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The National Health Insurance Company (NHIC) has announced that dental services will be covered from today under Seha – the National Health Insurance Scheme. |
All Qataris covered by the Seha scheme can now get the full range of medically-necessary dental treatments at a large number of hospitals, clinics and specialised dental centres within the authorised provider network.
All basic dental services and emergency treatments are fully covered within the Seha provider network and do not require any co-payments from members.
However, a small number of specified procedures require prior authorisation by NHIC and a second opinion from a member of the Panel of Experts nominated by the Qatar Council of Health Practitioners.
These treatments include indirect veneers, tooth implants, and orthodontic procedures. If, based on the international expert guidelines, the treatment in question is medically necessary, then it is fully covered without any co-payments.
In cases where a treatment is medically necessary but an equally effective yet lower-cost alternative exists, members are free to choose the higher-cost treatment, provided this is not for cosmetic purposes.
Lower-cost treatments will be covered in full by Seha in such cases.
Should a member select a higher-cost procedure, Seha will cover such treatments up to a total of QR5,000 per year. Treatments above this limit will be subject to a 10% member co-payment for amounts above QR5,000. Purely cosmetic procedures and teeth whitening are not covered by Seha.
Seha members are able to access dental treatment at all network providers with dental clinics, which include Al Ahli Hospital, Al Emadi Hospital, Al Esraa Medical Centre, Doha Clinic Hospital, Al Hayat Medical Centre, Al Jazeera Medical Centre, Apollo Clinic, Atlas Medical Centre, Atlas Polyclinic, Bin Muftah Medical Centre, Future Dental Centre, Future Medical Center and Ocean Medical Centre.
A number of specialised dental clinics have been added to the Seha network, giving members more choice when seeking dental treatment. These are three branches of the Gulf Dental Centre and four branches of Madina Dental Centre in addition to Teba Specialised Dental Centre, Dr Marwan Kalla Dental Centre, Doha Specialised Dental Centre and Najat Dental Centre.
Members may also visit three new providers that have joined the Seha network – Al Shefa Polyclinic, Al Salam Medical Polyclinic Centre and Al Shorook Medical Centre – to access both dental treatment and broader healthcare services.
Additional providers, both specialised dental clinics and broader health clinics, will be added to the Seha network over the coming days and weeks, including Magrabi Eye, Ear and Dental Centre which is scheduled to join the network on July 1, 2014. A full list of service providers is available at www.seha.qa.
Hamad Medical Corporation and Primary Health Care Corporation facilities will not offer dental services under the Seha health insurance scheme at this point in time although patients may still seek treatment these providers using the HMC health card.
“Our aim is to provide Seha beneficiaries access to the best possible healthcare services, of which dental forms an important component. We have developed Seha’s dental coverage based on best practices from around the world with a comprehensive set of services included within the scheme,” explained Dr Faleh Mohamed Hussain Ali, acting CEO of the NHIC.
Currently in its second stage, Seha provides Qatari nationals with comprehensive health insurance coverage for the full range of basic health services and forms a key component of the National Health Strategy 2011-2016 and the nation’s longer-term development goals as set out under the Qatar National Vision 2030.
Coverage includes both in-patient and out-patient services through a quality network of public and private providers, including, in addition to dental, preventative care, emergency treatment, physiotherapy, occupational therapy, speech therapy, long-term care, radiology, ophthalmology, laboratory testing and prescription medicines.
Qatari nationals who wish to use Seha’s services need only to present their Qatar ID when visiting a network provider and, during their first visit, provide details of their residential address. The address details can be found on the plate installed by the Centre for Geographical Information System (CGIS) on all buildings across the country.
Information and updates about Seha and the Seha provider network are available at www.seha.qa and through social media at facebook.com/SehaQatar and twitter.com/SehaQatar.
Members can also contact the Seha call centre on 4020-8444 or visit the customer contact centre on the sixth floor of Amwal Tower in West Bay.
