Nextcare — Third Party Administrator (TPA)Processes claims for ADNIC, AXA & others

    Dental Clinics in Dubai that Accept Nextcare Insurance

    Nextcare is one of the UAE's largest Third Party Administrators — managing health insurance claims on behalf of ADNIC, AXA, and other UAE insurers. Find dental clinics in the Nextcare network, understand how TPA claims work, and learn how to use your Nextcare card to pay only your co-payment.

    Unsure how your plan compares to others? Read the dental insurance Dubai overview covering all five major insurers, what basic plans include, and how the claims process works.

    Direct billing and pre-auth, without the reception surprise

    A Nextcare-network clinic checks your card, underlying insurer, remaining AED dental cap, and co-pay in real time. Routine check-ups, cleaning, X-rays, fillings, and simple extractions usually direct bill on the day. Root canals, crowns, bridges, and surgical extractions need pre-authorisation first, and the clinic submits that request through the Nextcare portal.

    AED 500–1,500
    Annual cap (Basic)
    AED 2,000–4,000
    Annual cap (Standard)
    AED 4,000–7,000
    Annual cap (Enhanced)
    10–20%
    Co-pay (typical)

    Insurance plan-fit checklist

    Ask a verified clinic to confirm your NextCare plan before you book.

    Shortlist verified clinics by area and treatment, then confirm network status, direct billing, pre-authorisation, and your remaining dental limit before treatment starts.

    Card check

    Confirm your exact policy and network tier.

    Co-pay clarity

    Ask what is covered and what remains self-pay.

    Nearby options

    Shortlist clinics in the areas you actually visit.

    Ask clinics to confirm plan fit

    Confirm before treatment: clinic participation, direct billing, pre-authorisation, and remaining dental limits can vary by plan tier, branch, provider network, and treatment code. Ask the clinic and NextCare to verify your exact policy before you approve treatment.

    Patient confirming NextCare coverage at a Dubai dental clinic

    NextCare network check

    Confirm direct billing, dental sub-limit, and pre-auth needs with the clinic and insurer before treatment.

    Reviewed by Dentist Near Me Dubai Team · April 2026
    Quick Answer

    Nextcare is the UAE's largest third-party administrator (TPA), managing dental claims for multiple insurers including MetLife, Sukoon, and AXA. Nextcare-administered plans accept dental treatment at thousands of UAE network clinics via direct billing. Coverage terms depend on your underlying insurance plan, not Nextcare itself.

    • TPA — not an insurer; manages claims for MetLife, Sukoon, and others
    • Direct billing at all Nextcare-network clinics
    • Pre-auth submitted by your clinic through Nextcare portal
    • Check your plan's dental sub-limit (varies by insurer, AED 1,500–3,000)
    • Nextcare portal and app for claims tracking and provider search

    Who Are the Underlying Insurers Behind Nextcare?

    Nextcare administers claims for multiple UAE-licensed insurance companies. Your dental benefits are set by whichever insurer underwrites your policy.

    Nextcare is a TPA — not an insurer

    Nextcare processes your claims but does not underwrite your policy. Your actual insurance coverage — what's covered, annual limits, co-pay — is set by your underlying insurer (e.g., ADNIC or AXA). Check your policy schedule for exact dental benefits.

    Underlying InsurerNextcare's Role
    ADNIC (Abu Dhabi National Insurance)Primary underwriter for many Nextcare-managed plans
    AXA Insurance UAESome AXA group plans are administered by Nextcare
    Noor TakafulTakaful-compliant plans managed by Nextcare
    Other licensed UAE insurersNextcare administers claims on behalf of multiple carriers

    What Does Nextcare Dental Coverage Include?

    Coverage depends on your underlying insurer's plan. The below reflects typical Nextcare-administered plan dental benefits across ADNIC and AXA group plans.

