myMetLife User Guide:

e-Services User Manual
For Insured Members
TABLE OF CONTENTS:
6
16
LOG IN
HOME PAGE
19
My Benefits
23
My Claims
40
Network
42
Services
54
FREQUENTLY ASKED QUESTIONS
E-SERVICES
A State Of The Art Online Portal
e-Services is a state of the art online portal that will allow Agents to view
and manage policies.
KEY FEATURES
• Portfolio Inquiry: Member and dependent details
BENEFITS
• Complete coverage, benefits & beneficiary
information
• Coverage details and Table of Benefits
• Submit cash claims
• Claim Summary
• Monitor claims and pre-approvals
• Change Beneficiary
• Edit profile information
• Dependent Addition
• Search for medical providers
• Dependent Termination
• Download forms
• Photo and Document upload
• Print / request for certificates
• Request for temporary / replacement Medical
Cards
REQUIREMENT
S
Minimum System Requirements
The minimum requirements to access the e-services
portal
• Internet Explorer 7 or higher
• Ensure that your Pop-up blocker disabled
4
LOG IN
5
LOGGING IN
Accessing our website through the Individuals pages
Visit www.metlife.ae
Go to “Access eServices”
Click on
“Login to e-Services”
6
LOGGING IN
Accessing our website through the Business pages
Visit www.metlife.ae
Click on “Login to
e-Services”
7
LOGGING IN
Directly accessing e-Services website: www.eservicesgulf.metlife.com
Enter your Username
& Password then click
on “Login”
(continue on page 11)
Click here if you are a
new user
(Continue on page 9)
Click Here if you
forgot your password
or if your account is
locked
8
LOGGING IN
New User
Once you click on “New
User” a window will pop
up,
Select your access type:
Agent
Broker
Insured member
Policyholder
Then click on “Register”
9
LOGGING IN
Registration Step 1
Tips that help you
during the registration
process.
1
1
2
2
Enter your Certificate
Number
3
Enter your date of
birth
4
Click on “Submit”
3
4
Enter you Policy
Number
NOTE: The Policy and
Certificate numbers are
available on your Medical
Card
10
LOGGING IN
Registration Step 1 (continuation)
After clicking on
submit, the system will
show:
• Your Name and
• Your Employer
Review your Member
Name and Employer
If your Member
Details are correct,
click on “Register”
NOTE: If your member
Details are not correct,
please contact your HR
Department
11
LOGGING IN
Registration Step 2 (continuation)
Enter your email
address in both fields
(as your user ID)
Read the Terms and
Conditions before
acknowledging then
click on “Register”
Once you click on
“Register”, you will
receive your password
by email
Click on the link on
the email to proceed
to log in
12
LOGGING IN
First time Login
Log in using your
username and the
password provided to you
by email after registration
13
LOGGING IN
New Password
Once you login, the system
will automatically prompt
you to create a new
password and set-up a
secret question.
Once this activity is
completed, you can log in
again with your new
password
PASSWORD RULES:
Do make sure you’ve
selected a password that is
of a length between 8-13,
is alphanumeric (A-Z, a-z,
0-9)
The in-built security features
of the e-Services portal
ensure that any information
that you access of transmit
via this portal is secure and
not compromised
14
LOGGING IN
Contact & Bank Details
Enter your personal
information, your
address & contact
details
Select your preferred
mode of payment
If mode of payment
selected is “Wire
Transfer”, you need to
enter your bank details
NOTE: The page will
be automatically
pre-populated if you
have already provided
this information
15
LOGGING IN
Contact & Bank Details
Enter your sponsor
information like sponsor type,
Sponsor ID, Sponsor contact
number and email,
Your residing and working
location and
Your salary details
Click Here to know more
about each of these fields
Click “Submit”
16
HOME PAGE
17
HOME PAGE
Toolbars
1
2
1
To answer any inquiry
you may have
2
To send us an email for
inquiries, clarifications or
suggestions
3
To view or edit your
address, contact
information and change
password
3
4
4 Toolbar with a selection
of services
Access of Offers and
Special Features
18
HOME PAGE
Toolbar Selections
MetLife’s e-Services is a
central hub, In which you
can find all the required
forms and templates to
manage your policy,
generate certificates, and
much more…
19
What are you covered
against?
Do you want to see your
beneficiary(ies)
information?
MY BENEFITS
Who are the dependents
registered under your
policy? And what are their
benefits?
My Benefits allows you to
view your dependents
details, all your coverage
benefits and your
Beneficiary (ies)
information.
