All you want to know about the..... PREMIER HEALTH PLAN
PREMIER
HEALTH PLAN - Benefits & Premiums
INDIVIDUAL & FAMILY/SINGLE PARENT PLANS
| Plans | PHP 1 | PHP 2 | ||||||
| Benefits | INDIVIDUAL | FAMILY/SINGLE PARENT | INDIVIDUAL | FAMILY/SINGLE PARENT | ||||
| ADULT | CHILD | ADULT | CHILD | ADULT | CHILD | ADULT | CHILD | |
| PERSONAL ACCIDENT | RM | RM | ||||||
| Accidental Death | 100,000 | 50,000 | 100,000 | 50,000 | 50,000 | 25,000 | 50,000 | 25,000 |
| Partial & Permanent Disablement | 100,000 | 50,000 | 100,000 | 50,000 | 50,000 | 25,000 | 50,000 | 25,000 |
| Natural Death (All Causes) | 20,000 | 10,000 | 20,000 | 10,000 | 10,000 | 5,000 | 10,000 | 5,000 |
| Overall Annual Limit per Insured | 135,000 | 40,000 | ||||||
| HOSPITAL BENEFITS | Maximum per Any One Disability | |||||||
| Daily Room & Board (Max. 120 days) | 300 | 175 | ||||||
| Intensive Care Unit (Max. 60 days) | 600 | 350 | ||||||
| Hospital Supplies & Services | ..... As Charged ..... | ..... As Charged ..... | ||||||
| Operating Theatre | ..... As Charged ..... | ..... As Charged ..... | ||||||
| SURGICAL BENEFITS | Surgical Expenses comprising the following, but excluding organ transplantation:- | |||||||
| i) Pre-Surgical Diagnostic Services | ..... As Charged ..... | ..... As Charged ..... | ||||||
| ii) Pre-Surgical Specialist Consultation | ..... As Charged ..... | ..... As Charged ..... | ||||||
| iii) Surgical Fees | 67,500 | 20,000 | ||||||
| iv) Anaesthetist's Fees | 20,250 | 6,000 | ||||||
| MEDICAL BENEFITS (Non-Surgical) |
Medical Expenses for non-surgical treatment, comprising:- |
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..... As Charged ..... | ..... As Charged ..... | ||||||
| OUT-PATIENT BENEFITS | ||||||||
| Emergency Out-Patient Treatment for Accident Only (within 24 hours) | ..... As Charged ..... | ..... As Charged ..... | ||||||
| Out-Patient Physiotherapy Treatment | ..... As Charged ..... | ..... As Charged ..... | ||||||
| Ambulance Fees | 1,500 | 300 | ||||||
| Monthly Out-Patient Kidney Dialysis & Cancer Treatment | 5,000 | Nil | ||||||
| OTHER BENEFITS | ||||||||
| Heart, Kidney, Lung or Liver Transplantation | 50,000 | Nil | ||||||
| Daily Cash Allowance at Govt. Hospitals (Max. 120 days) | 55 | 45 | ||||||
| Medical Report Allowance | 50 | 50 | ||||||
| Comprehensive Blood Test | A yearly free examination (excluding children) | A yearly free examination (excluding children) | ||||||
| ANNUAL PREMIUM | PHP 1 | PHP 2 | ||||||
| AGE BAND* (AGE LAST BIRTHDAY) | Individual | Family | Single Parent | Individual | Family | Single Parent | ||
| TOTAL ANNUAL PREMIUM - AT ENTRY | TOTAL ANNUAL PREMIUM - AT ENTRY | |||||||
| 15 days - 17 years | 479 | 310 | ||||||
| 18 - 30 years | 896 | 2,404 | 1,514 | 556 | 1,469 | 920 | ||
| 31 - 44 years | 962 | 2,536 | 1,580 | 589 | 1,535 | 953 | ||
| 45 - 50 years | 1,170 | 2,952 | 1,788 | 693 | 1,743 | 1,057 | ||
| 51 - 55 years | 1,678 | 3,968 | 2,296 | 872 | 2,101 | 1,236 | ||
| 56 - 60 years (Renewal only) | 1,678 | 3,968 | 2,296 | 872 | 2,101 | 1,236 | ||
| 61 - 69 years (Renewal only) | 2,228 | 4,869 | 2,647 | 1,086 | 2,412 | 1,332 | ||
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AGE LIMIT AT ENTRY - The Plans shall cover eligible persons between the ages of 15 days to 55 years old (age last birthday).
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CONDITIONS - Unmarried children under the Family/Single Parent Plan must be over 15 days old but under 19 years of age or 23 years of age if still on full-time higher education, and who are not gainfully employed.
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CONDITIONS - Premiums payable for the Health Benefits will increase with age, as indicated by the relevant Age Band for the respective PHP Plan purchased. Premium will be based on the older of the two spouses.
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CONDITIONS - If more than one spouse, only one named spouse will be covered. However, all the children are covered.
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PREMIUMS - For PHP to remain in force, you must pay the premiums when due. Premiums for the Death (Basic Policy) are level and guaranteed. Premiums for all other benefits (Rider Benefits) are yearly renewable and the Insurer have the right to review from time to time. Premiums for these benefits can only be changed if premiums for all PHP Plans issued on the same terms as yours are similarly changed and written notice is given.
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NOTE - All services from MediExpress 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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NOTE - For Hospitalisation & Surgical benefits, you will be subjected to a deductible of RM50 from each and every claim.
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NOTE - Upgraded Room & Board Co-Payment: If the Insured is hospitalised at a Room & Board rate which is higher than his/her eligible benefit, the Insured shall bear 20% of the other eligible benefits described in the Schedule of Benefits for each and every claim.
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