FAQs

Accounts

You can send an email request to the HanseMerkur Accounts Department. You may also refer to the invoice copy for the bank details.

Administration

To obtain a quote for health insurance from HanseMerkur, you can follow these steps:

Visit the HanseMerkur website at www.hansemerkurintl.com.
Click on the “Support” tab on the top menu of the website.
Under the “Support” tab, click on “Get a Quote”.
Fill out the Quote Request Form.

Submit the form: After completing the form, click on the “Submit” button to send the request to HanseMerkur.

Wait for a response: A representative from HanseMerkur will contact you to assist with a quote based on your requirements.

Alternatively, you can contact HanseMerkur directly by phone or email to request a quote for a group health insurance. It is recommended to provide as much detail as possible about your company’s requirements to ensure that the quote is tailored to your specific needs.

When a quotation has been confirmed and accepted, it will take four (4) working days from the receipt of the complete document(s) to validate your policy. The Hansemerkur Administration team will send the policy documents and the copy of the member’s e-card once the policy has been activated.

Once an application is approved and payment has been made, an email will be sent to the policyholder or its representative confirming that policy issuance has been completed along with the E-card(s) copy.

You must send a completed Census Addition Template to the Administration Department and this request will be processed within four (4) working days. An invoice will then be sent to you and that is payable within 30 days from the date of the invoice. The VAT amount must be paid in full within 14 days from the date of invoice.

Any request for deletion must be sent to the Administration Department along with the completed deletion template and a copy of the visa cancellation.

For an Individual & Family policy, you need to complete a medical application form (MAF) and send it to the Administration Department along with the birth certificate, hospital discharge summary and the completed Census Addition Template. The request will be reviewed and the Administration team will provide update on the status of the application.

For a Group policy, you need to provide a duly filled Census Addition Template along with the birth certificate and hospital discharge summary.

Note: If the mother is insured under a DHA compliant Policy, HanseMerkur provides cover for a baby in the first 30 days from birth (As per DHA). If addition would be after 30 days from birth, the application would be subject to underwriting.

Yes, you are still required to fill out the CIF and provide an estimated amount.

Benefits

The differences between the two types of insurance are huge and can be seen in 4 distinct areas.

(i) Level of Cover – The benefits with HanseMerkur are richer (more benefits with higher limits and sub-limits)

(ii) Exclusions – Many local insurers follow the DHA basic minimum exclusions or a slightly diluted version of this basic list. These are the same exclusion applied to an AED 600 per year labourers’ insurance policy. In other words local insurers may show some reasonable cover on the Table of Benefits but so much is then excluded in the small print
(iii) Service Levels – From policy administration, approvals, claim processing and just having proper 24/7 support that really wants to help you and solve your problems, here the difference is massive. HanseMerkur offers more personalized service and support than cheaper local health insurance plans. This can include access to a dedicated account manager, more efficient claims processing, and 24/7 customer support.

(iv) Interpretation of Benefits – Many local insurers are unfortunately often looking for reasons not to pay or too deny treatments and services, at HanseMerkur the policies are incredibly open and comprehensive, and staff are trained to try and make all reasonable efforts to support members and give the benefit of the doubt if there is ambiguity.

(v)Network of Providers: HanseMerkur may have a larger network of healthcare providers than cheaper local health insurance plans when it comes to global coverage. This means that you may have more options when it comes to choosing doctors, hospitals, and clinics with direct billing availability on Inpatient & Outpatient.

A HanseMerkur policy and a local insurance are not comparable and simply do not compete, they are aimed at completely different target markets. It’s important to carefully consider your healthcare needs and budget when choosing a health insurance plan. While cheaper local health insurance plans may offer lower premiums, they may not provide the same level of coverage and service as HanseMerkur. On the other hand, HanseMerkur’s plans may be a better fit for those who require more comprehensive coverage and personalized service.

Exclusions in health insurance refer to the treatments, services, and medical conditions that are not covered by an insurance policy. These exclusions can vary depending on the insurance provider and the specific policy. HanseMerkur policies seek to offer insured members the most comprehensive and open health insurance but no insurer can ever agree to pay for absolutely every and anything, there must be an element of control to ensure a policy is also fair to the insurer. The main exclusions are Medical Necessity, Cosmetic Treatments and Experimental/Unproven Treatments
It’s important to review the exclusions of a health insurance policy before purchasing it to ensure that you understand what is covered and what is not. If you have questions about the exclusions or any other aspects of a policy, it’s always a good idea to contact the insurance provider for more information.

In the Table of Benefits of HanseMerkur’s health insurance plans, “”covered”” typically means that the specified treatment or service is included as part of the policy’s coverage. This means that if you require the covered treatment or service, HanseMerkur will pay for it, up to the annual limit specified in the policy.

