The federal law lets you pay the maid's medical bills instead of insuring her. The visa counter does not.

The federal rule, in the words of the law

Federal Decree-Law No. 9 of 2022 concerning Domestic Workers, Article 11, lists ten obligations of the employer. The fifth, in MOHRE's published English text: "Incur the costs of the domestic worker's medical care in accordance with the health system in effect in the state, or, alternatively, provide the domestic worker with appropriate health insurance in accordance with the laws and regulations governing the state's health system."

Two things follow from the wording. First, the obligation is to the employer, which the law defines as "any individual or recruitment agency that hires a worker for domestic duties" — so it falls on the household directly, or on the agency in the agency-employment model where the recruitment office "functions as the employer". Second, the words "in accordance with the laws and regulations governing the state's health system" hand the detail to the emirate health insurance laws. The federal law does not say which policy, what cover, or whether a policy is needed at all; the emirate laws do, and all three now answer the last question the same way.

Article 11(13) closes the other door: "Employers may not charge domestic workers any costs or charges whatsoever, whether directly or indirectly, unless otherwise specified in this Decree-Law and its Implementing Regulation." No clause specifies health insurance as an exception. Whatever the policy costs, it is a cost of employing the worker, not a deduction from her wage.

Three regimes, one outcome

So the "or" in Article 11(5) survives only on paper. A household that chose to pay the bills rather than insure would reach the residence-permit application and be unable to file it. Our reading: the federal alternative was drafted for a country in which two emirates had compulsory insurance and five did not; since 1 January 2025 it describes no household's real position.

What the minimum product actually is, emirate by emirate

Northern Emirates: AED 320, and read the exclusions

MOHRE's scheme page names the population exactly — "private sector employees and domestic workers in Sharjah, Ajman, Fujairah, Ras Al Khaimah, Umm Al Quwain" — and the terms that matter to a household:

Two of those lines are the ones that turn into a dispute later. The co-payments are the worker's to pay at the clinic — the policy does not make treatment free, it makes it insured. And maternity is outside the package entirely, which for a live-in worker of child-bearing age is the single largest uninsured risk the household carries. Nothing stops a sponsor buying more than the minimum; the minimum is simply what the permit counter checks.

Dubai: the Essential Benefits Plan, from a Participating Insurer

Dubai's law does not price the policy; it sets a floor and a channel. Article 9(a)(3) makes the sponsor responsible for enrolling the persons he sponsors "provided that the Health Benefits he provides to them are no less than the Basic Coverage", and the DHA defines Basic Coverage as the Essential Benefits Plan — an AED 150,000 annual aggregate, maternity included, with a GP-referral gate for specialists. For anyone drawing a salary below AED 4,000, which describes almost every domestic worker in the emirate, DHA Policy Directive PD 11-2020 reserves the EBP to insurers approved as Participating Insurers, who in exchange cannot refuse the risk. The practical consequence for a household: buy from that list, and the insurer cannot decline the worker for age or a pre-existing condition. Our employer health insurance guide sets out the EBP benefit table in detail.

Abu Dhabi: the Basic policy, from the date of arrival

Abu Dhabi's regime is the oldest and the strictest on timing. Article 5 of Law No. 23 of 2005 obliges every sponsor to insure "those sponsored by him who are not covered by the Employers, as of the date of arrival in the State", and Article 12(7) of the Implementing Regulation starts the clock "after seven working days following the arrival of the Employee or the sponsored person to the Emirate or from the date on which the medical examination card is obtained, whichever occurs first". Article 12(2) adds a liability the other emirates state less bluntly: the sponsor "shall be personally liable for the cost of any healthcare services offered to any person on his sponsorship in the event that such person is not covered by a valid Health Insurance Policy". The product is the Basic Health Insurance Policy under the Department of Health's scheme; the law fixes the obligation and the benefit standard, not a tariff, and we have not verified a current premium from an official page, so we do not print one.

The policy you may also need, which is not health insurance

Households in the MOHRE system are offered a second product at the permit stage, and it is routinely mistaken for medical cover. The Worker Protection Insurance under Ministerial Resolution No. 318 of 2022 costs AED 105 for a domestic worker, runs for 30 months, and pays up to AED 20,000 per claim — for "unpaid end-of-service benefits", "unpaid wages (maximum of the last 120 days)", "unpaid repatriation expenses" and "unpaid medical expenses related to occupational injuries or diseases", in the words of the federal government portal. It is insurance against the employer defaulting, and the only medical line in it is work-injury treatment that the employer has failed to pay. It satisfies nothing in Article 11(5) and nothing in the emirate health laws. A worker with the AED 105 policy and no health policy is, for the purposes of the residence permit, uninsured.

