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Adjustments to Thiqa Programme – October 2020

Adjustments to coverage for All Thiqa members

  1. Coverage for Thiqa members is within the Emirate of Abu Dhabi
  2. Coverage of emergency services outside Abu Dhabi will be on reimbursement in private facilities (until the stabilisation of the member’s condition, after which the member will be transferred to a hospital within the new network in Abu Dhabi)
  3. By 13 January 2021, Daman will review all cases outside Abu Dhabi and arrange for patient transferals to facilities within Abu Dhabi in line with the new network.

Adjustments to eligibility of Thiqa Abu Dhabi Private Network for UAE Nationals from other Emirates residing in Abu Dhabi

  1. Working in Abu Dhabi
  • The employed individual is covered with their spouse and children.
  • Only the parents of the employed individual are covered by providing a proof of residency and personal declaration.
  1. Resident property owners
  • The owner is covered with their spouse and children.
  • The owner’s parents are covered by providing a proof of residency and personal declaration.
  1. Studying in Abu Dhabi:
  • Only the student is covered, and they require a letter from an Abu Dhabi-located academic institute confirming full-time study.
  1. Renting:
  • Renters coverage will be limited to public facilities in Abu Dhabi

Frequently Asked Questions

Q1. What about an existing approved case prior to 13 October 2020 in the Northern Emirates or Dubai for UAE Nationals from the emirate of Abu Dhabi?  What will be done for cases that are already undergoing treatment?

A: If the service is being provided then it is covered as part of the three-month period (as continuation of care).

Otherwise the approvals will be cancelled if the treatment has not begun.

Q2. Will emergency coverage still be covered in Dubai and the Northern Emirates for all categories?

A: Emergency coverage will continue across the UAE.

Q3. If a member owns a house in Abu Dhabi but is not working, will they still be eligible?

A: If the member resides in their own property, they are eligible for Thiqa private network in Abu Dhabi.

Q4. What if the house is owned by the husband who is the family book holder and does not work while the wife is the one who works?

A: Should one spouse be eligible because they own and reside in property in Abu Dhabi, and one spouse be eligible as they work, then both would be considered eligible for coverage.

Q5. Are the parents of the family book holder only considered for coverage? Or, will parents of the family book holder’s spouse be applicable for coverage as well?

A: In deciding eligibility, the family book is not taken into consideration. The parents of the Abu Dhabi employee or Abu Dhabi property owner (the basis of the coverage) are the ones eligible. They have to reside in the same property with the provision of personal declaration.

Q6. If my wife is employed in Abu Dhabi, will I still get coverage at private facilities?

A: Yes – the spouse of the employee (the wife or the husband) receives the coverage as well as their children.

Q7. Are parents-in-law eligible for private facility coverage, if the house is owned by the husband?

A: In this case, since the husband owns the property the coverage is extended to the wife and children as well as his parents. Parents coverage require proof of residency and a personal declaration.

Q8. In case the student is married, can his wife and kids get covered at private facilities in Abu Dhabi?

A: Coverage in the Thiqa private network is only for the student. The spouse and children will continue having coverage in Government hospitals.

Q9. How long is the sufficient time to be given for the Inpatient at the hospitals outside the Emirate of Abu Dhabi?

A: Three-months from the implementation of changes i.e. until 13 Jan 2021 as maximum or when the transfer of the patient is medically safe – whichever is sooner. (patient cases will continue to be reviewed).