NEXTCARE

What NEXTCARE does

Nextcare Claims Management LLC is a Third Party Administrator (TPA) for health insurance, founded in 1999 in Lebanon and headquartered in Dubai, UAE. The company operates as an indirect subsidiary of Allianz Partners SAS and serves approximately 5 million insured members across 10+ countries in the Middle East and Africa, including the UAE, Saudi Arabia, Lebanon, Egypt, Kuwait, Qatar, Bahrain, Oman, Tunisia, and Morocco. Nextcare's customer base spans 165+ insurance companies, self-insured employers, brokers, and government entities, supported by a contracted network of 13,000+ regional and 400,000+ global healthcare providers.

The company operates an integrated cloud-based health insurance administration platform comprising the Lumi mobile app and MyNextcare web portal for insured members, the PULSE provider portal for healthcare providers, and the Tatsh platform for insurer partners. Functional capabilities include eligibility verification, pre-authorizations, claims processing, direct-billing settlement, and digital member services such as a Health e-Card (replacing physical insurance cards), appointment booking, telehealth video consultations via Health at Hand, and an AI-powered Symptom Checker developed by Infermedica. Operational scale includes over 23 million medical claims processed, $2.6 billion USD in premium under management, and $1.9 billion USD in claims under management.

Nextcare generates revenue through negotiated, multi-year TPA and health insurance administration contracts with insurers, self-insured employers, brokers, and government entities. Fees cover claims management, eligibility verification, pre-approvals, provider network access, and digital platform services on a recurring basis. Pricing is not publicly disclosed. The go-to-market is sales-led B2B with direct enterprise sales targeting insurers and employers, supplemented by broker distribution and member-facing digital channels (Lumi app, MyNextcare portal) for member engagement and adoption of digital health services.

Name

NEXTCARE

Legal name

Nextcare Claims Management LLC

Website

https://nextcarehealth.com

Company type

Private

Founded year

1999

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Nextcare is a Dubai-based Third Party Administrator (TPA) and indirect subsidiary of Allianz Partners, providing health insurance administration, claims processing, and digital health services to 165+ insurers, self-insured employers, and 5 million insured members across 10+ MEA countries.

Ownership category

akta.pro rank

Product category

Health Insurance Third Party Administration (TPA)

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Agencies, Brokerages, and Other Insurance Related Activities (5242)

SIC

Insurance Agents, Brokers & Service (6411), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Member Services & Contact Center Operations (TPA) (HLAEALAI)

akta.pro secondary industries

Care Management & Population Health Program Administration (HLAEALAG), Medicare Plan Administration & Third-Party Services (TPA/BPO, Enrollment, Billing) (FSAIAGAI)

Keywords

• Health insurance administration
• Third party administration
• Claims management platform
• Healthcare provider network
• Insurance TPA services

Headquarters

HQ city

Dubai

HQ country

United Arab Emirates

HQ region

Middle East

Offices7 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. TPA and Health Insurance Administration Fees: Nextcare generates revenue by providing Third Party Administration (TPA) services to health insurers, self-insured employers, brokers, and government entities. Fees are charged for claims management, eligibility verification, pre-approvals, provider network access, and digital platform services. This is a B2B service model where insurance companies and employers pay for the administrative infrastructure that serves their insured members.

Pricing tiers

Go-to-market motion1 record

Distribution channels6 records

Marketing channels5 records

Core offering

Nextcare is a Third Party Administrator (TPA) providing end-to-end health insurance management services to insurance companies, self-insured employers, brokers, and government entities across the Middle East and Africa. Its core offering includes claims processing, eligibility verification, pre-approval workflows, provider network access, and member-facing digital services via the Lumi mobile app and MyNextcare web portal, supplemented by telehealth, AI symptom checking, and digital insurance cards.

Product overview

Nextcare is a Third Party Administrator (TPA) providing comprehensive health insurance management solutions as part of Allianz Partners. The product portfolio centers on the Lumi App (mobile) and MyNextcare Portal (web) as the primary member-facing platforms, supplemented by the PULSE Portal for healthcare providers and the Tatsh Platform for insurer partners. The integrated ecosystem includes digital insurance services (Health e-card, claims submission and tracking), healthcare network access, telehealth (See A Doctor), AI-powered symptom assessment (Symptom Checker by Infermedica), and appointment booking. Core backend services handle eligibility verification, pre-authorization, claims processing, and provider network management across 13+ countries.

Differentiator

Problem solved

Functional benefit

Brands

• Lumi App: Mobile application for insured members to manage claims, view policy benefits, access digital insurance cards, book appointments, and consult doctors via video.