    Typically Covered

    • Routine dental examination and X-rays (subject to underlying insurer plan)
    • Teeth cleaning and scale & polish
    • Basic composite and amalgam fillings
    • Simple tooth extractions
    • Emergency dental consultations
    • Root canal treatment (restorative plans, with pre-auth)
    • Dental crowns (restorative plans, with pre-auth)
    • Dental bridges (comprehensive plans, with pre-auth)
    • Partial dentures (where included in the underlying insurer plan)

    Typically NOT Covered

    • Dental implants (excluded across almost all Nextcare-administered plans)
    • Cosmetic veneers
    • Teeth whitening
    • Invisalign and clear aligner therapy
    • Orthodontics (unless medically necessary on specific plans)
    • Hollywood smile and cosmetic makeovers
    • Out-of-network treatment without prior approval

    See dental treatment costs in Dubai for out-of-pocket price ranges, or check how much dental implants cost in Dubai.

    Dental Clinics that Accept Nextcare

    Showing verified clinic profiles. Call ahead to confirm Nextcare acceptance for your underlying insurer.

    Ask verified clinics about Nextcare

    Use our search to find verified clinic profiles where you can ask about Nextcare near you.

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    How to Use Your Nextcare Card at a Dubai Dental Clinic

    A clear walkthrough — from choosing a clinic to paying only your co-pay.

    1

    Understand that Nextcare is a TPA, not an insurer

    Nextcare is a Third Party Administrator. They process your claims on behalf of your actual insurer (e.g., ADNIC, AXA, or another UAE insurer). Your dental benefits are defined by your underlying insurer's plan — not by Nextcare itself.

    2

    Find a Nextcare network dental clinic

    Nextcare maintains its own provider network portal at nextcarehealth.com. Use DentistNearMeDubai to also filter clinics that accept Nextcare, then verify directly with the clinic that they are registered in the Nextcare network for your specific insurer.

    3

    Present your Nextcare card at reception

    Show your Nextcare health card and Emirates ID at reception. The clinic scans your card and verifies eligibility, remaining dental balance, and pre-auth requirements via the Nextcare online portal in real time.

    4

    Pre-authorisation for major dental work

    Root canals, crowns, and bridges require prior authorisation from Nextcare/your underlying insurer. The clinic submits the request — Nextcare reviews it and responds within 1–2 working days. Never start major work without confirmed approval.

    5

    Pay your co-payment only

    Once authorised, the clinic submits the claim directly to Nextcare. You pay only your co-insurance amount — typically 10–20% of the approved claim. Keep your receipt as proof of payment.

    Typical Dental Plan Tiers — Nextcare Administered Plans

    Annual limits below are indicative for common ADNIC and AXA plans administered by Nextcare. Your actual limit depends on your employer's contract with the underlying insurer.

    Plan LevelAnnual Dental CapWhat's Covered
    Basic / PreventiveAED 500–1,500 / year (varies by underlying insurer)Check-ups, cleaning, basic fillings, simple extractions
    Standard / RestorativeAED 2,000–4,000 / yearAll Basic + root canals, crowns (pre-auth required)
    Comprehensive / EnhancedAED 4,000–7,000 / yearAll Standard + bridges, partial dentures, complex restorative
    Corporate ExecutiveEmployer-negotiated — can be higherMay include prosthodontics, limited orthodontic benefit

    Limits vary by underlying insurer and employer contract. Check with your HR department or call Nextcare on 800 NEXTCARE (6398 2273).

    Compare plans — see how Cigna, Daman, and Sukoon compare, or explore options for freelancers.

    Dental Procedures Covered by Category Under Nextcare Plans

    UAE dental insurance categorises procedures into four groups: preventive, basic restorative, major restorative, and orthodontic. Understanding these categories helps you assess your plan coverage and co-pay expectations.

