FAQ

Is Aafiya an insurance company?
How can I enrol my company (dependents, individuals) with Aafiya?

For this you must check with your HR either they have opted for dependent policy or not.

How can I use my health insurance medical card?

You may use it for all-inclusive medical health benefits at the provided network as per your policy.

How does the reimbursement process work and where can I get a reimbursement form?

Reimbursement is done on insurance company’s discretion on the submission of all the required documents and you may download the reimbursement form from www.aafiya.ae

What is the time limit to submit a reimbursement claim?

You must send us the claim within 60 days from the date of treatment for the treatment was taken with in UAE .For treatment outside UAE the claim must be submitted within 90 days from the date of treatment

Where shall I submit my reimbursement form?

To your respective insurance company through your HR/Insurance Brokers

Can I use my health insurance card at any Hospital or Clinic?

No, you must follow your applicable network. Usually clinics are meant to be used for Out Patient Treatment and Hospitals for the In Patient Treatment

How can I understand my network?

The complete list of network is provided to your HR with the location of all the network providers including Hospitals, Clinics and Pharmacies.

In case of emergency where shall I go and who shall I contact?

In case of emergency you may choose to go to any hospital/clinic and the amount will be reimbursed. Although, if you go to a provider which is part of your network then the treatment will be covered on direct billing (cashless). Moreover, for any emergency case insurance company must be informed within 24 hours via Email/Telephone etc. else there will be no reimbursement.

How do I understand the information mentioned on my card?

The information there is very simple and clear to understand, still for any further assistance you may contact your HR or dial the Helpline number mentioned on the backside of your card.

What does waiting period means?

For basic plans there is 6 months waiting period on Pre Existing and Chronic conditions, which means that for the first six months of the policy client can’t take any treatment pertaining to Pre Existing and Chronic Problems.

What is Pre Existing and Chronic Condition?

Any condition which lasts for the long-term Treatment is Chronic e.g. Hypertension, Diabetes etc. Any other critical condition which was present before the inception of the policy which however doesn’t last for the lifetime will fall under the Pre Existing Condition.

What is a complete reimbursement claim submission?

Detailed Medical Reports clearly specifying the Diagnosis, date of onset of disease, similar disease in the past . Previous & current treatment details including the prescribed medications, investigations and prognosis.

  • Original Itemized Invoices or receipts for the amount claimed (invoice must show cost per service).

  • Police Report /First-hand information report in case of accident related claims.
  • Copies of results of diagnostic tests
  • Referral Letter from the treating physician in case of prescribed physiotherapy
  • Valid Prescription from the treating physician for the prescribed medication
  • Discharge summary /Operative notes in case of Hospitalization or surgery.