Products and services

• Lumi App Primary mobile application for insured members to manage health insurance benefits, view digital insurance cards, track claims, search healthcare providers, access telehealth (See A Doctor), and check symptoms via the AI-powered Symptom Checker.
• MyNextcare Portal Web-based member portal for insured members to submit and track claims, view policy benefits, find healthcare providers, and access digital insurance services.
• PULSE Portal Web portal for healthcare providers (hospitals, clinics, pharmacies, laboratories) to verify patient eligibility, submit pre-authorization requests, check claims status, and process reimbursements.
• Tatsh Platform Proprietary platform for insurer partners providing real-time claims submission, automated portfolio management, and transparent claims processing capabilities.
• See A Doctor (Telehealth) Video consultation telehealth service providing access to qualified doctors from anywhere in the world with no co-pay, including prescription delivery and lab test request capabilities in Dubai.
• Symptom Checker AI-powered digital symptom assessment tool that analyzes user-reported health symptoms and suggests potential conditions or recommended next steps.
• Third Party Administration (TPA) Services End-to-end health insurance administration services for insurance companies, self-insured employers, brokers, and government entities, including eligibility verification, pre-approvals, claims processing, and member services.
• Healthcare Provider Network Extensive contracted network of hospitals, clinics, laboratories, pharmacies, and individual doctors enabling direct settlement of medical bills and access to care for insured members.
• Claims Management End-to-end claims processing system handling submission, pre-approval, processing, and reimbursement of medical claims for insured members across network and out-of-network providers.

Quantifiable outcome

• Over 23 million medical claims processed
• +5 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

AI capability2 records

Feature8 records

Partnerships

Six partnerships are on record, tiered supporting and core.

• InfirmarycasupportingTechnology or Integration · 16 June 2022Infirmaryca developed the AI-powered Symptom Checker tool integrated into Nextcare's Lumi app and digital platforms. The tool uses AI algorithms to analyze users' health symptoms and suggest appropriate next steps or care paths, enhancing Nextcare's digital health offerings.
• Health at HandcoreTechnology or Integration · 16 February 2020Health at Hand, a DHA-licensed telehealth provider in the Middle East, partnered with Nextcare to provide video consultation services to Nextcare's insured members. Members can consult doctors from anywhere in the world with no co-pay through the MyNextcare app. In Dubai, prescription delivery within 60 minutes and lab test requests are available through the app. This partnership extends Nextcare's e-health capabilities and supports continuity of care.
• Allianz PartnerscoreOthersNextcare is an indirect subsidiary of Allianz Partners SAS. As part of Allianz Partners, Nextcare benefits from global brand recognition, cross-selling opportunities within the Allianz network, shared technology investments, and a global footprint. Allianz Partners is a worldwide leader in insurance and assistance, providing Nextcare with strategic backing and operational synergies across regions.
• Healthcare Providers (13,000+ regionally, 400,000+ globally)coreOthersNextcare contracts with over 13,000 healthcare professionals regionally and over 400,000 globally including hospitals, clinics, laboratories, pharmacies, and individual doctors. These providers form the core network through which Nextcare offers direct settlement of claims for insured members. Members can access these services by presenting their insurance card or national ID.
• Insurance Companies (120+ partners)coreStrategic or Co-development PartnerNextcare serves as Third Party Administrator for over 120 insurance companies and healthcare payers across the MEA region. These insurer partners outsource claims administration, eligibility management, provider network access, and member services to Nextcare's platform.
• Tatsh PlatformsupportingTechnology or IntegrationNextcare provides insurer partners with access to the Tatsh platform, enabling real-time claims processing, transparency, and automated portfolio management. The Tatsh platform is a proprietary technology solution connecting Nextcare with its insurance company clients.

Scale indicators9 records

Recent moves9 records

Expansion highlights6 records

Direct peers

• MedNet: MedNet is one of the largest Third Party Administrators for health insurance across the MEA region, offering claims management, provider network access and digital tools. It is the most direct competitor to Nextcare in both geography and service scope.
• Globemed (Gulf Related): Globemed is a leading MEA health insurance TPA with a regional provider network and member-facing digital services, competing with Nextcare for insurer and self-insured employer contracts across the GCC and Levant.

Broad incumbents

• Daman (National Health Insurance Company): Daman is the largest health insurer in the UAE and also operates TPA-style administration for major public accounts. It is a broader incumbent that overlaps with Nextcare's TPA capabilities while also underwriting risk directly.
• Bupa Arabia: Bupa Arabia is the largest specialized health insurer in Saudi Arabia with strong in-house claims administration, a national provider network, and digital member tools — a broad incumbent that competes with Nextcare on large corporate accounts in KSA.
• Tawuniya (Cooperative Insurance): Tawuniya is one of the largest Saudi insurance groups offering health products with proprietary claims administration and provider networks. It is a broad regional incumbent whose in-house TPA function competes for similar insurer and corporate clients.
• AXA Insurance MENA: AXA MENA is a large multi-line insurer in the region with significant health administration capabilities and corporate accounts. It competes for self-insured employer and broker-driven mandates that Nextcare also targets.
• ADNIC (Abu Dhabi National Insurance Company): ADNIC is a leading UAE insurer with strong group health and TPA-style administration capabilities. It serves similar enterprise and government clients in the Gulf and competes with Nextcare on regional corporate accounts.

Others

• Allianz Care: Allianz Care is the international health insurance arm of Allianz Partners, and Nextcare's corporate sibling. It is comparable as a sister TPA/health-administration platform serving global clients, with cross-sell and shared technology.

Emerging players

• Sedgwick: Sedgwick is a global claims management and TPA provider expanding into health and benefits administration. It is comparable as a third-party administrator at scale serving insurers and employers with similar outsourced service models.
• Crawford & Company: Crawford & Company is a global claims and third-party administration firm with healthcare administration capabilities for insurers and self-insured plans. It is comparable as a multi-country TPA serving large payer clients, though its footprint in MEA is limited.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/nextcare/posts/?feedView=all
• Xx.com/NEXtCAREHealth

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about NEXTCARE