Why Getting a Pre-Approval for UAE Health Insurance is Beneficial
In Dubai and Abu Dhabi health insurance is mandatory for all residents, and it is a legal requirement to have this. This enables residents to obtain health cover at approved clinics and facilities across the Emirates, that are within their approved network list.
However, how does this process actually work if you need pre approval? And why is pre approval important?
Why is Insurance Pre-Approval Important?
Many people are not aware of the significance of pre-approval when it comes to their health insurance. Pre-approval, also known as prior authorisation or pre-certification, is the process by which your health insurance provider reviews your medical treatment plan before you undergo any procedures or treatments.
The purpose of pre-approval is to ensure that the treatment or procedure is medically necessary and that it is covered under your policy. This process is particularly crucial for expensive or complex treatments, such as surgeries or advanced diagnostic tests. Pre-approval is required for certain benefits, mostly for expensive treatments and in-patient treatments.
Depending on your plan, these treatments can include treatments for in-patient and out-patient surgery, day care treatment, Positron Emission Tomography (PET) and CT scans, pregnancy and childbirth complications, cancer diagnosis, dialysis of the kidney patient, rehabilitation therapy & treatment, medical repatriation or evacuation, and many more.
The pre-approval process supports in assessing each case, organises, and makes the hospital bill payments and admission process easier. It also ensures that you are covered before commencing a procedure.
Why is pre-approval a good idea?
There are several reasons why pre-approval is a good idea when it comes to your health insurance.
Firstly, pre-approval can save you a lot of money. If you undergo a medical treatment or procedure without pre-approval, there is a chance that your insurance provider may not cover the costs in full or in some cases at all. This means that you will be responsible for paying for the treatment or procedure out of your own pocket, which can be incredibly expensive.
Secondly, pre-approval can help you avoid unnecessary medical treatments or procedures. Your insurance provider will review your medical treatment plan and determine whether the proposed treatment or procedure is medically necessary. If it is not, your insurance provider may suggest alternative treatments that are covered under your policy.
Thirdly, pre-approval can help you plan for your medical expenses. If your insurance provider approves your treatment or procedure, you will have a better understanding of what your out-of-pocket costs will be. This can help you plan your finances accordingly and avoid any unexpected medical bills.
How do you obtain pre-approval?
Obtaining pre approval is a relatively straightforward process. You will need to contact your insurance provider and provide them with the details of your proposed treatment or procedure. Your insurance provider will then review your medical treatment plan and determine whether the treatment or procedure is covered under your policy.
It is important to note that pre-approval is not always guaranteed, even if the treatment or procedure is covered under your policy. Your insurance provider may require additional information or documentation before they can approve the treatment or procedure. It is also important to remember that pre-approval does not guarantee payment from your insurance provider. You will still need to pay any deductibles or co-payments that are required under your policy.
What happens if pre-approval is not obtained?
If you undergo a medical treatment or procedure without obtaining pre approval from your insurance provider, there is a risk that your insurance provider may not cover the costs. This means that you will be responsible for paying for the treatment or procedure out of your own pocket, which can be incredibly expensive.
In addition, your insurance provider may not cover any complications or adverse effects that arise from the treatment or procedure. This can leave you with additional medical expenses that you may not have anticipated.
In some cases, your insurance provider may deny coverage for a treatment or procedure even if you have obtained pre approval. This can happen if the treatment or procedure is deemed unnecessary or if there are alternative treatments that are covered under your policy.
In conclusion, pre approval is an essential aspect of health insurance in the UAE. It can save you money, help you avoid unnecessary medical treatments or procedures, and help you plan for your medical expenses. If you are planning to undergo a medical treatment or procedure, it is always a good practice to seek pre-approval from your insurance provider.
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