Aetna International has you covered
The health care system in Qatar is evolving and it’s moving the country towards a healthier population. With this growth and quality improvement comes the opportunity for us to deliver an even better care experience for residents in Qatar.
That’s why, as part of our enhanced global service strategy, we’re introducing our new locally compliant, Qatar Primecare supplemental plan. This health care benefits solution means members living in Qatar will be covered in all the right ways, whenever new regulations go into effect.
The plan is issued and insured through Qatar General Insurance and administered by GlobeMed Qatar. It’s designed to give members access to a broad provider network and a better experience when they need care in Qatar and includes:
- 100% coverage for care*
- Access to a wide network of more than 450 local providers
- 24/7 call centers for quicker service and safer outcomes
- In-person help in field offices at major hospitals across Qatar
- State-of-the-art digital tools to manage benefits from anywhere
Check out the FAQs below, for more details on what to expect, what's changing and what's staying the same.
*100% coverage applies to covered benefits only and includes no deductible, no copay and no coinsurance for care received outside of the U.S. and U.S. Territories.
Answers to frequently asked questions (FAQs)
Here’s what to know to help make this transition as smooth as possible.
Why is this plan change happening for coverage in Qatar?
We’ve been watching the changes in regulations and the health care system in Qatar. And we’re proactively rolling out a coverage solution for our members living in Qatar in anticipation of the Ministry of Public Health’s (MoPH) mandatory health insurance requirements. Aetna International will be partnering with one of the top-rated Qatari insurers, Qatar General Insurance (QGI) and providing expanded access to care through GlobeMed. This change is part of our broader global service delivery model to deliver health care benefits that meet all local regulations and mandates in Qatar. It will ensure members’ direct pay experience and access to care continues with minimal disruption.
When will this plan change take effect?
All new and renewing groups and members will start to transition to the Qatar Primecare plan for coverage in Qatar in Q1 2024. The plan is issued and insured through Qatar General Insurance and administered by GlobeMed Qatar.
Why was Qatar General Insurance selected for this solution in Qatar?
This strategic partnership makes sure our customers and members in Qatar will continue to have access to the quality health and wellness benefits and broad network of providers they expect from Aetna International. It’s important that we collaborate with those with shared values based in integrity, quality and best-in-class member experience.
- Qatar General Insurance will function as the local insurer to deliver local administration and compliance support. With 44 years of industry experience in Qatar, they’ll contribute a deep understanding of the region’s network capabilities and provide an established, local presence across three branches.
- GlobeMed is the largest Third-Party Administrator (TPA) in Qatar with a local presence since 2007. They bring over 32 years of industry experience in the Middle East and North Africa (MENA) region. As a fully-fledged operation with over fifty dedicated employees, GlobeMed Qatar’s broad local footprint delivers access to health care that’s backed with strong provider relationships that come with network discounts.
Will there be any changes to network provider access?
With over 450 direct pay providers in Qatar, changes to network access should be minimal. As the second largest network in the Qatari market, members will also benefit from GlobeMed’s pre-negotiated network discounts on services. The network includes hospitals, pharmacies, laboratories, radiology centers, doctors, dental clinics, polyclinics and optical clinics.
What are the differences between included plan features and coverage limits under the new plan?
The Qatar Primecare plan will match the coverage and benefits members currently have including, medical, dental, vision care and prescriptions. For a detailed list, refer to the Table of Benefits. Members will continue to keep their same Aetna International global coverage for when care outside of Qatar is needed.
How can members manage their benefits and find doctors in Qatar?
Member can download and use the GlobeMed FIT mobile app to:
- See policy details and plan information
- Find the nearest in-network doctors and facilities
- View and show their QGI-GlobeMed cobranded digital ID card when accessing care
- Submit chronic prescription refills and pre-approval requests
- Manage claims and reimbursement
- Access self-service digital wellness tools — anytime, anywhere!
Will members receive a separate member ID card for use in Qatar?
Yes. Members on the Qatar Primecare plan will receive a new cobranded, QGI-GlobeMed physical ID card that can be used to access services at in-network providers in Qatar. Details on understanding the member ID card can be found on page 3 of the welcome guide. Once enrolled, access to the cobranded, digital ID card will also be available through the GlobeMed FIT mobile app. Members will keep and continue to use their physical/digital Aetna International member ID card when accessing care outside of Qatar.
How will claims work with the new supplemental plan in Qatar?
With a wide local network of more than 450 providers in Qatar and 100% coverage for care most members won't need to submit claims for reimbursement. 100% coverage applies to covered benefits only and includes no deductible, no copay and no coinsurance. However, when a member does need to make a claim they can use the streamlined submission process on the GlobeMed FIT mobile app. The online process will guide members through the information needed to make the claim. Once all relevant information is provided and complete — most member-submitted claims are processed within ten working days. Claims can also be submitted by emailing customercare@globemedqatar.com.
Will members need to request preauthorization for care in Qatar?
No, preauthorization is not required for reimbursement of claims. All claims will be evaluated based on the documents provided and payment will be based on the policy terms and condition.
How will claim reimbursement for member paid claims incurred in Qatar be managed?
- Prior to enrollment in the Primecare plan, members can continue to submit all claims for services incurred in Qatar to Aetna International through their member website at AetnaInternational.com. Claims can be submitted for reimbursement within six months of the date of service.
- Claims that are still in process after the new plan effective date will still be managed by Aetna International.
- All new reimbursement claims incurred in Qatar on or after the new plan effective date can be submitted to GlobeMed Qatar through the GlobeMed FIT mobile app.
How will transition of care be managed if a GOP was received prior to enrollment in the new plan for a procedure taking place after the new plan goes into effect?
Members ill continue to use the same provider(s) for care associated with a GOP received prior to enrollment in the new plan. If treatment is ongoing and will be needed long-term, those will be addressed on a case-by-case basis.
Who should members contact with questions?
Member services can help with benefits questions and more
Prior to renewal
Contact Aetna International Member Services
Phone: +1-800-231-7729
Email: aiservice@aetna.com
After moving to the Qatar Primecare plan
Contact GlobeMed Qatar
Phone: +974-4405-6999
Email: customercare@globemedqatar.com
Does this new plan impact a member’s health coverage outside of Qatar?
No, this change is only to coverage in Qatar. Non-Qatar global plan is staying the same. That means members will still use their existing Aetna International member ID card and ID number for care outside of Qatar. They’ll log into the same member website at AetnaInternational.com and use the same Aetna International mobile app to find doctors, view plan documents submit and track claims. For Member Services support outside of Qatar, members can call the number on their Aetna International ID card.
Plans and programs are underwritten or administered by Aetna Life & Casualty (Bermuda) Ltd. or Aetna Life Insurance Company (Aetna). The insurer is Qatar General Insurance & Reinsurance Company Q.P.S.C - Al Asmakh St, Doha, Qatar.
The Information in this material is being designed to provide as guidance to the insured as detailed in the policy and does not purport to show full terms and conditions of coverage nor vary them in any way. The terms and conditions of the insurance policy shall prevail in the event of any inconsistency between this material and the policy.
Aetna does not provide care or guarantee access to health services. Not all health services are covered, and coverage is subject to applicable laws and regulations, including economic and trade sanctions. Information is believed to be accurate as of the production date; however, it is subject to change.
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