    Preventive Care

    Usually no co-pay
    • Dental examination and diagnosis
    • Dental X-rays — periapical, bitewing, panoramic OPG
    • Professional scale and polish (prophylaxis) — 1–2x/year
    • Fluoride treatment (select plans)
    • Fissure sealants for children (select plans)

    Basic Restorative

    10–20% co-pay typical
    • Composite resin (tooth-coloured) fillings
    • Amalgam fillings
    • Simple tooth extractions
    • Emergency dental treatment
    • Temporary fillings and emergency relief

    Major Restorative

    20–40% co-pay — pre-auth required
    • Root canal treatment (Standard plan and above)
    • Dental crowns — PFM and zirconia (50–70% covered)
    • Dental bridges (Comprehensive plan only)
    • Partial dentures (where in plan schedule)
    • Surgical extractions

    Orthodontic (Rarely Covered)

    Usually excluded — verify your plan
    • Traditional metal braces (excluded standard plans)
    • Ceramic braces (excluded)
    • Invisalign / clear aligners (excluded)
    • Retainers (excluded — unless following covered ortho)
    • Lingual braces (excluded)

    Need orthodontic treatment? See our braces cost guide, Invisalign Dubai options, and ceramic braces in Dubai for self-pay pricing.

    Frequently Asked Questions

    What is Nextcare and is it the same as an insurance company?
    Nextcare is a Third Party Administrator (TPA) — a claims management company that processes insurance claims on behalf of actual insurance carriers such as ADNIC, AXA, and others. When you show your Nextcare card at a clinic, the clinic submits claims to Nextcare who then settles with your underlying insurer. Your actual dental coverage, annual limits, and exclusions are determined by your underlying insurer's plan — not by Nextcare itself. Think of Nextcare as the back-office processor: your insurer decides what is covered, and Nextcare handles the paperwork and payment logistics.
    How does the Nextcare claims process work for dental treatment in Dubai?
    When you visit a Nextcare-network dental clinic, the receptionist scans your Nextcare health card and verifies your eligibility in real time through the Nextcare provider portal. For routine treatments (checkups, fillings, cleaning), the clinic submits the claim directly to Nextcare and you pay only your co-payment — typically 10–20% of the approved amount. For major treatments requiring pre-authorisation (crowns, root canals, bridges), the clinic first submits a pre-auth request; once Nextcare approves it on behalf of your underlying insurer, treatment proceeds and the direct billing claim follows automatically.
    Does Nextcare cover dental implants in Dubai?
    Dental implants are excluded from virtually all Nextcare-administered insurance plans in the UAE. Implants are classified as cosmetic or elective procedures regardless of the underlying insurer. If you need implants, you will pay out of pocket — costs at quality Dubai clinics range from AED 6,000–12,000 per implant including the crown. See our full dental cost guide for detailed pricing. The only exception would be a highly specialised medical-necessity case (e.g., implant following jaw trauma), which would require a written pre-auth request and is rarely approved.
    How do I find dental clinics in Dubai that are in the Nextcare network?
    You can search the official Nextcare provider directory at nextcarehealth.com — select 'Dental' as the speciality and 'Dubai' as the emirate. On DentistNearMeDubai, filter by 'Nextcare' insurance to find verified clinics in the network. Always call the clinic to confirm they are registered for your specific underlying insurer (e.g., ADNIC, AXA) as some clinics are in the Nextcare network only for selected insurers. Nextcare updates its provider directory regularly, so verifying by phone before your visit is always the safest approach.
    Do I need pre-authorisation for a root canal with Nextcare?
    Yes — root canal treatment under Nextcare-administered plans (Standard tier and above) requires prior authorisation. Your in-network clinic submits a pre-auth request to Nextcare with X-rays and clinical justification. Nextcare processes the request on behalf of your underlying insurer, typically within 1–2 working days. Starting treatment without authorisation on an eligible plan is grounds for claim rejection, meaning you would be liable for the full treatment cost. Never allow a clinic to begin root canal treatment without confirmed written approval from Nextcare.
    Which insurers use Nextcare as their TPA in the UAE?
    Nextcare administers claims for multiple UAE-licensed insurance carriers including ADNIC (Abu Dhabi National Insurance Company), AXA Insurance UAE (some group plans), Noor Takaful, and several other licensed UAE insurers. Your Nextcare health card will typically show your underlying insurer's name alongside the Nextcare TPA branding. If you are unsure which insurer backs your plan, check your employee benefits documentation, call your HR department, or log into the Nextcare member portal at nextcarehealth.com to view your plan details.
    What is the Nextcare online portal and what can I use it for?
    The Nextcare member portal at nextcarehealth.com allows you to check your remaining annual dental benefit balance, view your claims history and payment status, search for in-network providers by specialty and location, download your policy details and certificate of insurance, and submit or track pre-authorisation requests. The Nextcare mobile app provides the same functionality on iOS and Android. Checking your dental balance before booking major treatment is strongly recommended so you know how much coverage remains before committing to expensive procedures.
    What happens if I visit a dentist that is not in the Nextcare network?
