Major Benefits
This Plan provides coverage for:
• Hospitalization & Surgical Benefits
• Out of Hospital Benefits
AM Medi Flexi (AM MF) (effective 01/03/2010)
1 A deductible amount of RM50 is payable by the policyholder. This deduction is applicable per hospital
admission/ outpatient surgery and the same amount will apply for plans 1, 2 or 3.
The Company reserves the right to revise the amount of deductible at any time by giving 30 days’ written
ING MEDIPLUS (IMPlus) PREMIUM RATES
Annual Premium Rates for Standard Occupational Class 1 to 4 (for both sexes): (A) Non-Cashless Option
(B) Cashless Option
Premium rates for Occupational Classes 5 and 6 can be calculated using the following loading as a
percentage of standard premium rates (Classes 1 to 4).
NOTES:
a) Minimum Age at Entry: 30 days old
b) Maximum Age at Entry: 59 years old
c) Maximum renewal age: 69 years old
d) Hospital & Surgical is not allowed for pregnant employed female application.
e) For female risks, juvenile risks and student risks, Hospital & Surgical is granted @ Occupational Class of 1 to 6.
f) Hospital & Surgical is allowed for foreign applicants with working permits.
g) Only one IMPlus policy is allowed on per life basis.
REFERRAL EMERGENCY ASSISTANCE PROGRAM
The ING MediPlus also features a comprehensive international medical assistance programme consisting of the following:
a) International Medical Assistance Program
b) Domestic Medical Assistance Program
c) Car assistance Program#
d) Home Assistance Program#
e) Travel Assistance Program#
# Referral services only.
Major Benefit Limitations/Exclusions
No benefits shall be payable for hospitalization, surgery or charges caused directly or indirectly, wholly or partly
by any one (1) of the following :
• Pre-existing illness
• Any medical or physical conditions arising within the first thirty (30) days of the Life Insured’s cover or date of
reinstatement whichever is later except for accidental injuries.
• The following Specified illnesses and its related complications which occur within the first 120 days of insurance of
the Life Insured :
(a) Hypertension, diabetes mellitus and cardiovascular disease;
(b) All tumours, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system;
(c) All ear, nose (including sinuses) and throat conditions;
(d) Hernias, haemorrhoids, fistulae, hydrocele, varicocele;
(e) Endometriosis including disease of the Reproduction system;
(f) Verterbo-spinal disorders (including disc) and knee conditions;
• Plastic/Cosmetic surgery, circumcision, eye examination and any surgical and non-surgical defect correction and
external prosthetic appliances or devices.
• Non-accidental Dental conditions.
• Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilization, venereal disease, AIDS or AIDS
Related Complex and HIV related diseases.
• Treatment or surgical pertaining to congenital abnormalities or deformities including any hereditary conditions.
• Treatment, surgery, care and/or tests pertaining to pregnancy, child birth, miscarriage, abortion and prenatal or
postnatal care, birth control, infertility, erectile dysfunction, impotence or sterilization.
• Hospitalization primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical
examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not
Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a
Physician, vitamins/food supplements and treatments specifically for weight reduction or gain.
• Any Outpatient treatment unless provided under this Plan
• Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.
• Investigation and treatment of sleep and snoring disorders and alternative therapy such as treatment, medical service
or supplies other than Western medicines including but not limited to chiropractic services, acupuncture, acupressure,
reflexology, bone setting, herbalist treatment, massage or aroma therapy or other alternative treatment.
• Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic
manifestations).
• Costs and expenses incurred for services of a non-medical nature, such as television, telephones, telex services,
radios or similar facilities, admission kit/pack, medical report and other ineligible non-medical items.
• Any treatment following an unlawful act.
Note: The exclusions described have been summarized and are not exhaustive. Please refer to the policy document for detailed exclusions.
|