Expats in the Middle East have faced a number of changes to health insurance with cover becoming mandatory in some locations.

Mandatory health insurance has been introduced by the Dubai Health Authority in three stages since 2014 and now all residents, including expats and their dependants, must have adequate health insurance coverage.

The vast majority of health insurance for expats is provided by companies and indeed visas and business licenses are likely to not be issued or renewed in Dubai without employer sponsored insurance.

In Abu Dhabi, the Health Authority announced in June that workers aged 40 and older who have health care under the Abu Dhabi Basic Plan must not pay up to 50% of their insurance premiums.

The full implications of this change are not yet known, but many expat workers believe that the extra cost will be passed on by sponsors or companies and that the cost is going up.

This coverage, provided by The National Health Insurance Company Daman, was set at Dh600 per adult sponsored by groups, small investors, Emirati individuals and individual expats, but some are reporting a rise to Dh800.

Most small investors and groups pay the insurance premium at the time of renewing expat visas and many have taken to online forums to say they are concerned about the cost.

The changes also require Emiratis in Abu Dhabi to now pay 20% of the cost of private health care in Abu Dhabi, and 50% for treatment outside the emirate if the care is already available in Abu Dhabi.

Research suggests that some of the changes are resulting in more visits to hospitals. According to health insurance provider Pacific Prime, this could result in even higher costs.

In Dubai the DHA’s annual statistics for 2014 shows that the number of inpatient visits in 2014 increased by 8.4% from 2013. Meanwhile, the population in Dubai increased from 2.214 million in 2013 to 2.327 million in 2014, an increase of 5.1%.

‘When comparing these two figures it is clear to see that the number of inpatient visits is higher than the population growth. As many inpatient procedures are more costly than outpatient it is highly likely that the cost of care will increase, which will put pressure on insurers to cover these costs, especially as 2015’s and 2016’s figures will reflect the increased number of citizens covered by the DHA scheme,’ said a spokesman for Pacific Prime.

So far, Pacific Prime’s research has uncovered an increase in claims in Dubai in 2015 and 2016. ‘Combine this with the fact that many diseases, like diabetes, are increasingly affecting a larger number of people in the city and with all residents now covered by insurance, we predict that the number of claims will increase even further beyond what has already been seen,’ he explained.

‘This increase in claims, especially on costly diseases, and the fact that all plans secured in Dubai must also cover maternity and pre-existing conditions, has resulted in an increase in the cost of insurance as providers need to have more premiums in their pools in order to cover the increased claims,’ he added.

It is estimated that expats make up 80% of the population in Dubai and many want health insurance coverage both in Dubai and in their home countries. Subsequently, there has been a noticeable upward impact on the cost of health insurance. For example, the average cost of international health insurance in Dubai was US$8,038 in 2015 and is now US$10,213 in 2016, an increase of 27% in just one year.