    If you visit a dental clinic that is not registered in the Nextcare network, you will pay the full treatment cost upfront. You can then submit a reimbursement claim directly to your underlying insurer (not to Nextcare — Nextcare processes in-network direct billing claims only). Reimbursement is processed at your insurer's scheduled fee, which may be significantly less than a premium out-of-network clinic charges. Out-of-network reimbursement claims must typically be submitted within 90 days of treatment with original itemised invoices and your member ID.
    What is my co-payment (co-pay) under a Nextcare-administered plan?
    Co-payment under Nextcare-administered dental plans is typically set by the underlying insurer and ranges from 10% to 20% of the approved claim amount. For example, if your underlying plan covers a dental crown at AED 2,000 (the insurer's scheduled rate), you would pay AED 200–400 as co-insurance while Nextcare settles the remaining AED 1,600–1,800 with the clinic. Your specific co-insurance percentage is stated in your Certificate of Insurance. Some employer plans have a 0% co-pay for preventive care (checkups and cleaning) while applying 20% to restorative treatments.
    My Nextcare claim was rejected — what should I do?
    If a Nextcare dental claim is rejected, first request a written rejection notice from the clinic or contact Nextcare directly at 800-NEXTCARE (800-6398273) to understand the specific reason. Common rejection reasons include treatment without required pre-authorisation, visiting an out-of-network provider, exceeding the annual dental benefit limit, or requesting a procedure that is excluded from your underlying plan. If you believe the rejection is incorrect, you have the right to file a formal appeal with your underlying insurer. Provide all relevant documentation including clinical notes, X-rays, and the rejection notice. Appeals must typically be submitted within 30 days of the rejection.
    How is Nextcare different from direct insurance in the UAE?
    When you have direct insurance (e.g., Daman, Cigna, Bupa), you deal directly with the insurer for claims, pre-authorisation, and disputes. With Nextcare, you are dealing with a TPA that sits between you and your actual insurer. Day-to-day operations — card verification, direct billing, pre-auth submission — go through Nextcare's systems, but coverage decisions are ultimately made by the underlying insurer. The practical difference for patients is minimal: present your card at the clinic and Nextcare handles the rest. The key thing to remember is that if you have a dispute about what is or is not covered, the final authority is your underlying insurer, not Nextcare.
    Do different Nextcare-administered plans offer different dental benefits?
    Yes — dental benefits vary significantly depending on which underlying insurer has issued your plan and which plan tier your employer has selected. A basic Nextcare-administered plan from ADNIC might offer AED 500–1,500 per year for preventive care only, while a comprehensive plan from AXA administered through Nextcare might offer AED 4,000–7,000 per year with root canal and crown coverage. The Nextcare TPA does not set the benefits — your insurer does. Always refer to your Certificate of Insurance or call your HR department to understand exactly what dental treatments your specific plan covers.
    How do I contact Nextcare customer service for dental queries?
    Nextcare customer service is available 24/7 via phone at 800-NEXTCARE (800-6398273) in the UAE. For pre-authorisation queries, your in-network dental clinic handles submission through the Nextcare provider portal — you generally do not need to call Nextcare yourself for pre-auth. For reimbursement claim status, benefit balance enquiries, and provider network queries, call the helpline or use the Nextcare member portal at nextcarehealth.com. For corporate and employer enquiries, there is a separate business line. Always have your Nextcare member ID ready when calling.
    Does Nextcare cover teeth cleaning and check-ups without pre-authorisation?
    Yes — routine dental check-ups, scale and polish (teeth cleaning), and dental X-rays (periapical and bitewing) are typically covered without pre-authorisation at Nextcare-network clinics, provided your annual dental benefit has not been exhausted. These preventive treatments are processed via direct billing: the clinic verifies your card, submits the claim electronically, and you pay only the co-insurance. The frequency allowance (e.g., cleaning twice per year) is set by your underlying insurer. Always confirm your remaining dental balance before booking a second cleaning in the same plan year.
    Is Nextcare TPA the same as Nextcare Health?
    Yes — Nextcare Health is the brand name used by Nextcare (the TPA company), operating under the parent group International SOS in the UAE. The official brand is Nextcare, which you will see on health cards, the provider portal at nextcarehealth.com, and communications. Nextcare Health is not an insurance company — it is the TPA arm that administers claims, verifies eligibility, and manages the provider network for insurers that have contracted Nextcare as their claims management partner. Whether your card says Nextcare or Nextcare Health, the process for using your dental benefits at a network clinic is identical.
    What is the annual dental sub-limit on Nextcare-administered plans?
    Annual dental sub-limits on Nextcare-administered plans vary widely based on the underlying insurer and plan tier. Basic plans typically cover AED 500–1,500 per year for preventive care only. Standard restorative plans cover AED 2,000–4,000 per year including root canals and crowns with pre-auth. Comprehensive or enhanced plans may cover AED 4,000–7,000 per year with broader restorative benefits. Corporate executive plans can exceed this depending on the employer's negotiated benefit schedule. Your specific sub-limit is documented in your Certificate of Insurance. Use the Nextcare member portal to check your remaining balance in real time throughout the year.

