From 1 November 2026, every Basic, Enhanced and Flexi policy in Abu Dhabi covers organ and tissue transplantation for donor and recipient, complications included whenever they appear. Policies already sold carry the benefit without the premium.

This change does not wait for renewal, when a carrier could reprice. A Basic, Enhanced or Flexi policy written in March 2026 was priced without transplant cover, and from 1 November it carries that cover until it renews (DoH circulars). The circular sets no premium adjustment and no transition period.

The cost of every transplant episode between 1 November and each policy's renewal date falls on a premium set before the benefit existed. For an insurer with a book renewing evenly through the year, part of that book carries the benefit for most of a year without having paid for it.

For Basic policies, the circular adds inpatient transplant care at authorised hospitals to Clause Third of Schedule 1, and outpatient care at authorised hospitals and health centres to Clause Fourth. The member pays AED 20 per new visit, or AED 10 per new visit to a specialist or consultant on a GP referral, and follow-ups within seven days of the first examination are free (DoH circulars).

For Flexi, the member pays 20% of each inpatient service, capped at AED 500 per new service, with an annual copayment limit of AED 1,000, beyond which the insurer covers 100%; outpatient visits carry 20%. On our arithmetic, the AED 500 cap binds on any inpatient service costing more than AED 2,500, and two such services exhaust the annual limit.

Everything above that sits with the insurer for the rest of the year. For Enhanced policies, the circular sets the date and the federal duty but no cost-sharing table of its own.

The circular restates the federal duty in full. Insurers must cover every service connected to removal and transplantation for donor and recipient, before, during and after the procedure, including complications whenever they arise or are detected, under all schemes in the State (DoH circulars).

Non-compliance is a violation of Law No. 23 of 2005 on health insurance in the emirate. A transplant recipient covered on 1 November who develops a related complication years later is inside a duty with no stated discovery period. That is a long-tail liability attached to a product sold one year at a time.

For anyone valuing an Abu Dhabi insurer, a TPA or a medical portfolio, the circular changes three numbers. The first is the unpriced period: the months between 1 November 2026 and each in-force policy's renewal, multiplied by the expected transplant cost for that membership. The second is the reserve for complications with no discovery limit, which belongs in the balance sheet, not in next year's loss ratio.

The third is the reinsurance response: whether the treaty covers a tail defined this way. On our reading, a seller who has not modelled all three is presenting a loss ratio the buyer cannot rely on. For hospitals, the circular does the opposite. It gives a transplant service line a defined payer route and defined member cost-sharing, although the circular does not list which hospitals are authorised.