Daman National Health Insurance

Confirm the hospital is in-network for your specific plan tier. Some Enhanced plans cover only specific private networks. Network search on Daman app is the authoritative reference.

Review the EOB for reason. Common causes: non-network provider, out-of-coverage service, missing pre-authorisation for inpatient. Resubmit with documentation.

Wait 24-48 hours for sync. If still missing, the addition may have failed at Daman's end; resubmit with HR support.

Request the specific reason; common causes are non-network surgeon, alternative treatment recommended, or insufficient medical justification. Resubmit with specialist letter.

If self-paid, renew via Daman app. If employer-paid, contact HR. The lapse blocks residence renewal until restored.

Update plan filter in network search - some hospitals are tier-restricted. If consistently missing, your specific Enhanced tier may not include that network.

The Basic plan satisfies the minimum legal requirement. The annual premium is in the AED 600-1,000 range (confirm at quote, varies by age and health declarations). The network is restricted to lower-tier clinics and SEHA hospitals, and annual limits are conservative, but the plan is sufficient for visa compliance.

Thiqa is the programme for UAE nationals registered in Abu Dhabi, administered by Daman on behalf of the Department of Health. It offers full-cover health insurance with a very broad network including international referrals, with no annual limit, and no co-payment for most services. Basic is for expats and is much more constrained.

In-network: the clinic or hospital files directly with Daman, you pay any co-payment at the desk, and the claim settles automatically. Out-of-network: pay the full amount yourself, then submit the claim online through damanhealth.ae with the invoice, doctor's report, prescription and proof of payment. Reimbursement is typically processed within 15-30 days.

Usually yes if the policy includes family riders, which most Enhanced corporate plans do. Confirm by adding dependants on the portal during the policy year; some employers cover only the employee and require the family to be added separately at the employee's cost.

In-network providers have a contractual rate with Daman, so the cost is settled directly and the patient pays only any co-payment specified in the policy. Out-of-network means you pay the provider in full and seek reimbursement, typically at a lower percentage of the bill (commonly 80% or 50%) up to the annual limit.

Depends on the plan. Basic has limited maternity benefits. Enhanced plans usually include a maternity rider with sub-limits for delivery, pre-natal, and post-natal care, and a waiting period (often 9-12 months) from the policy start. Confirm the maternity benefit on the policy schedule.

Open damanhealth.ae > Find a Provider, filter by city and specialty, and the system returns the in-network providers. The Daman app has the same lookup. Network status can change, so confirm at the moment of booking, not at policy purchase.

Open Daman app > My Policy and confirm the Emirates ID number on the policy matches your current EID exactly. The policy should show as Active with end-date past your residence renewal date. ICP queries the Dhamani database in real-time at renewal; a mismatch or short policy silently blocks the renewal. If the policy is short, extend it (employer can usually do this within hours; self-sponsored residents purchase the extension via Daman directly). If the EID number is wrong (e.g., post-renewal the policy still references the old EID), call Daman to update - this is a common cause of silent ICP blocks at residence renewal time. Cross-check by viewing the policy on TAMM > Health > My Insurance which queries the same Dhamani database.

Basic (Thiqa for Emiratis; for residents the Basic equivalent under the mandatory scheme) covers Abu Dhabi public hospitals (SEHA network) and a limited list of private clinics. Co-pay typically 20-30% on outpatient visits, 0-20% on inpatient. Useful for residents who use SEHA hospitals primarily. Enhanced plans (Premier, Premier Plus, Health 360) offer access to a broader private hospital network (Cleveland Clinic, NMC, Mediclinic, Burjeel, etc.), lower co-pays, and often dental/maternity coverage. Premiums vary AED 1,500-15,000/year depending on tier, age, and dependents. For most working families with private healthcare expectations the Enhanced tier is the practical minimum; for residents comfortable with SEHA the Basic is sufficient. Employers in Abu Dhabi typically include at least Enhanced as standard benefits.

The Enhanced Benefit Plan tier has annual aggregate limits and sub-limits per condition category that policyholders should review at policy issuance. Typical EBP structure for 2026: aggregate annual limit AED 500,000-1,000,000 per insured person; in-patient room AED 1,500-3,000 per night standard private; maternity normal delivery AED 8,000-15,000 (caesarean AED 15,000-25,000); dental AED 1,500-5,000 annually; optical AED 600-1,500 every two years; psychiatric and mental health AED 5,000-15,000 annually with caps on session count; physiotherapy session-capped at 20-30 visits per year. Pre-existing conditions are covered after a 6-12 month waiting period (eliminated for EBP policies issued post-January 2026 for declared maternity). Network access on EBP includes Cleveland Clinic Abu Dhabi, Burjeel, NMC, Mediclinic, and a wide outpatient roster. Confirm sub-limits on the policy schedule; aggregate limits rarely bind, but condition-specific sub-limits frequently do.

Pre-existing conditions on most Daman policies have a 6-12 month waiting period from policy start date before claims for those conditions are paid. Diabetes, hypertension, asthma, chronic back pain, and similar conditions disclosed at enrolment are subject to this wait; emergency-only cover may apply during the wait. Maternity on new EBP policies issued from January 2026 is covered from day 1 for declared pregnancies; older policies retain the 9-12 month maternity waiting period. Cancer and major chronic conditions diagnosed pre-policy may face longer waits or be excluded entirely - the policy schedule lists exclusions explicitly. Critically, undisclosed pre-existing conditions found later can void the entire policy under the misrepresentation clause; disclosing at enrolment (even at the cost of a waiting period) is the safer path. The Dhamani database checks for prior claims history when issuing new policies, so undisclosed conditions are often caught at first claim.

Daman policies are issued per insured person, but corporate Enhanced plans typically include a family rider that allows spouse and children to be added on the same policy at the employer's expense or at the employee's cost (split varies by employer). Dependants must be added within 30-60 days of becoming eligible (marriage, birth, new arrival in UAE) to avoid a new waiting period; late additions are treated as fresh policies with full waiting periods reapplied. Each dependant has their own Emirates ID-linked policy under the family rider, their own digital card on the Daman app, and their own claim history. The sponsoring employee's policy tier determines the dependants' tier - upgrading the employee upgrades dependants automatically. Children are typically covered to age 18 (or 21 if in full-time education); spouse cover continues for the duration of the residence visa link. Confirm the family-rider clauses at policy issuance; some Enhanced plans cover only the employee and require dependants to be enrolled separately at policyholder cost.

Yes. The DOH-mandated Domestic Worker Basic plan, available through Daman and other Abu Dhabi insurers, is priced around AED 550-800 per year (confirm at quote) and satisfies the mandatory health insurance requirement for domestic workers (maids, nannies, drivers, cooks) sponsored under the Tadbeer or family file. The plan covers SEHA public hospitals and a small private-clinic roster, with co-pays on outpatient visits and full cover for inpatient emergencies. Annual limits are conservative (typically AED 150,000-250,000 aggregate). Maternity is excluded on most domestic worker Basic policies; mental health is excluded or capped. The plan is sufficient for residence visa compliance but does not cover private hospital outpatient visits comfortably - sponsors who want broader cover for a long-term domestic worker can upgrade to Enhanced at higher premium (AED 1,500-3,000). The plan is purchased online via Daman or through the Tadbeer centre during recruitment.