Co-insurance and co-payments are both cost-sharing mechanisms used in health insurance policies. While they are similar in some ways, there are important differences between the two:

Co-insurance: This is a cost-sharing mechanism where the policyholder and the insurance company share the cost of covered medical expenses. The policyholder pays a percentage of the cost of the treatment, while the insurance company pays the remaining percentage. For example, if the co-insurance is 20%, the policyholder would pay 20% of the cost of the treatment and the insurance company would pay the remaining 80%.

Co-payment: This is a fixed amount that the policyholder pays towards the cost of a covered medical expense. For example, if the co-payment is $20, the policyholder would pay $20 for each covered medical expense, and the insurance company would pay the remaining cost.

The key difference between co-insurance and co-payment is that co-insurance is typically calculated as a percentage of the total cost of the medical expense, while co-payments are typically a fixed amount.

Both co-insurance and co-payments are used to encourage policyholders to be more responsible with their healthcare spending, as they are required to pay a portion of the cost of their medical treatment. It’s important to review the details of your health insurance policy to understand the co-insurance and co-payment requirements, as they can have a significant impact on your out-of-pocket healthcare expenses.

Each HanseMerkur policy has a defined Area of Cover and insured members can access treatments and services in any country therein. Each plan can be tailored to suit the policy holders’ specific requirements, with additional cover, or partial cover in Home Countries or emergency cover for all members outside of the stipulated Area of Cover.

If you have purchased an international health insurance plan from HanseMerkur, you may be able to use your coverage in other countries around the world. However, it’s important to note that the specific coverage provided will depend on the policy you have purchased, and there may be limitations or exclusions for certain countries or regions.

If you plan to travel outside of UAE and want to ensure that you have coverage for medical emergencies or other healthcare needs, it’s always a good idea to review the details of your HanseMerkur health insurance policy and to contact the insurance provider directly for more information. They will be able to advise you on the coverage available and any limitations or restrictions that may apply to your specific policy.

“Global Direct-Billing”” is a feature offered by HanseMerkur that allows for seamless medical expenses to be paid for policyholders receiving medical treatment abroad. Instead of paying upfront for medical services and then submitting a claim for reimbursement, Global Direct-Billing allows policyholders to simply present their insurance card to healthcare providers and have HanseMerkur pay the provider directly for the covered medical expenses. This can help to reduce the financial burden on policyholders and simplify the reimbursement process.

With Global Direct-Billing, HanseMerkur has a network of medical providers and facilities in various countries around the world. When a policyholder receives medical treatment from a provider within this network, they can take advantage of the direct-billing feature. If a policyholder receives medical treatment from a provider outside of the network, they may need to pay upfront and then submit a claim for reimbursement.

It’s important to note that the availability and coverage of Global Direct-Billing will depend on the specific HanseMerkur health insurance policy that you have purchased. If you plan to travel abroad and want to take advantage of Global Direct-Billing, it’s a good idea to review the details of your policy and to contact HanseMerkur directly for more information on the coverage available.

These are the benchmark rates of any treatments and services for the Network, specific to an Insured Person’s Cover, as per specific Provider’s standard Network rates.

It is a non-commissionable float for all treatments and services related to the member’s pre-existing condition/s. Related costs above the amount are payable by the insurer up to the pre-existing condition/s limit of AED 250.000 as an example. Any amount not consumed is refundable

a) if the member is deleted from the policy or
b) at the end of the policy term.

At renewals all claims related to the condition/s will be added up and deducted from that year’s float, then the float must be replenished so a full float is in place when the new policy term commences.

NB: The float amount may be reassessed and revised at renewal.

In case that the policyholder decides not to renew with HanseMerkur or when the member is ultimately deleted from the policy there will be a 3-month lag until the final amount to be refunded is determined and settled.

As your company cover is a tailored group plan, we may not be able to offer you the exact same terms. However, we are happy to offer you similar terms from our Individual plan range. Please contact our Sales Team who will be happy to help.

As per the policy Terms and Conditions, if the number of Insured Persons at the Policy Start Date is 10 or more and subsequently falls below 10, the Insurer reserves the right to immediately and without notice revise the Terms & Conditions of the Policy such that the applicable Termination and Cancellation clause is changed from the Group Terms (no. of lives 10+) to the Individual & Family Policy Terms (no. of lives less than 10).

You can refer to Terms & Conditions page 3, Clause 5. Eligibility of Cover & Clause 17. Termination and cancellation, to understand how these changes may impact our client.

The recommended age for prostate cancer screening is 55, but for individuals at high risk, such as those with a first-degree relative diagnosed with prostate cancer, it is strongly advised to undergo PSA screening between the ages of 40 and 54, according to WHO guidelines.

