OMR500 will be the maximum cost of treatment at outpatient clinics and RO3,000 for in-patients per annum as part of the Unified Health Insurance Policy or Dhamani for workers in the private sector, the Capital Market Authority (CMA) has said.

The Decision No 34/2019 related to the policy has been issued by H E Abdullah bin Salim bin Abdullah al Salmi, Executive President of CMA.

It covers the health insurance of workers, their wives and children (not exceeding 21 years).

The insurance period will be for one year initially and the tenure can be increased as agreed on by the parties.

For outpatient treatment, CMA said, that OMR500 includes the cost of consultation, diagnostics, laboratory and medication.

The maximum cost of in-patient treatment can go up to OMR3,000 inclusive of hospital stay, doctor’s fees and diagnosis, medicines, ambulance expenses and patient care. Also, the maximum cost of repatriating the body of the deceased will be OMR1,000.

“It includes a number of optional benefits such as pregnancy, birth, child health, dental and eye care which the employer may include in the basic and compulsory coverage as agreed with the worker and the ability of the establishment,” Salmi said.

The decision also stipulates provisions not covered under the Dhamani scheme.

The fourth chapter of the decision states, “The following conditions are excluded from implementation of the mandate: Pre-meditated self-inflicted injuries, experimental treatment, pre-existing conditions, comprehensive check-ups that do not require treatment as per the law, or any check-ups that are for non-medical reasons such as travel, insurance, or getting a permit.”

Dhamani does not cover plastic surgery, unless required due to an injury included in the law, dental care such as fitting new teeth or braces unless related to a workplace injury, vision-correction, clearing of the nasal passages, treating baldness, weight control and infertility treatment.

It also does not include treatment of sexually-transmitted diseases, HIV and substance abuse.

“The policy will cover around 2.1mn workers in the private sector. CMA is cooperating with the Ministry of Manpower, the Ministry of Health, Oman Chamber of Commerce and Industry (OCCI) and the Public Authority for Social Insurance to implement it in Oman,” Salmi added.

CMA has held several meetings to seek views on Dhamani. It is cooperating with OCCI to organise meetings with business owners in North Batinah, Dakhliyah, South Sharqiyah and Buraimi to spread awareness about the health insurance policy.