Herbal Supplements

For Members

Nextcare coverage for herbal medications can vary significantly depending on the specific insurance plan, the country, and the regulations governing health insurance providers. Generally, herbal medications are less commonly covered than traditional pharmaceuticals. However, there are cases where coverage might be possible, typically under certain conditions:

1. 1- Medical Necessity: The herbal medication must be deemed medically necessary by a healthcare provider. This often requires documentation or evidence that traditional medications are ineffective or unsuitable for the patient.

1. 2- Prescription Requirement: Some insurance plans may cover herbal medications if they are prescribed by a licensed healthcare physician.

1. 3- Evidence-Based Support: The herbal medication should have sufficient clinical evidence supporting its efficacy and safety for the condition being treated. This might involve peer-reviewed studies or endorsements by recognized health organizations.

1. 4- Cost-Effectiveness: Practice-based evidence can sometimes demonstrate that herbal treatments offer a cost-effective alternative to conventional medications, which might influence coverage decisions.

1. 5- Regulatory Approval: In some regions, herbal medications that are approved or recognized by health authorities (such as the FDA in the United States or EMA in Europe) may be eligible for coverage.

1. 6- Plan-Specific Coverage: Certain health insurance plans may offer specific coverage for alternative or complementary therapies, including herbal medications. This is more common in plans that emphasize holistic or integrative health approaches.

1. 7- Safety Profile: Real-world data on the safety and side effects of herbal medications can be crucial in determining their eligibility for coverage. Below are the list of herbal medications that are covered by Nextcare UAE:

For Healthcare Providers

• All types of herbal preparations require Pre-Authorization from Nextcare.
• In case of rejection, the reasons for herbal supplements/medicines will be:
  • M009: Prescribed medicines not covered as per policy
  • NCOV-003: Service(s) is (are) not covered
  • NCOV-027: Non Coverage of certain medication as per policy