    Pre-Authorisation for Dental Treatment Under Nextcare

    Pre-authorisation (pre-auth) is a mandatory approval process for major dental procedures. Your in-network clinic submits the request — you do not file it yourself.

    ProcedurePre-Auth Required?Typical Timeline
    Consultation and examinationNoInstant — direct billing
    Dental X-rays (periapical, bitewing)NoInstant — direct billing
    Scale and polish (prophylaxis)NoInstant — direct billing
    Composite fillingsNoInstant — direct billing
    Simple tooth extractionNo (usually)Same day at clinic
    Root canal treatmentYes1–2 working days
    Dental crown (PFM or zirconia)Yes1–2 working days
    Dental bridgeYes2–3 working days
    Surgical extractionYes1–2 working days
    Partial dentureYes (if on plan)2–3 working days

    Never start major work without written approval

    If your clinic begins a crown or root canal without pre-auth from Nextcare or your underlying insurer, the claim will be rejected. You will be responsible for 100% of the treatment cost. Always confirm authorisation has been received before any major procedure begins.

    Emergency Dental Coverage Under Nextcare Plans

    Emergency dental situations are typically covered without pre-authorisation, even for procedures that would normally require prior approval. Here is what Nextcare-administered plans typically cover in emergencies.

    Covered in a Dental Emergency

    • Acute toothache requiring immediate intervention
    • Dental abscess drainage and antibiotic prescription
    • Emergency extraction of fractured or non-restorable tooth
    • Trauma — knocked-out or cracked tooth from injury
    • Severe gum infection (acute pericoronitis)
    • Broken filling or crown causing pain or sharp edges
    • Emergency temporary restoration to relieve pain

    Important Notes on Emergency Claims

    • 1.Visit an in-network clinic even in an emergency wherever possible — out-of-network emergency treatment is reimbursed at a lower rate, often 60–70% of the Nextcare schedule fee.
    • 2.Emergency treatment covers the immediate intervention only. Follow-up restorative work (e.g., crown after emergency root canal) still requires standard pre-authorisation.
    • 3.Keep all clinical documents, X-rays, and itemised receipts — these are required for any reimbursement claims on emergency out-of-network treatment.
    • 4.For same-day emergency care see our emergency dentist Dubai guide with clinics offering walk-in appointments.

    How to Find a Nextcare Network Dental Clinic in Dubai

    The Nextcare provider network spans hundreds of clinics across Dubai and the wider UAE. There are several ways to find an approved in-network clinic.

    🌐

    Nextcare Provider Portal

    Visit nextcarehealth.com and use the Find a Provider search, filtering by dental specialty and your city or area.

