MEDIGUARD LADY



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

  INTRODUCTION
 
With mediGUARD Lady, you have the flexibility to choose the ideal medical plan that best suits your needs. 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:
 
Protection against female illnesses:
-
Female Cancer includes almost all types of female related cancers.
-
Accidental Facial / Dental covers facial reconstructive surgery and sound natural teeth sustained from accident.
-
Pregnancy Complications arising from your moments of motherhood.
-
Maternity Death provides a lump sum amount for death caused by pregnancy complications.
 
Additional benefits:
-
Second Surgical Opinions covers charges for the second opinion sought for the necessity of an operation.
-
Major Medical provides increased annual limits on top of the Overall Annual Limit for a range of conditions.
-
Death / Permanent Total Disablement due to accident.



DASAR POLISI INSURAN 
Kandungan Produk
Perihal Manfaat
Pengecualian
Peruntukan & Syarat Khas
mediGUARD Lady

  PENDAHALUAN
 
Dengan Lady mediGUARD, anda mempunyai fleksibiliti untuk memilih pelan perubatan yang ideal yang paling sesuai dengan keperluan anda. Anda ditawarkan pilihan rancangan dengan atau tanpa kad perubatan. 

Dengan Kad Perubatan - Kemasukan Hospital Dan Pelepasan user Mudah Percuma 
Anda akan diberi Kurnia Insurans (Malaysia) Berhad kad perubatan. Hanya tunjukkan kad anda di mana-mana panel hospital kami untuk mendapatkan mengakui, tiada deposit diperlukan. Klik di sini untuk mencari hospital panel. Kad ini menjamin kemasukan repot percuma dan pelepasan untuk keadaan yang dilindungi. Anda mungkin hanya memerlukan untuk menyelesaikan Bayaran tidak dibayar, jika ada. 


Tanpa Kad Perubatan A - Anda Mempunyai Pilihan Bebas Hospital 
Hanya menjelaskan bil penuh sejurus selepas anda keluar dan mengemukakan kepada Kurnia Insurans (Malaysia) Berhad untuk pembayaran tuntutan untuk keadaan yang dilindungi. 

Anda boleh menikmati faedah tambahan yang murah hati: 

Perlindungan terhadap penyakit wanita:
 - Kanser Wanita merangkumi hampir semua jenis kanser 
   berkaitan wanita:

 - Melintar Wajah / Pergigian meliputi pembedahan 
   rekonstruktif muka dan bunyi gigi asli yang dialami 
   daripada kemalangan.

-  Komplikasi kehamilan yang 
   timbul dari detik-detik anda keibuan.

 - Kematian bersalin menyediakan jumlah wang sekaligus 
   untuk kematian yang disebabkan oleh komplikasi 
   kehamilan. 

Manfaat tambahan:
 - Pendapat Kedua Untuk 
 - Pembedahan merangkumi caj bagi pendapat kedua  
   yang dicari untuk keperluan operasi.
 - Perubatan Utama menyediakan meningkat had tahunan 
   di atas Had Tahunan Keseluruhan untuk pelbagai 
   keadaan.-
   Kematian / Hilang Upaya Kekal Jumlah akibat 
   kemalangan.

保险的政策细节
产品详细信息
福利说明
排除
特别规定与条件
mediGUARD Lady

  简介
 
mediGUARD 女士

，您可以灵活地选择理想的医疗计划最适合您的需求。您提供选择的方案有没有医疗卡。
 
随着医疗卡 - 麻烦免费的入院和出院
 
你会得到一个天安保险（马来西亚）有限公司医疗卡。只要出示您的卡在任何我们的面板医院的得到承认，没有存款要求。点击这里搜索的面板医院。此卡保障的覆盖条件下轻松自由的入院和出院。如果有的话，您可能只需要，解决非支付费用。
  
如果没有医疗卡 - 你有自由选择医院
 
刚出院时，解决您的法案，并提交天安保险（马来西亚）有限公司的覆盖条件下的索赔报销。
 
您可以享受丰厚​​的额外的好处：
 
预防女性疾病：
-
女性癌症包括几乎所有类型的女性有关的癌症。
-
从事故意外面部护理/牙科覆盖面部重建手术和持续的良好的天然牙。
-
从你的时刻，母亲妊娠并发症产生。
-
产妇死亡提供了一笔金额妊娠并发症引起的死亡。
 
额外的好处：
-
第二次手术意见涵盖了操作的必要性，寻求第二意见的收费。
-
主要医疗提供了各种条件下的年度总限额之上的年度限额增加。
-
因意外事故，死亡/永久完全伤残。


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
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
Female Cancer (per lifetime limit)5,0005,0005,0005,0005,0005,000
Accidental Facial / Dental Cosmetic(per lifetime limit)2,5003,5005,0006,5008,00010,000
Pregnancy Complications5,0006,0007,0008,0009,00010,000
Maternity Death10,00015,00020,00025,00030,00035,000
OVERALL ANNUAL LIMIT50,00070,00090,000110,000 130,000 150,000 
DOUBLE OVERALL ANNUAL LIMIT FOR ACCIDENTAL INJURY WHILST TRAVELING OVERSEAS100,000 140,000180,000 220,000 260,000 300,000
MAJOR MEDICAL (per lifetime limit)10,00015,00020,00025,00030,00035,000
LIFETIME LIMIT150,000 210,000 270,000 330,000 390,000 450,000 
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 from 19 years old up to 65 years old. 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
19-254414995656908591,000
26-355906717599191,1241,297
36-457088049171,1141,3711,595
46-559131,0501,2151,4811,8522,173
56-601,1561,3681,6081,9952,5473,020
61-651,4811,7732,0912,5963,3343,967
66-70 (Renewal only)1,9812,4132,8583,5364,5845,501
 
Section A : Without Medical Card (Reimbursement Basis) Option
Age / PlanPlan 1Plan 2Plan 3Plan 4Plan 5Plan 6
19-25397449509621773900
26-355316046838271,0111,167
36-456377238251,0021,2341,436
46-558219451,0931,3331,6671,956
56-601,0411,2311,4471,7962,2932,718
61-651,3331,5961,8822,3373,0003,570
66-70 (Renewal only)1,7832,1722,5733,1834,1264,951
 
Section A & B : With Medical Card & Out-Patient Clinical Benefit Option
Age / PlanPlan 1Plan 2Plan 3Plan 4Plan 5Plan 6
19-257397978639881,1571,298
26-358889691,0571,2171,4221,595
36-451,0061,1021,2151,4121,6691,893
46-551,2111,3481,5131,7792,1502,471
56-601,4541,6661,9062,2932,8453,318
61-651,7792,0712,3892,8943,6324,265
66-70 (Renewal only)2,2792,7113,1563,8344,8825,799
 
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.

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