Oman Rolls Out Unified Health Insurance Policy - or 'Dhamani'

In March 2019, the Capital Markets Authority (“CMA”) introduced the Unified Health Insurance Policy (“UHIP”), also known as Dhamani, as part of the mandatory health insurance plans being rolled out by the government for expatriate and local workers employed in the private sector.

Under the policy, all persons employed by the private sector in Oman, as well as all visitors to the country, will be required to obtain health insurance through providers authorised by the CMA.  The policy will also provide coverage to the spouses of employees in the private sector, as well as to their children under the age of 21.  The policy does not apply to public sector employees and is distinct from the social health insurance currently in place which is partially or entirely funded by the government.  The premiums in respect of insurance coverage for private sector employees will be payable by their employers.  It is anticipated that health insurance coverage in the private sector will increase from around 470,000 workers to more than 2 million workers.  Domestic workers who are currently not usually provided with insurance coverage by their employers will mandatorily be covered under the provisions of the UHIP.

UHIP sets forth a minimum level of benefits that the insurance policy must provide, including doctors’ fees, diagnostic services, ambulatory services, and emergency services, but will not include treatment in connection with pre-existing conditions, self-inflicted injuries, drug or alcohol abuse, sexually transmitted diseases, or use of alternative medicine or therapies.  Medical treatment in connection with pregnancy and childbirth will not mandatorily be covered under the UHIP and will be left to the discretion of employers.

Under the terms of the policy, the maximum coverage in respect of inpatient treatment shall be OMR 3,000, which will include hospital stay, treatment, medicines, etc.  The maximum coverage in connection with outpatient treatment will be OMR 500, which will include the cost of consultation, diagnostics, medicines and laboratory fees.  The maximum amount payable in connection with the repatriation of a deceased expatriate’s remains will be OMR 1,000.

The CMA is currently in the process preparing the necessary regulations and legislation to implement the policy.  The CMA has indicated that the implementation of the UHIP will take place gradually over 2019 and 2020 and will be determined in accordance with the classification of the private sector companies, with the larger local companies and international companies being expected to comply with the policy initially, with smaller companies being required to comply at a later stage.

In connection with the implementation of the UHIP, the CMA announced a tender in April 2019 in connection with the creation of an electronic platform to enable the efficient rollout of the UHIP by conducting health insurance transactions online between insurance companies, private health service providers, third-party administrators, and the relevant regulators.