All you want to know about the.....


 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! 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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