Q:
Why do I need this plan?
A:
Because hospital costs can be substantial and could wipe out your precious
savings. The last thing you want to worry about when you go to a hospital
is money! Furthermore, you are covered for accidental and life.
Q:
Who is eligible to apply?
A:
Any Malaysian from the ages of thirty (30) days old up to sixty (60) years
old next birthday and who is in good health. For Foreigners
(expatriate/professional, PR or Malaysia My Second Home), they can
purchase Plan 1 - Plan 4, but coverage is restricted to Malaysian Hospitals
ONLY.
Q:
When does my cover begin?
A:
From the day we approve your application form.
Q:
Is the MedicaGen
200
Plan renewal
Guaranteed?
A:
Yes, renewal is GUARANTEED up to age 75 or when the Lifetime Limit is exhausted
(whichever is earlier).
Q:
Is there a waiting period?
A:
Yes, 30 days from effective date of policy unless resulting from accident.
Q:
If I renew my MedicaGen
200 Plan insurance policy, will the 30-day waiting period apply?
A:
No.
Q:
How much can I claim?
A:
You may claim up to the Overall Annual Limit in a year and up to the Lifetime
Limit during your lifetime under the chosen plan subject to
individual benefit limits.
Q:
Is there any deductible from each and every claim?
A:
NO, there is no deductible in the MedicaGen
200
Plan.
Q:
What is Upgraded Room and Board Co-Payment?
A:
If the Insured person is hospitalised at a Room & Board rate which
is higher than his/her eligible benefit, the Insured Person shall bear
20% of the other eligible benefits described in the Schedule of Benefits
for each and every claim.
Q:
If MedicaGen
200 Plan is cashless, why does the Insured still have to pay a certain
amount of deposit during admission?
A:
This is usually a deposit for Non-Medical related expenses such as telephone
charges, laundry, etc., or Co-Insurance amount to be borne by the Insured.
Depending on hospitals, this deposit normally ranges from RM200 to RM2,500.
Q:
Can I seek treatment at a Non-Panel Hospital?
A:
Yes. However, the policyholder has to pay first and seek reimbursement
later, based on Customary and Reasonable charges.
Q:
Why does or why would a hospital not accept the MedicaGen
200 Plan Medical Card?
A:
The followings are common circumstances whereby this can happen: 1) illness is
not covered, first 30 days waiting period, Specific illnesses, Underwriting
exclusions, General exclusions or Non-disclosure of Pre-existing illnesses; 2)
Final diagnosis is different from the initial diagnosis; 3) Policy has expired;
4) Application has not been approved; 5) Policy has expired, but renewal premium
was paid (could possibly due to policy could not be approved as there is a
shortage of premium or relevant documents are not complete or timing is
incorrect); 6) Hospital Admission Staff refused to contact the MCO; and/or
7) Policyholder goes to a Non-Panel Hospital.
Q:
May I upgrade my plan?
A:
Yes, you may. However, any request to upgrade will be treated as a
new application and may require you to provide details of your current
state of health.
Q:
How do I make a hospitalisation and/or surgical claim?
A:
In the event you have been treated at a hospital which is not a
participating hospital, just call 1-800-88-2318
to make
your claim. All services from the MCO on admission & discharge
are subject to eligibility, benefits of your plan and a waiting period
of 90 days at the first policy year.
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