20
MY BENEFITS
Member details
Selections to view the
benefits details under
your policy
21
MY BENEFITS
Continuation…
Click here to view benefit
details (details on next
page)
22
MY BENEFITS
Continuation…
Download detailed Table of
Benefits
Medical Benefits are
displayed in various tabs:
Comprehensive Major
Medical, Dental, Optical,
Maternity and Others
Maximum Annual
Coverage
23
Do you want to submit a
cash claim from home?
Do you know the status of
your latest claim?
Are you just retrieving
your claim history?
MY CLAIMS
My Claims allows you to
do all that!
PAGE 24
PAGE 33
24
CLAIMS
The Search Page
There are 2 ways to look
for a claim:
OPTION 1:
Search by entering the 18
digits “Tracking Number”
NOTE: The Tracking Number is
available in the acknowledgment
email
OPTION 2:
Search through the below
information:
• Insured name
• Benefit
• Service date from / to
• Claim status
25
CLAIMS
Results: - Claims Summary
Once you click on submit,
you will get a table with a
list of claims reflecting the
amount claimed and
approved along with their
tracking numbers
Click on the “Action” row
to add or resubmit files
Click on any of the Claim
Number to see the claim
details
NOTE: Please go to the next
page to know more about the
“add” and “resubmit” features.
26
CLAIMS
Add & Resubmit features
Once a claim is
submitted, you will have
till 12:00am to submit any
additional file to support
your claim
The option will be
available once a decision
is taken about the claim.
It can be used to
resubmit it for
reassessment by
uploading all supporting
documents
27
CLAIMS
Claims Details & Report
From the Claims
summary page, click on
any of the “Claim
Numbers” to view its
details including:
• Claim number
• Payment mode
• Service provided
• Date
• Approved claim
amount
• and more…
To get / print a copy of
the claim report, click on
“View Claim Report”
28
CLAIMS
Claim Report Templates
Page 1
(view close up and summary
on page 38-40)
Page 2
(view close up and full
summary on page 41)
29
CLAIMS
Claim Report Templates: What’s in the Report
Page 1
1 Report Date
2
1
3
4
2 Claim Number
3 Claim Status
Header (displaying
4 Report
name/address)
5
5 Policyholder Summary
(displaying policy details)
6
6 Claim summary
7
7 Patient Share (displaying
what needs to be paid by
patient)
8
8 Contact us information
30
CLAIMS
Claim Report Templates: What’s in the Report
Page 1 (close up)
1
4
5
6
2
3
7
8
9
1
Date Policy came in force the 1st
time
2
Last renewal date
3
Currency of country where
policy was issued
4
Date service is provided
5
Date claim is processed
6
Date payment is processed
7
Maximum amount paid for this
claim based on Policy T&C’s
8
Amount to be paid by patient
9
Amount claimant will receive
31
CLAIMS
Claim Report Templates: What’s in the Report
Page 1 (close up)
1 Date service is received
the first time
1
2
3
2 Date service is received
the last time
3 Exchange rate used (if
applicable
4 Payment date
5 Amount paid to patient
4
5
6
6 Payment mode
32
CLAIMS
Claim Report Templates: What’s in the Report
Page 2
1
2
1 Claim number
2 Claim details (displaying
consultation, details,
amount claimed / paid /
denied with the dates)
3
3 Additional remarks (if any)
4
4 Payment summary
(showing amount, mode of
payment & date)
5 Contact us information
5
33
2
CLAIMS
Cash Claims Submission: Layout
This page has 5 sections
Policy Details
(page 34)
Contact Details
(page 35)
Claim Details
(page 36)
Payment Method
(page 37)
Document Upload
(page 38)
34
CLAIMS
Cash Claims Submission:- Policy Details
This section will show you
your:
• Policy Number
• Policyholder Name
• Certificate Number
• Insured Name
All fields are pre-populated.
Just confirm that these are
your details.
You can find the 10 digit
Policy Number on the bottom
left corner of your Medical
Card
NOTE: If you need to update any
of your details, please contact
MetLife Customer Service.
35
CLAIMS
Cash Claims Submission:- Contact Details
abc@d e f g . com
This section will show you
your:
• Preferred Mobile Number
& your email address
All fields are pre-populated.
