UAE Set to Mandate Insurance Coverage for Organ Donors, Recipients
The UAE is set to mandate medical insurance coverage for organ donors and recipients in the country, top officials have revealed to sources.
A draft law that will make amendments to legal provisions on organ donation and transplant has called for the inclusion of medical insurance provision in “Hayat,” the National Programme for Organ and Tissue Donation and Transplantation, according to two senior officials.
“Earlier, the law was not clear about the role of insurance in organ donation and transplantation, but now it is clear,” said Dr Ali Al Obaidi, chairman of the UAE National Transplant Committee.
“Now we know that health insurance support is also part of the new [draft] law and it is mandatory for everybody [insurance companies to comply].”
He said the proposed law says that all insurance companies can support the Hayat programme. “It actually calls on insurance firms to be strategic partners with the programme,” Dr Al Obaidi explained.
Dr Marwan Al Mulla, CEO of Health Regulation Sector at Dubai Health Authority (DHA), said the new draft law states that transplantation and donation is the right of the patient. “So it should be part of the insurance coverage.”
He said the DHA would work with the national committee to mandate it in Dubai.
Last week, the two officials and representatives of multiple health authorities in the UAE held a meeting with insurance companies in this regard.
Various mechanisms were discussed to ensure accessibility and sustainability of the organ transplant programme for everyone, irrespective of nationality or gender.
What is the current scenario?
According to healthcare insurance experts, insurance policies typically do not include coverage for transplant surgeries, except for certain high-end health insurance plans or International Private Medical Insurance products, which may offer limited transplant coverage.
DHA’s essential benefit plan’s table of benefits currently excludes health services and associated expenses for organ and tissue transplants, irrespective of whether the insured person is a donor or a recipient. “This exclusion also applies to follow-up treatments and complications unless if left untreated will develop into an emergency,” says the table of benefits.
Insurance for recipient, donors
However, some critical insurance plans offer a significant level of coverage for transplant procedures. Yet, challenges arise when policy limits are insufficient for surgery costs and some policies have limited coverage for recipients but not for donors.
“In scenarios where transplant procedures are covered, it is important to note that the insurance usually only accounts for the costs associated with the transplant and recipient, while excluding expenses incurred by the donor. However, there are government programmes and several charitable organisations that provide support for transplant surgeries,” said one insurance expert.
Challenges in coverage
Another expert said insurance companies generally avoid including transplant coverage in all types of policies. “This strategy is aimed at maintaining the affordability of health insurance premiums.
“Transplant surgeries are often classified under expert quaternary care, which involves substantial costs. One of the significant challenges in transplant procedures is the rigorous and often arduous process of finding a medically suitable donor.”
Furthermore, he said, the spectrum of post-transplant complications can range from minimal to severe, with some cases unfortunately resulting even in loss of life. “These complications can have a considerable impact on the patient’s lifestyle and overall well-being, even after the transplant procedure is completed,” he pointed out.
Hence, a health plan may cover the entirety of the cost of a transplant procedure but not the cost of additional care needed in the post-transplant period.
Addressing gaps
However, the upcoming law is expected to cover both donors and recipients, addressing the existing gaps, said Dr. Aliasger Bagasrawala, director of Revenue Cycle at King’s College London in Dubai which has become the first liver transplant centre in Dubai.
He said the implementation of mandatory coverage will encourage more organ donations. “In certain circumstances, costs associated with organ retrieval, transportation, surgeries, and post-transplant care can pose financial challenges.”
Once the new scheme becomes mandatory, he said, the transplant programme will become sustainable and accessible for both donors and recipients.
“One thing is clear. The leadership and health authorities are committed to preventing financial constraints from hindering patients’ access to transplantation procedures, offering support to all eligible residents. This is really a reassuring national policy for UAE residents.”
Incentivising donations
Fr Davis Chiramel, popularly known as the Kidney Priest from India, whose ‘Green Life’ campaign has been roped in to champion the message of organ donation among UAE residents, said insurance companies can also play a big role in spreading awareness about organ donation.
“While offering insurance, they could get the insured pledge their commitment to the Hayat programme. They could also look at the possibility of offering an extra month of free coverage to those who sign up to donate their organs,” said Fr Davis, who has donated his kidney and campaigns to promote the donation of kidney and other organs.
Since 2017, the Hayat programme has seen tens of thousands of pledged and 582 organs transplanted which included 328 kidney, 199 liver, 16 heart, 26 lungs, and 13 pancreas transplants. One person has the potential of saving the lives of eight individuals who are in desperate need of an organ transplant, including those suffering from cancer, heart disease, lung failure, cirrhosis, kidney failure and more.