Work injury itself sits in a third place. Article 11(9) of the Domestic Workers law makes the employer provide "the prescribed compensation for work injuries and occupational diseases as provided for in Decree-Law No. 33 of 2021", and adds that "Employers may not be relieved of this obligation unless the insurance company pays the compensation outlined herein". A health policy covers the treatment; the compensation scale for disability or death is a separate liability, and it is the household's unless a policy pays it.

Sick leave pays the wage, not the bill

Article 10(6) gives a domestic worker 30 days of sick leave per year of service, "the first fifteen days… paid in full" and "the next fifteen days at half pay", on a report from an approved health authority. That clause is about remuneration during absence. It says nothing about who pays the clinic — that is Article 11(5), and it is answered by the policy. Keep the two apart when the first illness arrives: the wage continues under Article 10, the treatment is claimed under the policy, and the co-payment at the counter is the worker's under the policy terms.

Two further clauses make the stakes of an uninsured illness concrete. Article 19(6) ends the contract when the worker "exhausts all his / her sick leave or… is medically un-fit to work", and Article 19(2) makes the employer responsible "for the costs of repatriating a deceased or ill worker to their homeland". A household that chose to self-insure would meet a long illness as an unlimited bill followed by a flight ticket; a household with a policy meets it as co-payments.

What non-compliance costs, and where

The exposure is different in each emirate, and the federal law adds a layer that is easy to miss.

• Dubai. Law No. 11 of 2013, Article 23: a fine of "not less than five hundred Dirhams (AED 500.00) and not more than one hundred and fifty thousand Dirhams (AED 150,000.00)", doubled on repetition within a year up to AED 500,000, with the amount per violation set by resolution of the Chairman of the Executive Council. Article 11(4) adds the cost of "health services and medical intervention in Emergency Cases" for an uninsured sponsored person.
• Abu Dhabi. Law No. 23 of 2005, Article 24(1): "Any employer or sponsor who refrains from subscribing to the health insurance scheme or renewing the health insurance policy is punishable by a fine of not less than Dhs. 300 (three hundred) for each month not subscribed", compounded per person; Article 24(2) adds a general fine of AED 5,000–20,000 for other breaches. And the personal liability for healthcare costs in Article 12(2) of the Regulation.
• Northern Emirates. MOHRE's scheme page states no fine. The enforcement is the permit itself: without a policy the residence permit is not issued or renewed, and a worker whose permit has lapsed is in the overstay regime at AED 50 a day.
• Federal, everywhere. Article 25 of the Domestic Workers law delegates administrative penalties for breaches of Article 11 to the Executive Regulation; Article 17 reserves the criminal fines for other conduct — employing without a work permit, AED 50,000–200,000, is the one a household is most likely to meet if the permit lapses and the worker stays on. And the worker's own claim: Article 26 gives the state courts jurisdiction, exempts the worker from court fees, and gives her three months from the end of the relationship to sue — for unpaid medical costs among other dues.

One date, two official pages

MOHRE's scheme page states that the permit condition "excludes those with valid work permits dated before 1 January 2025. However, the insurance must be purchased upon renewal of their residency permits." The federal government portal's health insurance page, read the same day, prints the exemption as applying to "work permits issued before 1 January 2024". Our observation: the two official pages disagree on the year; MOHRE runs the scheme, its page is the one its Business Services Centres apply, and either way the exemption ends at the first renewal — so for a household the practical rule is the same: insure at the next permit transaction, whichever year the old permit carries.

If you sponsor someone at home

1. Treat the policy as a permit document, not a benefit. File it with the entry-permit and residence application; in Abu Dhabi, have it in force within seven working days of arrival.
2. In Dubai, buy from a DHA Participating Insurer if the wage is under AED 4,000 — the insurer cannot refuse the worker, and the product is the EBP the law requires.
3. In the Northern Emirates, budget AED 320 a year and tell the worker, in writing, that maternity and dental are not covered and that co-payments apply at the clinic.
4. Never recover the premium from the wage — Article 11(13) federally, Article 11(2) in Dubai, Article 12(6) in Abu Dhabi all forbid it, directly or indirectly.
5. Buy the AED 105 worker-protection policy if MOHRE's system asks for it, and understand that it is not the health policy.
6. Diarise the renewal. The two-year federal policy and the residence permit do not necessarily end on the same day; the permit renewal is the moment the gap is found.