NOTE: Details can be updated in
the “Contact details” section under
your Profile page
36
CLAIMS
Cash Claims Submission:- Claim Details
Steps to follow:
1
Select Dependent Code Name
(use the scroll down option)
2
Choose the Country where you
received the treatment in
3
Select the type of Medical Facility
& enter its name
4
Enter the total claim amount
5
Select the claim currency
6
Choose the currency you would
like us to pay you in
7
Select the Payee Name
8
Enter the Date of Service (From)
9
Enter the Date of Service (To)
1
2
3
5
4
6
7
8
9
37
CLAIMS
Cash Claims Submission:- Payment Method
You can receive your claim
reimbursement amount
through:
• Wire transfer (directly into
your account) or;
• Check
If Wire Transfer is selected,
system will automatically
show your account details
including:
• Bank name
• Branch name
• Account number
• Swift code
• IBAN
NOTE: You can update your account
details in your “Profile” page. All you
need to do is click on the “Profile”
tab to access the page.
38
CLAIMS
Cash Claims Submission - Document Upload
You need to share your
physician’s diagnosis, report,
test lab (if any) or any other
document to support your
claim.
This page allows you to
upload all your documents.
1
All you need to do is:
4
2
3
1. Type the document
1
description
2. Select the file you wish to
2
upload by using the
“Browse…” option
3
3. Click on “Add File”
4. To upload more files, click on
4
the “+” sign and repeat the
above 3 steps.
• To Remove / delete a
file, click on the “-” sign
39
next to it
CLAIMS
Cash Claims Submission - Submit the Claim
Once you upload your
documents, the following
information will appear under
the upload table:
Claim submission
requirements
Authorization Statement
Disclaimers
Read the above document,
tick on the box and click on
submit to send your request.
An acknowledgement will be
sent to your email
40
Having problems locating
a Medical Provider near
you?
Use our medical provider
finder tool to browse
amongst our list of more
than 1000 medical
providers in the UAE!
NETWORK
The Search Provider tool
helps you filter them by:
•
•
•
•
•
Country
City
Area
Category
Specialty
41
NETWORK
How to find a Medical Provider
Enter required
information to find a
medical provider
Click “View Network
List”
42
Are you looking for a Claim
Form?
Do you need a Certificate
for the Embassy?
What is the status of your
Pre-Approval request?
SERVICES
PAGE 43
PAGE 44
MetLife e-Services ensures
that all required forms and
services are just a few
clicks away!
PAGE 46
PAGE 48
PAGE 50
PAGE 51
Now you can download
forms, certificates, and
monitor your Pre-approval
request just by logging in!
PAGE 52
PAGE 53
PAGE 56
43
SERVICES
Download Forms
Download Enrollment
Forms (in PDF)
Download the following
forms (in PDF)
44
SERVICES
How to Request for a Certificate
Select the Type of Certificate
Life Certificate: Applicable only for members
who have life coverage
Medical Certificate: Applicable only for
insured members who have medical
coverage
Temporary Medical Card : Temporary card
designed for new joiners who did not receive
their medical cards yet (It can only be used
with selected Medical Providers)
Sharjah Ministry Health Certificate:
Applicable only for insured members who
have medical coverage. A request will be
sent to MetLife to provide stamped certificate
GPA Certificate : Applicable only for GPA
policies
JAFZA Certificate: Applicable only for
policies having medical benefits and has a
sub office in JAFZA. A request will be sent to
MetLife to provide stamped certificate
Medical Replacement Card : Temporary
card designed for insured members who lost
their medical cards (card can only be used
with selected Medical Providers)
45
SERVICES
How to Request for a Certificate
Select the Type of Certificate
The certificate will be
immediately generated for you
and your dependents
You can either open it directly
or save on your computer
46
SERVICES
How to Request for a Certificate
Select the insured followed
by the required periods, the
click on “Search”
1 Pre-Approval ID: Click on the
Reference Number for more
details (details on page 51)
2 Policy no.
3 Certificate no.
4 Dependent code
5 Name of the Insured
6 Insured ID
1
2
3
4
5
6
7
8
7 Submission date
8 Status
47
SERVICES
Pre-Approval Full Details
Pre-Approval ID full details
48
SERVICES
Change Beneficiary
Guidelines for updating
beneficiary
Current Beneficiary info.
