MEDIGUARD FAMILY - 30 days to @19 (unmarried) /@23 up to @ 65)Eligible


mediGUARD FamilyPOLICY DETAILS
Product Details
Description of Benefits
Exclusions
Special Provision & Conditions


INTRODUCTION
 
Health is precious especially to your loved ones, when a sudden illness or accident could leave you financially burdened. As hospital costs are getting higher and higher, give them the protection that they rightly deserve with the most comprehensive medical and hospitalization plan......mediGUARD Family. With mediGUARD Family, you are offered choice of plans with or without a medical card.
 
With A Medical Card - Hospital Admission And Discharge Will Be Hassle Free
 
You will be given a Kurnia Insurans (Malaysia) Berhad medical card. Just present your card at any of our panel hospitals to get admitted, no deposit required. Click here to search for a panel hospital. This card guarantees hassle free admission and discharge for a covered condition. You may only need to settle non-payable charges, if any.
   
Without A Medical Card - You Have Free Choice Of Hospital
 
Just settle your full bill upon discharge and submit to Kurnia Insurans (Malaysia) Berhad for claims reimbursement for a covered condition.
 
You can enjoy generous additional benefits:
-
Out-Patient Kidney Dialysis / Cancer Treatment
-
Emergency Accidental & Dental Out-Patient Treatment
-
Out-Patient Physiotherapy Treatment
-
Organ Transplant
- Insured Daily Guardian Benefit
-
Second Surgical Opinions
-
AIDS
- Home Nursing
- Double Overall Annual Limit For Accident Occurs Overseas
- Major Medical
- Accidental Death
- Permanent Total Disablement Due To Accidental Injury
- Bereavement Benefit On Accidental Death
- Out-Patient Clinical Benefit (Optional). Click here to search for a panel clinic.
- Full Reimbursement for Government Hospital (up to overall annual limit)




SCHEDULE OF BENEFIT
 
SECTION A : BENEFIT / PLAN
Plan 1
(RM)		Plan 2
(RM)		Plan 3
(RM)		Plan 4
(RM)		Plan 5
(RM)		Plan 6
(RM)
IN-HOSPITAL BENEFITSMaximum Per Disability
Accommodation:
Hospital Room & Board (daily max up to 150 days)100150200250400600
Intensive Care Unit, ICU (daily max up to 20 days)Full Reimbursement
Medical & Surgical Procedures:
Surgical Fees (including post-surgery                               care up to 60 days from date of surgery)Full Reimbursement
Operating Theatre
Anaesthetist Fee
Pre-Hospital Diagnostic Tests & Specialist Consultation (31 days prior to admission)
In-Hospital Physician Visit (daily max up to 150 days)
Post-Hospitalization Treatment (within 60 days from date of discharge)
Hospital Supplies & Services
Prescribed Medicines (within 150days during hospitalization and 60 days after discharge)
Ambulance Fees
OUT-OF-HOSPITAL BENEFITS
Out-Patient Benefits:
Annual Out-Patient Kidney Dialysis Treatment20,00025,00035,00040,00050,00060,000
Annual Out-Patient Cancer Treatment20,00025,00035,00040,00050,00060,000
Emergency Accidental & Dental Out-Patient Treatment (seek treatment within 24 hours and follow-up within 31 days)Full Reimbursement
Out-Patient Physiotherapy Treatment (within 60 days from discharge)
EXTENDED BENEFITS
Organ Transplant (per lifetime limit)Full Reimbursement
Daily-Cash Allowance At Government Hospital (up to 150 days)5060708090100
Insured Daily Guardian Benefit (aged below 15 years, up to 150 days)505050505050
Medical Report505050505050
Second Surgical Opinions50507070100150
Government Service Tax5% of Hospital Room & Board Eligible Expenses Reimbursable
SPECIAL BENEFITS
AIDS (per lifetime limit)5,0005,0005,00010,00010,00010,000
Home Nursing5,0005,0006,0008,0008,00010,000
OVERALL ANNUAL LIMIT70,00080,00090,000100,000 120,000 150,000 
DOUBLE OVERALL ANNUAL LIMIT FOR ACCIDENTAL INJURY WHILST TRAVELING OVERSEAS140,000 160,000180,000 200,000 240,000 300,000 
MAJOR MEDICAL (per lifetime limit)10,00015,00020,00025,00030,00035,000
LIFETIME LIMIT210,000 240,000 270,000 300,000 360,000 450,000 
PERSONAL ACCIDENT BENEFITS
Accidental Death10,00015,00020,00025,00030,00035,000
Permanent Total Disablement Due To Accidental Injury10,00015,00020,00025,00030,00035,000
Bereavement Benefit On Accidental                               Death Only1,5001,5001,5001,5001,5001,500
 
