As a medical card holder, do you understand the medical card you have purchased? Here are the 7 things you need to know before buying a medical card
1. Monthly/annual premiums (Premium)
How much does your card cost per year? Some people choose to pay the premium every month, while others choose to pay every six months and some choose to pay annually for convenience.
2. The maximum amount that can be claimed each year (Overall Annual Limit)
The maximum claim amount for a typical medical card is RM100,000 to RM150,000 per year, with an additional coverage of up to RM990,000 per year. What is the maximum annual limit for your medical card?
3. Overall Lifetime Limit
There are 2 types of medical cards, i.e. unlimited lifetime claims and limited claims. An unlimited claim is one where there is no limit to the amount that can be claimed for the lifetime of the insured person, while a limited claim is one where there is a maximum amount that can be claimed for the lifetime of the insured person, e.g. RM1.2 million for the lifetime of the insured person.
4. Hospital Room and Board per diem claim
The maximum daily amount that can be claimed when the insured person is hospitalised is specified on the medical card, with some cards only covering RM150 per day, some RM200, some RM300, etc. The maximum number of days of hospitalisation that can be claimed per year is 180 days.
5. Co-Insurance
This is where the insured person has to share a small portion of the hospitalisation and medical expenses with the insurance company: most medical cards have a Co-Insurance provision where the insured person is responsible for 10% of the hospitalisation expenses, or a minimum of RM300 and a maximum of RM1,000, and the insurance company is responsible for the rest of the hospitalisation and medical expenses. Does the medical card you have purchased have this provision?
6. Insurance Company’s Panel Hospitals
Many insured persons think that their insurance company will only pay for medical treatment at a designated hospital, but this is not the case. The difference is that the insured person will be responsible for the cost of treatment at a designated hospital without paying for it, while at a non-designated hospital the insured person will have to pay for the treatment and then claim the cost from the insurance company. What hospitals are covered by the medical card you have purchased?
7. Exclusions
Accidents caused by plastic surgery, childbirth, suicide, dangerous sports, drug abuse, war or riots are not covered.
