Nextcare

When it comes to health insurance, what really matters is how easily you can access care when you need it. That’s where Nextcare comes in. As a trusted third-party administrator (TPA), it works behind the scenes to make sure everything runs smoothly between insurance companies and healthcare providers — so that patients can focus on getting better, not the paperwork.

Founded in 1999 and part of the Allianz group for over 14 years, Nextcare has grown into a name people rely on. It has built relationships with over 120 healthcare partners — both locally and internationally — to help insured members find the right care fast.
In this blog, we’ll walk you through everything you need to know about Nextcare health insurance —from how it works to who its partners are and why it plays such a big role in the UAE’s insurance space.

Types of Nextcare Healthcare Facilities

Nextcare Insurance in Dubai offers two primary healthcare networks to ensure members receive appropriate medical care tailored to their needs. Let’s find out more about them —

Primary Care Provider (PCP) Clinics: In the PCP network, your healthcare journey begins with a designated Primary Care Provider. This is a general practitioner who serves as your main point of contact for medical needs.

This approach emphasises coordinated care, where the PCP manages routine health concerns and provides referrals to specialists within the network when necessary.

RN3 Network: The RN3 network encompasses a curated selection of clinics and hospitals. Members have access to a wide range of healthcare services within this network, with the PCP coordinating care and facilitating referrals to specialists as needed. This structure provides comprehensive coverage through a trusted network of providers.

Note: Nextcare is a TPA, not an insurance provider. The term ‘Nextcare insurance’, thus, refers to the insurance services available with it.

Nextcare Services and Specialists

Nextcare in the UAE offers a comprehensive range of healthcare services and access to a diverse team of specialists. Some of the services and specialities provided by Nextcare health insurance in the UAE include —

1. Diagnostic Services: Nextcare facilitates various diagnostic procedures such as laboratory testing, imaging services (X-rays, CT scans, MRI scans), and pathology services. These services help with the accurate diagnosis and monitoring of health conditions.
2. Emergency Care: It operates emergency departments in select locations, providing urgent medical care for emergencies and critical conditions. These departments are equipped to handle acute injuries, accidents and medical emergencies.
3. Surgical Procedures: The TPA collaborates with renowned surgeons and hospitals to offer a wide range of surgical procedures. This includes both minor and major surgeries across various specialities.
4. Dental Care: Nextcare Insurance may also include dental services such as routine check-ups, preventive care, restorative procedures, and dental surgeries. Dental specialists and general dentists may be available within the network.
5. Hearing and Vision Aids: It provides hearing and vision aids in case of emergencies.
6. Maternity Cover: Nextcare also provides coverage during the maternity period (after approval from the insurance company).

Important: The availability of specific services and specialists may vary across different Nextcare facilities and locations in the UAE. For detailed information about the services, specialists, and availability, it is recommended to contact Nextcare directly or refer to its official website for the most up-to-date information.

Insurance Providers Linked With Nextcare

With more than two decades of experience in the healthcare industry, Nextcare medical insurance has become a name people trust when it comes to managing their health benefits. Over the years, the TPA has built strong relationships with some of the most respected insurance providers in the region and helped millions of members get easy access to quality healthcare.

Some of the well-known insurers working with Nextcare include:

1. Orient Insurance: Orient Insurance, a well-established insurance company in the UAE, offers a wide range of insurance products and services. With a focus on customer satisfaction and comprehensive coverage, Orient collaborates with Nextcare to provide policyholders with access to a diverse network of healthcare providers.
2. Takaful Emarat: Takaful Emarat is a leading Sharia-compliant insurance company in the UAE. Committed to ethical and transparent practices, Takaful Emarat partners with Nextcare to deliver healthcare services aligned with Islamic principles and ensure that policyholders receive the necessary medical care and support.
3. Orient Takaful Insurance: Orient Takaful Insurance, a subsidiary of Orient Insurance, specialises in providing Takaful insurance solutions. Through its collaboration with this TPA, the company provides policyholders with access to a wide range of healthcare providers, catering to their specific needs within the framework of Islamic principles.

Claim Procedure of Nextcare

Nextcare offers two types of claims in terms of procedures: direct settlement and reimbursement. Let's explore each of these types in detail —

Direct Claim

When you visit a healthcare provider within Nextcare's extensive network, the billing is handled directly between the provider and Nextcare. This means you won't need to pay upfront for covered services — just present your insurance card and the provider will take care of the rest.