    🔍

    DentistNearMeDubai Filter

    Use the insurance filter on our browse page to find verified clinics that accept Nextcare, then read reviews and compare.

    📞

    Call Nextcare Directly

    Call Nextcare on 800 NEXTCARE (800 6398 2273) to speak to a customer service agent who can confirm which clinics accept your specific underlying insurer.

    📋

    Call Your Clinic First

    Always call ahead and confirm the clinic is in the Nextcare network for your underlying insurer (e.g., ADNIC, AXA). Some clinics are in the network for only selected insurers.

    🏢

    HR Department

    Your HR department or benefits administrator may have a pre-approved list of dental clinics that have worked well for your company plan.

    📍

    Network Areas

    Nextcare has strong network coverage in JLT, Dubai Marina, Business Bay, DIFC, Deira, Bur Dubai, and most major residential areas across Dubai.

    Nextcare vs Other UAE Dental Insurance Options

    Nextcare is a TPA — so comparing it directly with insurers requires comparing the underlying insurer plans. Here is how ADNIC (a major Nextcare-administered insurer) stacks up against other UAE dental insurers.

    Insurer / PlanAnnual Dental CapImplantsNetwork Size
    ADNIC via Nextcare (TPA)AED 500–7,000 (plan-dependent)Not coveredVery wide — UAE-wide
    Daman (Smart Care)AED 1,000–5,000Not coveredLargest UAE network
    AXA Insurance UAEAED 1,500–20,000Not coveredLarge employer network
    Sukoon (formerly Oman Insurance)AED 3,000–7,000Not coveredGood Dubai coverage
    Cigna Global (international)USD 1,500–5,000+Some plans includeInternational + UAE

    For full insurer guides, see: Daman, AXA, Sukoon, Cigna, Bupa.

    Tips to Maximise Your Nextcare Dental Benefits

    Simple strategies to get the most value from your Nextcare-administered dental plan each year.

    1

    Use your cleaning allowance every year

    Most Nextcare plans allow 1–2 scale and polish sessions annually. These are typically pre-authorisation free. Book both sessions — a professional cleaning prevents expensive restorative treatment later and costs you nothing on a Standard or above plan.

    2

    Book a check-up in January, not December

    Annual dental caps reset at the start of your policy year — usually 1 January or your employment anniversary. If you are approaching your annual limit in November–December, wait until your new policy year begins before starting non-emergency work, to access a fresh annual maximum.

    3

    Confirm your underlying insurer at every new clinic

    When switching clinics, always call ahead with both your Nextcare card details AND your underlying insurer name (e.g., ADNIC, AXA). Some clinics are in the Nextcare network only for specific underlying insurers. Assuming coverage without confirmation risks a full out-of-pocket bill.

    4

    Request pre-auth as soon as a crown or RCT is diagnosed

    Pre-authorisation for crowns and root canals takes 1–2 working days. Ask your dentist to submit the pre-auth request at the diagnosis appointment so treatment can begin at your next visit without delay.

    5

    Keep copies of all clinical documents

    If your direct billing claim has any issue, you will need original itemised invoices, X-rays, and treatment notes. Ask your clinic for a printed or emailed copy of all documentation at every visit — not just when you think there might be a problem.

    6

    Prioritise in-network clinics for significant treatment

    For straightforward cleanings and fillings, any licensed clinic will do. But for crowns, root canals, or bridges costing AED 2,000–8,000, the difference between in-network direct billing (you pay 10–20% co-pay) and out-of-network reimbursement (you pay 100% upfront and wait for partial refund) is significant. Always use an in-network clinic for major work.

    What Is Excluded From Nextcare Dental Insurance in Dubai

    Understanding exclusions prevents claim rejections. These treatments are not covered under standard Nextcare-administered plans regardless of the underlying insurer.

