Medical Insurance 002

Medical Insurance

Medical Insurance coverage of Gulf Drug and subsidiaries


 

 


The group medical insurance plan is renewed under Abu Dhabi National Insurance Company and TPA NAS.

 

1.Cards– refer to the Virtual card copy of self and dependents. These copies are as good as hard copies and all network provider accept these soft copies. Moreover the enrolled members’ EID is already tagged with their Insurance card so they can present their EID.

 

2.Health Hub– refer to 90% of healthcare providers in the market (Both within and outside network), refer to Dr’s profile, book an appointment. All providers and doctors within network will have a green tick mark while outside network will have red tick mark. Members can also book appointment through health hub directly.

 

3. TruCare by TruDoc 24×7 – provides you access to highly trained and licensed Doctors, Wellness Experts, Psychologist, and Care Coordinators to support you with non-life threatening, chronic and preventive care via voice/video calls and live chat.

 

4My Policy– Download network list, Table of benefits and claim form.

 

5.Reimburse claims– Submit reimbursement claims.

 

In line with the subject matter, we are pleased to provide you with all the guiding information with respect to your category. Below are the most updated  network coverage where you can access your medical insurance benefits.

 

NETWORK LIST  AND TABLE OF BENEFITS 2020-2021

 

CAT A
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/Egh3CO6CApBFgd2geTJg2ucB0JhXZVTnvonCZNcKHMMvXg?e=g180pE

 

CAT B
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/EkWV0D15MYlClNOClmf9nAoB9hgdbxo3NE47JRdmVMsGRw?e=B5aKEn

 

Cat C
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/Ep4Z0fi3-jBJvIJwNREuBg4BxO7mm_VH-3f3Yzh_P9Pnsw?e=cC5a4b

 

 

Cat D
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/El1GhD7-obtJuM-qC9AxrNkBUE9UWlQJNJspdMgO_q9v1g?e=IpIstP

 

Cat E
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/Ep8cHviJI4ZGvZAt2GK8YDsBOJFGvO0OlqZ4vQlcbl3j2w?e=Ch7jiL

 

GDTS Location
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/EjztgVmvZ5RJgIBBzWFLr7cBfLQC974aOOOnqOTOUtASLg?e=ig8pkA

 

IBN HAYAN Visa Holders (Abu Dhabi)
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/ErdAfdQZasFDpPEEFNkvmMMBogTVlgSsI2PKjsIw-4hwXg?e=61J3HR

 

SEHA Facilities
https://gulfdrug0-my.sharepoint.com/:f:/g/personal/victoria_gusarova_gulfdrug_com/EnOBDmhGGZFKlVCyaP_wOgMBqzg1g8XKlPkd3VhW4YM18A?e=3emuRt

 

 

We recommend you to download the mobile app where you can easily access medical insurance ecard, network and benefit hence coverage is linked to your Emirates ID. 

 

Below are key facilities on My NAS. Members can sign up using EID number and insurance card number.

 

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This application is designed for your convenience as it guides you to the nearest healthcare provider in your area and provides information concerning inclusion and exclusion of the coverage as per your category.

 

Attached herewith is the User’s guide and reimbursement form:

 

https://gulfdrug0-my.sharepoint.com/:b:/g/personal/victoria_gusarova_gulfdrug_com/EYdsJigP8eFFt6EW95reG5QBbvHhnjfBoWa4e8bkfapD1Q?e=Tf9XXa

 

REIMBURSEMENT PROCEDURE 

 

 

Medical claims need to be submitted in softcopies on your member portal/member app “ MY NAS”.

 

Attached the required documents mentioned below and submit claims for reimbursement.

 

REIMBURSEMENT CLAIMS CHECKLIST :

 

-Completed Claims Form (signed by both member & doctor with stamp)
-Original Bills / Invoices with Itemized breakdown of services provided
-Physicians Prescriptions and Referrals
-Investigation Results
-Medical Reports (if any)
-Discharge Summary (if any)

 

Inpatient treatment : In case the member is in need of any inpatient treatment, ADNIC can arrange for a direct billing at the hospitals within the network. Should you require additional support on the approvals. Please feel free to get in touch with below:

 

24/7 NAS Claims Center  / Toll Free: 800 654 42

 

-Claim settlement happens within 10 working days via bank settlement, as per the terms & conditions of the policy.
-Claims submission timeline is 120 days within and  outside UAE for the eligible members.

 

  • Sanctions Clause will apply:  Please note that Insurers would not pay claims incurred in sanction countries. We suggest you to seek insurers prior approval before travelling to sanction country for business trip

 

 

Afghanistan Lebanon South Sudan
Belarus Libya Sudan
Burma/Myanmar Mali Syria
Burundi Nicaragua Tunisia
Central African Republic North Korea Ukraine (Crimea)
Cuba Republic of Guinea-Bissau Venezuela
Democratic Republic of Congo Republic of Guinea Yemen
Egypt Russia Zimbabwe
Iran Serbia
Iraq Somalia

 

 

HOW TO USE MOBILE APP AND YOUR MEDICAL INSURANCE BENEFIT

If you would like to learn more about your benefits and how to utilize them better, please review the presentation below:

 

https://gulfdrug0-my.sharepoint.com/:p:/g/personal/victoria_gusarova_gulfdrug_com/EeTTBAOCKxVCm8BNSa0Tt3kBG7t9VpsOwH9hiAsDcyz9Wg?e=LESK0D

 

Should you need further assistance, please don’t hesitate contacting Ms. Romalyn Dasugo, our Medical Insurance Specialist who would be pleased to receive all your inquiries on her email below.

 

Romalyn_Dasugo@gulfdrug.com