Click on “Edit” to change
beneficiary details
NOTE: The change Beneficiary
function will be available only if
you have a Life Coverage and
the Policyholder is not the
Beneficiary
49
SERVICES
Change Beneficiary (continuation…)
Select required option
Select Rows to delete
Add multiple beneficiaries
Click here to save and print
the Amendments
50
SERVICES
Add Dependents
Existing Dependent
Information
Click on “Add New” to add a
dependent
Enter Dependent Details
NOTE: The following function
will be available only if your HR
is a registered e-Services user
and has granted you access to
add dependents
51
SERVICES
Add Dependents
Upload photo and documents
if applicable
Enter Sponsor details and
other regulatory information
Click here to know more
about each of these fields
Click “Save” to submit the
transaction for HR approval
NOTE: The following function
will be available only if your HR
is a registered e-Services user
and has granted you access to
add dependents
52
SERVICES
Terminate Dependents
Select dependents to be
terminated
Enter termination effective
date
Click here to submit the
transaction for HR approval
NOTE: The following function
will be available only if your HR
is a registered e-Services user
and has granted you access to
terminate your dependents
53
SERVICES
Photo Upload
Format description of the
photo that can be uploaded
Select required entries
Browse and select the photo
Click on “Upload Photo” to
submit the transaction for HR
approval
NOTE: The following function
will be available only if your HR
is a registered e-Services user
and has granted you access to
upload photos
54
SERVICES
Document Upload
1
2
4
3
1
Click on “Click Here” to view
the documents required for
your policy
2
Select the type of document to
be uploaded
3
Select required entries
4
Browse and select the
document
Upload the document. You will
be prompted to upload more
documents. If you do not wish
to add any more documents,
the transaction will be
submitted to your HR for
approval
NOTE: The following function will
be available only if your HR is a
registered e-Services user and55has
granted you access to upload
SERVICES
Profile Management
To manage and update
member/dependent
information
Click to change your profile
password
Enter bank details and claim
reimbursement mode to be
updated.
56
SERVICES
Profile Management
Choose the insured whose
information is to be updated
Enter insured details to be
updated
Enter Sponsor details and
other regulatory information
Click here to know more
about each of these fields
Click save and continue
updating information for other
insureds
Click “Update profile” once
all the information has been
57
updated.
FREQUENTLY
ASKED
QUESTIONS
58
FAQ’S
Frequently Asked Questions
Who should I contact for inquiries or clarifications?
For any inquiries or clarifications, you can send us an email at [email protected]
Is my information secure?
Yes. The data is secured using a 128 bit encryption using SSL (Secured Socket Layer)
Please email us at:
[email protected]
My Account is Blocked, how can I re-activate it?
To unlock your account, please email us at: [email protected]
I am having trouble selecting a password. What should I do?
There are guidelines to follow for creating a password. These guidelines are available in the
“Password Change Screen”. If you are still facing difficulties in creating a password, please email
us at: [email protected]
59
FAQ’S
Frequently Asked Questions
I am unable to login, why?
There are several reasons why you may not be able to login:
1. You may have incorrectly entered your username. In case you need to double-check your
username against the confirmation email you received when your account was set-up.
2. There may be a mismatch between the username and password.
3. You account is locked.
If you are facing difficulties in login, please send us an email at [email protected]
Please email us at:
[email protected]
During Registration, the system is asking me to enter my Bank Account details.
Why?
Through our newly launched Wire Transfer Capability, you now have the option to receive your
claim reimbursements directly deposited to your bank account. By providing your bank details, you
will be able to d=benefit from this new secure feature. If you still prefer receiving your cash claim
reimbursements though cheque, kindly tick the checkbox next to “cheques”.
60
FAQ’S
Frequently Asked Questions
I want to cancel my access. Who do I contact?
To cancel your access, please email us at: [email protected]
The system signed me out automatically. Why?
If your page remains inactive for 30 minutes, e-Services will automatically sign you out as a
security measure. As with many secured web application, e-Services provides this feature in
order to ensure your data is secured and protected from potential access by an unauthorized
individual.
Please email us at:
[email protected]
What is the secret question?
The secret question is a verification question to which only you know the answer. You create the
question during your first login process. The answers to these questions are used to reset your
password and confirm your identity. We recommend that you do not share the answers to your
questions with anyone.
If I cancel my e-Services access, will my policy also be cancelled?
No, your policy will not be cancelled if you decide to cancel your e-Services access.
61
FAQ’S
Frequently Asked Questions
Some of the Claims presented amounts are hidden, why?
These amounts are called Provider Claims (or Direct Billing Claims). They represent the claims
that were submitted by the Provider for the services you paid through direct billing.
Some of the Claims are clickable and some are not, why?
The “Clickable” claims are the Cash Claims which are submitted by you for reimbursement. By
clicking on them, you can view al the details of your claim, what was approved or denied and the
full amount paid.
Please email us at:
[email protected]
Can I see a reason why a Claim was denied or partially paid?
Yes. Just click on the Claim number to view all details about that specific claim.
Can I submit a Claim online?