SECTION B : BENEFIT / PLAN
Plan 1Plan 2Plan 3Plan 4Plan 5Plan 6
OUT-PATIENT CLINICAL BENEFITS (OPTIONAL)
Out-Patient GP Care (in the Physician's office or clinic)
· Consultation
· Medication
· Diagnostic Test (for accidental injury only)		Panel
- Co-payment RM 5 per visit
- Unlimited number of visits per annum

Non-Panel
- Reimburse up to 80% of the actual charges or maximum RM 20 per visit, subject to emergency basis only

Out-Patient Specialist Care (in the Physician's office or clinic)
· Consultation
· Medication
· Diagnostic Test (for accidental injury only)		Co-payment RM5 per visit up to RM100 per visit (inclusive of co-payment) subject to referral by panel clinics only (reimbursement basis)
Preventive Screening For Annual Pap Smear Or Prostate Specific AntigenFull Reimbursement at panel GP clinics only
OVERALL ANNUAL LIMITRM 1,500
LIFETIME LIMITRM 4,500
 
Please refer to Description of Benefits for definition of terms.


ELIGIBILITY
 
Enrolment age up to 65 years old and any child from 30 days to 19 (if unmarried) or 23 years old (if unmarried & completing tertiary studies). Renewal is up to age 65 at the option of the Policyholder, thereafter at the discretion of the Company up to 70 and provided that you are enrolled before 61 years old.

PREMIUM
 
Premium is calculated based on age next birthday and type of plan.
 
Annual Premium Table On Age Next Birthday (RM)
 
Section A : With Medical Card Option
Age / PlanPlan 1Plan 2Plan 3Plan 4Plan 5Plan 6
30 days - 185756597409141,1371,288
19-254685346057359101,049
26-354765426167489251,067
36-455996867909661,2031,399
46-558961,0471,2261,5141,9112,242
56-601,2021,4261,6802,0872,6593,132
61-651,5491,8602,2002,7353,5074,148
66-70 (Renewal only)2,0872,5493,0283,7554,8615,803
 
Section A : Without Medical Card (Reimbursement Basis) Option
Age / PlanPlan 1Plan 2Plan 3Plan 4Plan 5Plan 6
30 days - 185015796548151,0211,160
19-25402463529649811939
26-35410471539661825957
36-455236047008631,0831,264
46-557999381,1031,3691,7372,043
56-601,0821,2881,5231,9002,4292,866
61-651,4031,6902,0042,5003,2133,807
66-70 (Renewal only)1,9002,3272,7713,4424,4665,337
 
Section A & B : With Medical Card & Out-Patient Clinical Benefit Option
Age / PlanPlan 1Plan 2Plan 3Plan 4Plan 5Plan 6
30 days - 188739571,0381,2121,4351,586
19-257668329031,0331,2081,347
26-357748409141,0461,2231,365
36-458979841,0881,2641,5011,697
46-551,1941,3451,5241,8122,2092,540
56-601,5001,7241,9782,3852,9573,430
61-651,8472,1582,4983,0333,8054,446
66-70 (Renewal only)2,3852,8473,3264,0535,1596,101
 