HanseMerkur provides coverage for probiotics when deemed medically necessary, particularly for conditions such as gastroenteritis.

Generally, transfers within SEPA countries are treated as domestic transfers, and many banks offer these transfers free of additional charges or at a lower cost compared to international transfers.

However, it’s important to note that specific policies can vary between banks and financial institutions. Some banks may offer free SEPA transfers as part of their standard service, while others may charge fees depending on the type of account or service plan.

To determine whether transfers to SEPA countries are free of charges in your specific case, you should check with your bank or financial institution directly. Review the terms and conditions of your account or contact customer service to get accurate and up-to-date information on any fees associated with SEPA transfers.

In instances where a benefit involves coinsurance, and a client chooses to avail the service through a pay-and-claim approach, both the network coinsurance and the benefit coinsurance (along with any applicable deductible on doctor’s consultation) will be applied. The Out of network coinsurance does not apply on Dental, Optical and Pharmacy claims.

Should you have any further questions or require additional clarification on this matter, please do not hesitate to reach out to us.

Healthcare services or treatments for this condition are covered provided they are for symptomatic purposes and not cosmetic. HanseMerkur provides coverage for such treatments when deemed medically necessary.

The procedure, storage of stem cells, is an exclusion as per the policy T&Cs.

Healthcare services or treatments for this condition are covered provided they are for symptomatic purposes and not cosmetic. HanseMerkur provides coverage for such treatments when deemed medically necessary.

With HanseMerkur Globalcare Plans, the Optical covers a pair of prescription eyeglasses and contact lenses up to the Optical limit as stipulated in the Table of Benefits. This benefit also includes yearly eye exams and corrective lasik surgery.

No, all prescribed medications, including psychiatric medications, are fully covered without any out-of-network coinsurance being applied. A “benefit coinsurance” will only be applicable if specified in the policy Terms of Benefits (TOB).

Yes, authorization for coverage of physiotherapy sessions, whether through direct billing or reimbursement, necessitates a doctor’s referral from either a general practitioner (GP) or a specialist.

Customer Service

A claim reimbursement request can be submitted by email or via the TPA (Third Party Administrator) mobile app. Click here for our guide.

It normally takes within 10 working days from the receipt of complete documents to completely process a claim reimbursement. For any claims inquiry, you can directly contact the TPA (Neuron/Nextcare/Henner).

To check the status of your claim, please login to your mobile app (Neuron/Nextcare/Henner) and view ‘reimbursement claims’. You can also directly contact the TPA (Neuron /Nextcare/Henner).

The Explanation of Benefit is available on the mobile app under ‘reimbursement claim’. Partial payments may be due to normal policy exclusions, copays, benefit coinsurance or reimbursement penalty. For inquiries, you may directly contact the TPA (Neuron/Nextcare/Henner).

HanseMerkur values feedback from customers as this allows us to take necessary steps to improve our service. HanseMerkur will take all necessary steps to review any concerns and to resolve any concern or complaint at the earliest possible.

Please speak directly with the staff member(s) you have been dealing with if you are unhappy with a service received from us.

For any questions related to mobile app, please contact Neuron/Nextcare/Henner.

You can call the TPA and seek assistance with regard to arranging a Guarantee of Payment (GOP). GOP is subject to provider’s acceptance and can only be arranged for Inpatient Hospitalization. For Outpatient cares, you can pay and claim, and it is subject to evaluation as per your policy T&Cs. You can find the claim submission guide here.

It’s the provider (within the network) who will send the approval request to the TPA and coordinate with them as well. If you visit an out of network provider, no authorization is required. You have to pay and claim.

It’s your doctor/ healthcare provider(s) (within the network) who will send the approval requests to the TPA and coordinate with them as well.

For Reimbursement, you can submit the completed reimbursement claim form along with the supporting documents required to evaluate the claim (see guide here) via the TPA mobile app or via email.

The TPA contact details can be found here.

If you visit a provider outside your network(s), or in the unlikely event a network provider still does not accept direct-billing after you have presented your card and sought assistance from Neuron or Nextcare, you will need to pay and claim to be reimbursed.

  1. A signed, stamped and fully completed claim form is required along with the supporting documentation.
  2. A Discharge Summary & Medical Report for all Inpatient and Day Patient Claims
  3. Diagnostic Reports/Results: Pathology and Scans (X-rays, CT, MRI & PET), etc.
  4. Prescriptions for all Medicine and Supply Claims
  5. Proof of payment, all Invoices (itemised, with a breakdown of amounts) and Receipts
  6. For ongoing treatment of a medical condition (e.g. a program of physiotherapy sessions), subsequent invoices/receipts must be submitted with a copy of the completed claim form
  7. For Neuron or Nextcare all documents must be in English or Arabic (a translation must be provided if in other languages). For Henner any language is acceptable, but some may take longer to process
  8. Copies of documents are acceptable (but please keep the originals in case they are required), please submit through the respective Mobile App or E-Mail

You can find the nearest providers through your mobile app (Neuron/NAS/Nextcare). You can also contact the TPA directly. The contact details of the TPA can be found on your mobile app or you can click here.