    Excluded TreatmentWhy ExcludedTypical Out-of-Pocket Cost
    Dental implantsClassified as elective prosthetic — not medically necessaryAED 5,500–12,000 per implant
    Teeth whitening (in-clinic or take-home)Cosmetic only — no medical indicationAED 800–2,500 per session
    Porcelain veneersPurely cosmetic restorationAED 1,500–4,000 per veneer
    Invisalign and clear alignersOrthodontic/cosmetic — excluded on most UAE group plansAED 12,000–25,000 full treatment
    Hollywood smile packagesCosmetic makeover — no clinical needAED 15,000–45,000
    Orthodontic braces (standard plans)Not medically necessary unless malocclusion is severeAED 8,000–18,000 full treatment
    Implant-supported overdenturesContains implant component — excludedAED 20,000–60,000

    Need to budget for excluded treatments? Our 2026 dental cost guide covers full price ranges for every treatment in Dubai. For implants specifically, see dental implant costs in Dubai. For cosmetic work, explore smile makeover options and dental veneers.

    Find a Nextcare Network Dentist in Dubai

    Use our locate a dental clinic nearby to compare clinics, read reviews, and book appointments.

    Browse verified clinic profiles, then ask each clinic to confirm your exact Nextcare plan, network tier, and billing route before you book.

    Also see other insurance providers:

    Understanding Nextcare as a TPA — Key Differences from Direct Insurers

    Many Dubai residents are confused by the TPA model. Here is a clear comparison between Nextcare as a TPA versus dealing with an insurer directly.

    AspectNextcare (TPA Model)Direct Insurer (e.g., Daman, AXA)
    Who manages your claimNextcare processes claims on behalf of your actual insurer (ADNIC, AXA)Insurer processes claims directly
    Who sets dental benefitsYour underlying insurer (ADNIC, AXA) sets benefits — not NextcareInsurer sets all benefit details
    Card brandingCard may show Nextcare + underlying insurer nameCard shows insurer name only
    Who to call for disputesContact both Nextcare AND your underlying insurer for escalationsContact insurer directly
    Network verificationVerify clinic is in Nextcare network for your underlying insurerVerify clinic is in insurer network
    Pre-auth submissionsClinic submits pre-auth to Nextcare portal; Nextcare reviews for underlying insurerClinic submits directly to insurer portal
    Annual cap authorityAnnual cap is set by your underlying insurer — Nextcare tracks usageInsurer sets and tracks annual cap

    Bottom line for dental visits

    At the clinic, the process is identical whether your card shows Nextcare or a direct insurer name. Present your card and Emirates ID — the clinic verifies coverage through the Nextcare portal and bills accordingly. The TPA distinction only matters when you need to appeal a rejection or escalate a coverage dispute.

    How to Submit a Reimbursement Claim to Nextcare

    If you visit a dental clinic outside the Nextcare network, you pay upfront and file a reimbursement claim. Here is the process.

    1

    Collect all clinical documentation at the clinic

    Before leaving the dental clinic, obtain: an original itemised invoice (not a summary receipt) listing each procedure code, clinical notes and diagnosis documentation, all X-rays taken during your visit, and a copy of any prescription. Out-of-network reimbursement claims that lack clinical documentation are rejected.

    2

    Download the Nextcare reimbursement claim form

    Visit nextcarehealth.com and download the reimbursement claim form for your underlying insurer. Some claims can now be submitted via the Nextcare mobile app. Complete all sections accurately — member ID, policy number, date of treatment, clinic details, and procedure codes.

    3

    Attach proof of payment

    Attach your credit card statement or bank transfer proof alongside the itemised invoice. The reimbursement claim cannot be processed without evidence that you personally paid the full amount. Personal cheques or cash payment proofs are also accepted.

    4

    Submit within the deadline

    Most Nextcare-administered plans require reimbursement claims to be submitted within 90 days of treatment. Late submissions are rejected. If you are unsure of your submission deadline, call Nextcare on 800 NEXTCARE (800 6398 2273) before submitting.

    5

    Track your claim status

    After submission, track your claim status on the Nextcare portal or app. Nextcare typically processes reimbursement claims within 14–21 working days. If approved, reimbursement is credited to your registered bank account at the schedule fee rate — which may be lower than the premium clinic's actual charge.

    For the full picture on how the claim process works in Dubai, read our dental insurance guide for Dubai. For freelancers without employer coverage, see our freelancer dental insurance guide.

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