Why do I need this plan?
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.
Who is eligible to apply?
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
When does my cover begin?
From the day we approve your application form.
Is the MedicaGen
Yes, renewal is GUARANTEED up to age 75 or when the Lifetime Limit is exhausted
(whichever is earlier).
Is there a waiting period?
Yes, 30 days from effective date of policy unless resulting from accident.
If I renew my MedicaGen
200 Plan insurance policy, will the 30-day waiting period apply?
How much can I claim?
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.
Is there any deductible from each and every claim?
NO, there is no deductible in the MedicaGen
What is Upgraded Room and Board Co-Payment?
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.
200 Plan is cashless, why does the Insured still have to pay a certain
amount of deposit during admission?
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.
Can I seek treatment at a Non-Panel Hospital?
Yes. However, the policyholder has to pay first and seek reimbursement
later, based on Customary and Reasonable charges.
Why does or why would a hospital not accept the MedicaGen
200 Plan Medical Card?
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.
May I upgrade my plan?
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.
How do I make a hospitalisation and/or surgical claim?
In the event you have been treated at a hospital which is not a
participating hospital, just call 1-800-88-2318
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.