Yes, You can submit cash claims through e-Services. All you need to do is go to “Cash Claim
Submission” section to submit the claim and upload supporting documents. Please note that for
some cases, we may ask for the original document(s).
62
FAQ’S
Frequently Asked Questions
What are the Certificates available on e-Services?
Certificates are formal documents produced by MetLife – Gulf to certain entries as a proof of your
coverage:
1. Medical Certificate for the UAE Residency Visa: Some Emirates in the UAE require a
Medical Insurance certificate in order to issue a residency visa. You can simply request
MetLife to issue a certificate for you.
1. Life Insurance Certificate: If you have a Life Insurance Coverage in your policy, you can
immediately generate a Life Insurance Certificate as a proof.
Please email us at:
1. Medical Insurance Certificate: This certificate acts as a proof that you have a Medical
Insurance with MetLife. It may be required when applying for a visa such as Schengen.
[email protected]
2. Medical Authorization Certificate: This certificate can be used by employees who newly
joined their company at specific Medical Providers until they get their Medical Cards. The list
of providers is available in the Download Forms page under Services.
1. Sharjah Ministry Health Certificate: Sharjah Ministry requires a Medical Insurance
certificate in order to issue a residency visa. You can simply request MetLife to issue a
certificate for you.
1. Medical Replacement Card: This certificate can be issued to employees who have lost their
cards, and used a specific Medical Provider until their Medical Card is re-issued. The list of
providers is available in the Download Forms page under Services.
63
APPENDIX 1
Field Name
UID number
UAE visa place of issuance
Sponsor type
Description
For UAE/GCC national
Available on First or Last Page of passport
For Expatriates
Available on Resident Visa Page in the passport
Choose from below values
Dubai
ABU DHABI
AJMAN
FUJAIRAH
RAS AL KHAIMAH
SHARJAH
UMM AL QUWAIN
UAE national
Dubai national
GCC national
Diplomat
Choose from below values
Resident
Citizen
Establishment
Property Owner
Description of
information
required for DHA
64
CONTINUATION
Field Name
Visa Sponsor ID
Description
For Members,
If the value in field "Sponsor Type" is
1. Establishment, then the value will be autopopulated
2. Resident then the Sponsor's UID number should be
entered
3. Citizen, then the Sponsor's Citizen File number
should be entered
4. Property Owner, then the Sponsor's UID number
should be entered
For Dependents
If the value in field "Sponsor Type" is
1.Establishment, then the Sponsor's Establishment
Entity Number / Al Munshaa number should be
entered
2. Resident then the value will be auto-populated
3. Citizen, then the Sponsor's Citizen File number
should be entered
4. Property Owner, then the Sponsor's UID number
should be entered
Description of
information
required for DHA
65
CONTINUATION
Field Name
Description
Please enter the 15 digits without hyphens or spaces
Example: 784198012345676
Choose from below values
Salary less than 4,000 AED per month
Salary between 4,001 and 12,000 AED per month
Salary greater than 12,000 AED per month
Gross salary range(Required for Regulatory Purpose) No salary-for dependents or children that do not
acquire a salary
In the bulk upload templates (available under Services
menu), the value should be 1 or 2 or 3 or 4
National id no
Salary based on commission
Description of
information
required for DHA
Choose from below values
Yes
No
In the bulk upload templates (available under Services
menu), the value should be Y or N
66
CONTINUATION
Field Name
Residing Emirate
Residing location
Work location (Emirate)
Description
Choose from below values
Dubai
ABU DHABI
AJMAN
FUJAIRAH
RAS AL KHAIMAH
SHARJAH
UMM AL QUWAIN
Residing Emirate Dubai: Click Here
Residing in other Emirates: please choose
OTHER EMIRATES (OUTSIDE DUBAI)
Choose from below values
Dubai
ABU DHABI
AJMAN
FUJAIRAH
RAS AL KHAIMAH
SHARJAH
UMM AL QUWAIN
Description of
information
required for DHA
67
CONTD..
Description of information required for DHA
Field Name
Work location
Did member have insurance in the past 6 months in
UAE
Sponsor contact no
Sponsor mail id
Description
Work Location (Emirate) Dubai: Click Here
Working in other Emirates: please choose
OTHER EMIRATES (OUTSIDE DUBAI)
Choose from below values
Yes
No
In the bulk upload templates, the value should be Y
or N
This is applicable for dependents who are not under
the Primary member's visa. The Sponsor's contact
number needs to be entered
This is applicable for dependents who are not under
the Primary member's visa. The Sponsor's email id
needs to be entered
68