Abu Dhabi: Expat cancer patients in Abu Dhabi are hit hard as most insurance firms do not have direct billing agreements with Shaikh Khalifa Medical City.
Patients have to pay huge sums for their treatment at the sole cancer treatment facility in the capital from their own pockets before seeking reimbursement from their insurance firms.
Besides coping with the killer disease, many patients fall into debt traps due to maxing of credit cards and loans to fund treatment till hospital bills are reimbursed — a process that can take three months or more, XPRESS has learnt.
Credit cards
An Indian father whose one and a half year old daughter was diagnosed with leukemia, said he is meeting hefty treatment bills at SKMC through credit cards.
“I have an AXA Star insurance coverage provided by my employer. But the hospital does not have a Guarantee of Payment (GoP) arrangement with the insurance provider. Hence I have to pay from my pocket every time I take my daughter to the hospital,” Hareesh Madhavan (name changed on request), an engineer based in Abu Dhabi told XPRESS.
Madhavan has to shell out Dh15,000 to Dh30,000 a month for his daughter’s treatment. His child was diagnosed with leukemia when she was just six months old.
“The cost is beyond my reach. Despite having health insurance coverage, I have no alternative but pay by credit card. I am juggling my finances by paying monthly credit card bills till my bills get cleared,” said Madhavan.
Another patient, an Indian expat who is being treated for bone marrow cancer at the same hospital, said he is in a similar financial crisis. His medical insurance card provided by ADNIC (Abu Dhabi National Insurance Company) has similar restrictions on direct billing and GoP.
“My nephew was referred to SKMC from NMC Hospital after they diagnosed him with cancer. We were totally unprepared for this huge financial burden as his monthly salary is only Dh12,500,” said the patient’s relative on condition of anonymity.
The family said they have taken a person loan of Dh100,000 to meet any medical emergency.
Guarantee of payment
XPRESS approached at least five insurance companies but none came forward to comment on why GoP cannot be offered in cases of chronic illness.
GoP is a system in which patients get prior approval from insurance companies after an estimated treatment cost is worked out with the hospital. That way, their treatment expenses are billed to the insurance company directly and there is no need of self pay.
One provider who asked not be named said it is ultimately the responsibility of the employer to provide comprehensive insurance coverage to their employees. ‘Many companies opt for basic coverage schemes. Premium cards of most insurance companies are accepted in SKMC and other hospitals,” said the official who represents one of the leading insurance providers in the market.
SKMC, which operates under the Abu Dhabi Health Authority, is a government medical facility that offers free treatment for Emiratis. Expatriates can obtain treatment in an emergency or when they are medically referred in cases where specialist treatment is not available in other private hospitals.
In all other cases they have to foot the bill.
As most expats in Abu Dhabi have mandatory health insurance provided by their employers since 2006, treatment costs are covered. But most patients with critical ailments like cancer who are referred to SKMC find themselves in a financial quandary when their medical insurance cards are not accepted by the government hospital.
Reimbursement
Reimbursement is also not a cakewalk for patients.
“After receiving the treatment invoice, I have to fill up the reimbursement form, go back to the doctor for his signature, and submit it to my office. They will send it to the insurance company, and many times bills get held up or claims rejected for silly reasons,” said Madhavan.
Patients say they have to provide for their treatment for at least two to three months, any given time, which is almost impossible as the estimated treatment costs running into thousands of dirhams are way beyond their monthly income.
There was no immediate comment from SKMC, but reliable sources at the hospital told XPRESS that most health insurance cards are accepted at SKMC as long as they offer premium coverage.
“We accept many cards like AXA Star Seha, CN SEHA and GN SEHA cards, and Premium and Corporate cards from Oman Insurance, just to name a few,” said the source.
Expatriate patients who don’t have premium coverage can avoid the financial burden of self-pay if their employer submits a GoP letter to the hospital with a validity period of six months or more.
“Then we will be billing the company directly, and they can easily negotiate and get reimbursement from the insurance provider,” said the source.
Patients are demanding that insurance companies and hospitals agree on a GoP for patients with critical ailments like cancer. “Without GoP, the very purpose of having medical insurance coverage is defeated as we are running helter skelter to arrange cash when we have a heath insurance card in our pocket,” said a cancer patient at SKMC.
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