If a clinic wasn’t covered by insurance, you may still be eligible for reimbursement
Dubai: If you’ve recently had a medical test or treatment at a clinic that isn’t covered by your health insurance network, or paid for a service that wasn’t directly billed to your insurer, you may still be able to get your money back through a reimbursement claim.
A reimbursement claim allows you to pay for your treatment upfront and later request your health insurance provider to refund the eligible amount. Here’s how the process works.
You can typically file a reimbursement claim in situations such as:
Visiting a hospital or clinic outside your insurance network
Receiving a medical service not directly billed to your insurer
If the clinic or hospital does not have a direct billing arrangement with your insurer, you’ll need to settle the full bill yourself at the time of treatments
Keep all the original medical and payment documents, as these will be needed to process your claim. These may include:
Hospital bills and discharge summary (if admitted)
Complete your insurer’s reimbursement claim form.
Attach all required receipts and medical documents.
Submit your claim through your insurer’s mobile app, website, email, or in person at a branch.
Once submitted, your insurance company will review the claim to confirm whether the treatment is covered under your policy.
The insurer may contact you or the healthcare provider for additional details or clarification.
If approved, the eligible amount will be processed for reimbursement.
Once the claim is approved, your insurer will refund the eligible amount directly to your bank account or issue a cheque.
Processing times vary but usually take between 7 and 30 working days, depending on the provider.
You will only be reimbursed for services covered by your policy and within your plan’s limits.
Some insurers may deduct a co-payment or administration fee.
Claims can be rejected if documents are missing or if the treatment isn’t covered.
Always review your policy network and coverage rules before visiting a clinic outside your insurer’s network.
Note: This article is for informational purposes only. Before seeking treatment, contact your insurance provider to confirm the reimbursement process, required documents, and the percentage of costs covered under your policy when visiting a non-network clinic or hospital.
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