Not on the Dubai and Northern Emirates minimum plans, if the follow-up is for the same condition within seven days of the first visit. Enhanced plans usually have the same or a better rule, but check your Table of Benefits.
What happens when I reach my medicines limit?
The plan stops paying for medicines until the policy renews, and you pay full price. On Dubai’s minimum plan the limit is AED 2,500 a year including your 30% share, so a member with steady monthly prescriptions can reach it partway through the year.
Can I get a health insurance plan with no co-pay in the UAE?
Yes. Enhanced and many employer group plans have zero co-pay, usually for a higher premium. The co-pays in this guide are the most a minimum plan can charge, not a requirement that every plan charges them.
Is the co-pay paid at the clinic or claimed back later?
Inside your insurer’s network, the clinic collects only the co-pay at the desk and bills the insurer directly for the rest. If you use a provider outside the network, you normally pay the full bill and claim the covered part back under the reimbursement terms.
Official Sources
- Dubai Health Authority: External Circular GC 03/2024, Updated Table of Benefits for the Essential Benefits Plan (effective 1 January 2025)
- Abu Dhabi Media Office: Daman reveals key updates to the Basic Health Insurance Plan (effective 1 July 2024)
- Daman: Abu Dhabi Basic Insurance Plan updates FAQ
- Ministry of Human Resources and Emiratisation: Health Insurance Scheme (Northern Emirates package)
Information current as of October 2026. Verify with official authorities before proceeding.
This guide is for informational purposes only. Health insurance terms, limits and co-pays are set by each policy and may change at renewal. Always check your own Table of Benefits and confirm with your insurer before treatment.
