All you want to know about the..... SIHAT MALAYSIA
Frequently Asked Questions
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!
Q: When does my cover begin?
A: From the day we approve your proposal.
Q: Is there a waiting period?
A: Yes, 30 days from effective date of policy unless resulting from accident.
Q: If I renew my Sihat Malaysia 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 under the chosen plan.
Q: What is 20/80 Co-Payment clause?
A: The Policyholder and the Insurer will bear 20% and 80% of the eligible hospital treatment costs respectively. The Co-Insurance will apply in the following two circumstances: 1) All types of scanning such as CT Scan, MRI and Heart Scan; and 2) Staying in a higher Room & Board rate than the purchased plan.
Q: If Sihat Malaysia 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 Sihat Malaysia 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 MCO; and/or 7) Policyholder goes to a Non-Panel Hospital.
Q: Upon renewal, if I upgrade or downgrade my plan will the takeover benefit be given?
A: Yes. However, this must be effected through the same agent and relevant documents submitted within 30 days from the expiry date.
Q: How do I make a claim?
A: Just call 1-800-88-2318 (24 Hours).
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