Loading will be imposed based on height and weight of the insured person. Please refer to Height and Weight Table

Kurnia Hassle Free Hospital Admission
 
 Medical Claim
 
1.
Call 24 Hrs Kurnia Call Centre for location of nearest Kurnia Panel Hospitals.
2.
Present the Medical Card to the Admission Counter of Kurnia Panel Hospital.
3.
Kurnia Panel Hospital will then liaise with Kurnia for policy verification and fax the Admission Report to Kurnia Medical Insurance Department.
4.
Kurnia return fax with Guaranteed Letter to Kurnia Panel Hospital for all Covered Conditions; Letter of Decline for non-covered conditions.
5.
Private Hospitals may require basic deposits for incidentals/non-covered expenses.
6.
Kurnia Panel Hospital will prepare the Discharge Documentation and fax to Kurnia;               
Kurnia Medical Insurance Department process the documentation immediately and return fax with Payment Advice to the Panel Hospital.
7.
Upon settling incidentals/non-covered expenses, if any, insured may be discharged.


BReimbursement Claims
  
1.
Insured are allowed to be admitted to any Private Hospitals (non-Kurnia Panel Hospitals) under Reimbursement Claims Procedures.
2.
Written Notification is required for all Hospital Admissions; within 30 Days from date of admission.
3.
Complete Claims Documentation which includes original itemised bills & receipts, completed claim form, completed physician's medical report and other relevant claims documents are required to be submitted to Kurnia (within 30 days from discharge date) for claims processing.
4.
For covered conditions, an offer letter and discharge voucher will be issued to the Insured on the amount payable. Upon receipt of the signed discharge voucher from the Insured, Kurnia will proceed to issue claims payment.




Just because you eat veggies and hit the gym regularly doesn't mean you are immune to an illness, or an accident won't happen to you.

There was an incident way back many years ago published by The Star that a little boy need RM150,000 for a special treatment suit to wear on for one year or more for recuperation and rejuvenate his scalded wounds which was 80% due to fire and so lucky he was to have a sponsor for his medical bill from a rich Arab Emir. Not so lucky for a quite similar situation as my ex-colleague.

I use to know this young colleague from insurance company telemarketing division, which has experience burn from very hot boiling water from neck downward and shoulder during his childhood. He was trying to reach for food or something in the kitchen, grab the boiling pot that bathed him all over and badly scalded his shoulder and neck. His plight was lifetime as the skin behind his neck and shoulder cannot growth normally and lose the elasticity of a normal skin. The skin growth on his neck and shoulder is so abnormal as it affect his physical growth and height.

Everyone requires medical help at some point and if you don't have insurance, the resulting bill is going to be painful. Deliver a baby -- without complications --and expect to fork over an average of RM10,000 according to one doctor, use to be my wife gynecologist of the Subang Jaya Medical Centre. Get diagnosed with cancer and the expenses can  go into the hundreds / thousand-ringgit range.

If your employer doesn't offer coverage in a group plan, look into an individual policy. Just be aware that private health insurance typically requires holders to pay higher premiums than they would with a group plan. And coverage may be more limited. To find the right individual plan, continue to read this web site, which often lists area insurance providers, and web sites like e Health Insurance.com and My Insurance Expert.com for free information.

Visit our pages for more on choosing and getting the best health plan.
SelectionFile type iconFile nameDescriptionSizeRevisionTimeUser
SelectionFile type iconFile nameDescriptionSizeRevisionTimeUser
ċ
View		   Dec 5, 2010, 12:50 AM Simon Poon
SelectionFile type iconFile nameDescriptionSizeRevisionTimeUser
Ċ
View Download		   104k v. 3 Jun 3, 2010, 11:18 PM Simon Poon
SelectionFile type iconFile nameDescriptionSizeRevisionTimeUser
Ċ
View Download		   687k v. 3 Jun 3, 2010, 11:17 PM Simon Poon
Comments