The term NextCare Medical Insurance is commonly used when referring to medical insurance policies administered through NextCare. NextCare is a Third Party Administrator (TPA) rather than the insurance company itself.
For eligible Al Buhaira medical insurance policies assigned to NextCare, Al Buhaira National Insurance Company remains the insurer, while NextCare may provide healthcare administration services such as medical network access, approvals, claims processing and member support.
Not every Al Buhaira medical insurance policy uses NextCare. Members should check their medical insurance card, policy schedule or applicable member services to confirm their assigned TPA and medical network.
NextCare works with insurers and healthcare providers to administer healthcare services for eligible insured members. Its role may include managing medical networks, treatment approvals and medical claims according to the applicable insurance arrangement.
Al Buhaira includes NextCare among its appointed medical Third Party Administrator networks for eligible medical insurance arrangements.
When NextCare is assigned to an Al Buhaira medical policy, Al Buhaira continues to provide the insurance policy while NextCare may administer specified healthcare services on behalf of the insurer.
Coverage remains subject to the issued Al Buhaira policy, schedule of benefits, eligibility, medical necessity, annual and benefit limits, exclusions, co-payments and other applicable conditions.
Members using NextCare Medical Insurance in Dubai or elsewhere in the UAE should confirm the specific NextCare network assigned to their policy before receiving planned treatment.
Access to hospitals, clinics, pharmacies, diagnostic centres and other healthcare providers depends on the network assigned to the member's insurance policy.
NextCare administers healthcare-provider networks that may include hospitals, clinics, pharmacies, diagnostic centres and other healthcare facilities.
The important point is to check your specific assigned NextCare network. A healthcare provider participating in one NextCare network may not necessarily be available under every NextCare-administered medical insurance policy.
Hospitals and clinics available to a NextCare member depend on the specific healthcare network assigned to the insurance policy.
Members should therefore avoid relying only on whether a hospital generally accepts NextCare. Always confirm that the provider belongs to the specific network shown on your medical insurance policy or card.
Before planned or non-emergency medical treatment:
Certain healthcare services may require prior authorisation before treatment is provided. This can depend on the type of treatment, medicine, diagnostic test, procedure or hospital admission and the applicable policy conditions.
Where approval is required, the healthcare provider may submit the necessary clinical information through the applicable NextCare process.
Approval does not automatically mean that every associated expense will be payable in full. The final covered amount remains subject to policy benefits, limits, co-payments and exclusions.
When eligible healthcare services are received from a participating provider within the assigned network, the healthcare provider may process the covered portion of the medical expense through the applicable direct-billing arrangement.
The member remains responsible for applicable co-payments, deductibles and expenses that are not covered by the insurance policy.
Members submitting an eligible reimbursement claim may need to provide claim information and supporting medical documents according to the applicable claims process.
Supporting documents may include:
Where reimbursement is permitted under the policy, eligible members who pay medical expenses directly may submit a reimbursement claim for review.
NextCare provides digital claim services that may allow eligible members to submit supporting information and follow the progress of their reimbursement claim.
Submission of a claim does not guarantee reimbursement. Payment remains subject to eligibility, policy coverage, medical necessity, limits, exclusions, co-payments and the required supporting documents.
Eligible NextCare members can use the Lumi app to access available digital healthcare and insurance services.
Service availability may depend on the member's location, insurance coverage and applicable NextCare services.
NextCare currently provides the following UAE member-support contact details:
Members should also check the contact number shown on the back of their medical insurance card, particularly for policy-specific assistance.
NextCare administration applies only to eligible Al Buhaira medical policies assigned to NextCare. Other Al Buhaira products may use different medical networks or Third Party Administrators.
For information about Al Buhaira medical insurance benefits and services, visit our Medical Insurance page.
You can also learn more about healthcare coverage across the UAE in our Medical Insurance UAE guide.
To review Al Buhaira's appointed medical TPA networks, visit our Medical Network – Appointed TPA page.
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