For insurers and TPAs
Insured is not the same as cared for.
medicAI puts a licensed doctor at the first step of care, inside your network, tariffs and approvals. Members get care they actually use. You get a report on every case.
UAE health insurance, in four numbers
AED 36.4bn
health premiums written in 2025
+15.1%
growth in health claims in 2025
75.3%
market health loss ratio in 2025
11%
expected medical cost trend for 2026
Sources: CBUAE insurance statistics 2025; Aon Global Medical Trend Rates 2026.
How it fits
Built to sit inside your rules, not around them.
Pay per consultation
A fee for each consultation enabled. No annual platform fee, and nothing built into the premium.
Your panel, your choice
You decide which providers and specialties your members see, plan by plan.
Your tariffs, your TPA
Providers bill your TPA at contracted rates. Approvals, claims and payments stay where they are today.
Licensed where the member is
Members in Dubai see DHA licensed facilities. Members in Abu Dhabi see DoH licensed facilities and pharmacies.
Every case visible
Route, cost and outcome for each case, with a live view of active and completed cases.
Measured, not promised
Monthly utilisation reviews and quarterly claims reviews, on clean data, ahead of each renewal.
Members book the same care as everyone on medicAI: video consultations, specialists, home lab tests, pharmacy delivery and wellness. Corporate clients can run their own programme through the employer portal.
The insurer portal
Your plans, your clients, one view.
Set what each plan includes, link your corporate clients and follow how care is used, in a portal built for insurers and TPAs.
Decide what each plan includes.
Switch each medicAI service on or off, plan by plan. Members only see what their plan covers.
- A benefit matrix for every service
- Changes apply to members straight away
- Second opinion credits set per plan
| Service | Basic | Plus | Premier |
|---|---|---|---|
| Video consultations | |||
| Specialists | |||
| Home lab tests | |||
| Pharmacy delivery | |||
| Wellness and IV drips | |||
| Second opinion | |||
| Health score and rewards |
Press a cell to include or remove a service. 15 services switched on across three plans.
Why the first step matters
What a lower outpatient bill is worth.
Outpatient care is where most avoidable cost enters. Small shifts at the first step move whole points of loss ratio.
- 60%+of primary care cases resolved by video across three corporate pilots
- 2.5xmore preventive checkups among heart failure patients
Source: medicAI programme data.
Claims saved a year
AED 2.4M
Loss ratio
75% to 72.6%
2.4 points lower
Illustrative only, not a forecast. We calibrate it on your own claims data during the pilot.
How we start
A six-month pilot, measured against your own book.
- Weeks 1 to 3
Set it up on your rules
We map your network, tariffs, specialties and TPA, and agree the provider panel and plan matrix with you.
- Weeks 4 to 8
Launch with one group
One corporate client goes live, alongside a matched control group from your book.
- Months 3 to 6
Measure what changed
Utilisation and claims cost, pilot against control. Scale up only if the numbers hold.
The pilot scorecard:
- Virtual resolution rate
- ER visits per 1,000
- Referrals per 100 consults
- Medicine cost per episode
- Member satisfaction
Clear roles
Everyone keeps the role the law gives them.
Licensed facilities
Diagnose, treat and prescribe under their own DHA or DoH licence, and keep the medical record.
Licensed pharmacies and labs
Dispense medicines and run tests once approval is in place. Members choose where.
Insurer and TPA
Decide cover, approve and pay claims. Nothing changes here.
medicAI
Connects, coordinates and reports. Never treats, prescribes, sells insurance or decides claims.
Talk to us
Let's design a pilot around your claims data.
Tell us a little about your book. We'll come back within two working days with a pilot outline for your team.
+971 56 991 1993support@medicai.aeReady to set up your account?