You need to contact the TPA helpline to get the details of the rejection. The TPA contact details can be found here.

For emergency hospitalilzation outside UAE and within the area of cover as per the policy TOB and T&Cs, here’s the standard claims procedure of the local TPAs (if via direct billing):

  1. The insured member is taken to hospital in an emergency
  2. A family member or the hospital contacts the TPA (NAS/Neuron/Nextcare) to assist with direct-billing or to issue a Guarantee of Payment (GOP) (This is subject to review and approval)
  3. A GOP is then issued by the local TPA’s with the help of their International Assistance Partners to the provider

Below is the standard claims procedure of Henner, your international TPA.

  1. The insured member is taken to hospital in an emergency
  2. A family member or the hospital contacts Henner within 48 hours. Note: No prior agreement is required for the first 3 days of Emergency hospitalization
  3. Henner issues a Letter of Guarantee, within 2 hours valid for 3 days
  4. After 3 days of hospitalization, authorization procedure is required to extend the inpatient stay
  5. A prior agreement form is completed and sent to medical@henner.com for approval
  6. The Prior agreement Form can be found in the mobile app myHenner, or member online portal
  7. Henner issues a Letter of Guarantee to the hospital and a copy is sent to the insured
  8. Henner settled the invoice directly with the medical provider

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Yes, free pharmacy delivery can be arranged in the UAE with your provider and the services vary depending on the TPA which is assigned to your policy.

  1. Neuron: Through Soukare and via King’s College & Trudoc24x7 Teleconsultation services
  2. NAS: Through Soukare and via King’s Colleged & Trudoc24x7 Teleconsultation services
  3. Nextcare: Through Health at Hand Teleconsulation services

Henner is a Third-Party Administrator (TPA) who is responsible for the direct billing and reimbursement of claims incurred outside these countries covered by your local TPA in GlobalCare policies.

Neuron: UAE, Oman, Bahrain & Qatar
NAS: UAE, Oman, Bahrain & Qatar
Nextcare: UAE, Oman, Bahrain, Qatar, India, Kuwait, Egypt, Lebanon & Saudi Arabia
Henner: Rest of the World

If a c-section was planned ie: a surgery then this would have to be declared. Being pregnant and planning for a normal delivery does not require to be declared.

Henner sends a Welcome Email after 10 days from the policy inception/addition date. The Welcome Email consists of the Henner ID No. and the steps on how you can signup to the myHenner mobile app.

The Henner Pass (ecard) can be downloaded through your myHenner mobile app or Henner online portal. A copy is valid for 6months from the date it was downloaded hence you may need to log back in to your myHenner mobile app Henner for an updated Henner Pass (ecard). Please note that the validity date on the Henner Pass won’t affect your eligibility and access to care.

You may call Henner for assistance in regard to checking provider network and for approval requests.

When visiting providers, you may present the “Henner Pass” (can be downloaded through the mobile app) to in-network providers.

There are cases wherein the Reception of the Facility (provider office) does not recognize the Henner Pass. To avoid such issues, you may need to contact Henner in advance so you can be assisted on direct billing. You need to provide these details when calling Henner:

  1. Member Henner ID
  2. Provider Name and Location (country & city)
  3. Treating Doctor Name
  4. Contact No of provider (if available)
  5. Date of Planned Visit

Telehealth service providers vary according to which Third Party Administrator (TPA) is assigned to your policy:

Neuron: Download the Neuron App to access telehealth services, then simply press the Meet Doctor or Call Doctor buttons in the Mobile App to connect with the following services: King’s College free Teleconsultation with a GP and Trudoc24x7 free Teleconsultation.

NAS: Download the NAS App to access telehealth services, then simply press the Meet Doctor or Call Doctor buttons in the Mobile App to connect with the following services: King’s College free Teleconsultation with a GP and Trudoc24x7 free Teleconsultation.

NEXTCARE : Download the NEXTCARE App to access telehealth services, then simply follow steps 1-3 to connect to the following services: Health at Hand Teleconsultation:

  1. Click teleconsultation icon
  2. Tap “See a doctor now
  3. Connect with a doctor

Available to all insured members

  • Access highly trained, licensed doctors and wellness experts
  • Enhanced customer experience
  • Convenience
  • Free pharmacy delivery (UAE Only)
  • Chronic Medication Program
  • Free Nutritionist Sessions
  • No deductible to be paid
  • Helps control claims costs, which helps control policy renewal increases