Reimbursement Claims: When You Pay First

If you receive medical services outside of Nextcare's network or in situations where direct billing isn't available, you may need to pay the provider upfront and then seek reimbursement.

Here's how to do it —

1. Registration & Login - Visit the Lumi app and register or log in using your username and password.
2. Go to Claims - Once logged in, go to the ‘Submit New Claim’ section. Make sure you have all the necessary details such as the name of the healthcare provider, service date, description, and the physician's name.
3. Gather Supporting Documents - Make sure to keep all the supporting documents for the claim submission. This includes the medical form, signed by your doctor and stamped by the clinic or hospital, which should contain the history of the current illness, past medical history, clinical history, and prescribed medical tests or medicines.

Additionally, submit any medical results, such as test results and radiology reports, as well as the medical invoice from the clinic or hospital.

1. Complete the Claim Submission - Fill in all the required claim information and upload or capture the supporting documents mentioned above. Once everything is complete, click ‘Submit Claim’ to finalise the process.
2. Confirmation and Reimbursement - After submitting your completed claim form, you will get a confirmation email indicating that your claim has been successfully submitted.

Note that the Nextcare medical insurance reimbursement claim should be submitted within 30 days from the date of the treatment, whether from inside or outside the UAE. If you encounter any difficulties, you can contact the provider or email the Nextcare PB (Policy Benefits) department for assistance.

The Nextcare medical claim reimbursement process takes around 15 working days to process. Once the claim reimbursement is approved, the insurer will provide a Payment Order (PO) with the necessary details.

How to Track the Status of Your Reimbursement Claim with Nextcare?

Waiting to hear back on a claim can feel stressful. But with Nextcare health insurance, staying updated is easy and convenient.

Here are a few easy ways to check the status of your reimbursement claim —

Use the Lumi Mobile App (Fastest Way)
Download and log into the Lumi app. Once you're in —

• Tap on the ‘Claims’ section.
• Go to the ‘View Claims’ page.
• Here, you can search for your submitted claim and instantly see its current status — whether it’s being reviewed or approved or requires more information.

This is the quickest way to stay informed.

Connect with the Call Centre

If you prefer to speak with someone directly, you can dial the customer service number printed on your insurance card. A representative will guide you and answer any questions about your Nextcare medical insurance claim.

Reach Out on WhatsApp

You can also contact Nextcare through WhatsApp. It’s a convenient way to ask questions or follow up on your claim without making a phone call.

How to Contact Nextcare in Case of Emergency?

In case of a medical emergency, it's important to know how to contact Nextcare promptly to receive the assistance you need.

The TPA provides several channels that you can use to reach out quickly and efficiently —

1. Call Center: For immediate assistance, you can contact Nextcare's Call Centre. The contact number is found on your insurance card. Alternatively, you can use the Lumi mobile app to access contact information.
2. Lumi Mobile App: Nextcare's Lumi app offers a convenient way to manage your health insurance needs. Through the app, you can access emergency contact numbers, submit claims, and track their status. The app is available for download on both iOS and Android platforms.
3. WhatsApp Support: For quick inquiries, the TPA provides support via WhatsApp. The specific number for WhatsApp support can be found on their official website or within the Lumi app.
4. Regional Contact Numbers

Here is a table with Nextcare's contact numbers for various regions—

Please note that these numbers are subject to change. Always refer to your insurance card or the official Nextcare website for the most up-to-date contact information.

How to Find Hospitals, Diagnostic Centres, Pharmacies, and Doctors with Nextcare?

You can locate hospitals, diagnostic centers, pharmacies, and doctors with this TPA through the following methods —

Nextcare Website: Visit the Nextcare Healthcare Network page to search for medical providers. You can filter your search by country, city, area, type of facility (such as clinic, dental, diagnostic center, hospital, pharmacy), and network.

This allows you to find healthcare providers that best suit your needs and are covered by your insurance policy.

Lumi Mobile App

Download the Lumi app from the App Store or Google Play to access a range of services, including searching for healthcare providers. After logging in:

• Go to the ‘Healthcare Providers’ section.
• Use the search function to find providers by name, country, city, area, type, and network.
• The app can also locate providers near your current location, home, or workplace.

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