When planning our finances for the future, it’s important to take into account unexpected events that could happen along the way such as medical expenses. Treatments for non-communicable diseases (NCDs) such as heart disease, stroke, cancer and diabetes cost the Malaysian government around RM10 billion per year.
In Malaysia, the government provides subsidised and even free public healthcare for some. As treatments at public hospitals tend to be significantly more affordable, these facilities often have long queues and waiting time. For those who prefer to seek medical treatment at private facilities, where there is less crowd, medical costs can add up to thousands of ringgit.
Depending on where you receive treatment, medical costs can be expensive and diminish your savings quickly if you’re paying out of your own pocket. One way to safeguard your savings is to buy medical insurance, which provides you with coverage on certain health expenses.
Read Also: Guide To Purchasing Life And Critical Illness Insurance Via EPF’s i-Lindung
How Medical Insurance Works In Malaysia?
When you buy medical insurance, you will need to pay premiums to your insurance provider, which is usually every month. In exchange, you will be able to claim medical expenses from your insurance provider for covered illnesses.
The extensiveness of coverage varies according to the insurance plans offered. It’s important to make sure you have sufficient coverage so when choosing an insurance plan, you want to consider factors such as the type of coverage and coverage limit.
Medical insurance plans in Malaysia typically offer coverage for hospitalisation, surgery and medical expenses. Some plans are more extensive in their coverage. For example, PRUMillion Med 2.0 by insurance provider Prudential offers coverage for outpatient rehabilitation treatments such as physiotherapy and alternative treatments and other value-added services such as second medical opinion.
You can compare the different medical plans offered by insurance providers to find out which has the most value at a price you can afford. Typically, the more comprehensive a plan, the higher the premiums will be. If you get a plan that offers comprehensive benefits but you are not able to pay your monthly premiums within the grace period, this can result in a policy lapse and cancellation, which means you will lose your insurance benefits.
Another factor to consider is the annual and lifetime limits, which set a ceiling amount on how much you can claim from your insurer. A higher annual and lifetime limits provide you with more financial protection in the event of an illness.
What Are Typically Excluded From Medical Insurance Coverage?
When considering an insurance plan, it’s also important to look at some of the common exclusions from a medical plan so you’re aware beforehand what could be covered and not by policies.
Generally, insurers will not cover pre-existing illnesses whereby these illnesses were diagnosed prior to you buying the insurance plan.
Many medical insurance plans also typically do not cover certain expenses incurred from cosmetic surgery, dental treatment, pregnancy, childbirth, treatment of congenital condition or deformities and sickness that arises from the result of hazardous sports.
It’s also important to note that there is typically a qualifying period after purchasing an insurance plan, whereby you will have to wait for the qualifying period to pass before you can make a claim. Any medical conditions that arise before the qualifying period passes will not be claimable.
Claiming Your Expenses
Should you find that you require treatment at the hospital, you may first contact your insurer to find out if the treatment is claimable and if the hospital is your insurer’s panel hospital.
If the hospital where you’re getting your treatment in is a panel hospital, your insurer can issue a hospital guarantee letter and you can be admitted without having to pay for expenses. The insurer will arrange to pay the treatment fees directly to the panel hospital.
On the other hand, if the hospital is a non-panel hospital, you will need to pay the hospital bill first and claim it later on with your insurance provider.
You can request your doctor to fill in and sign your claim form, which may be chargeable. Then, you will need to submit a written notice to your insurer within 30 days of the treatment period.
Make sure to compile all claim documents that may include original receipts, medical reports and referral letter for the submission of your claim.
Follow Us On Telegram & Instagram!
Join our Malaysia Telegram channel (@dollarsandsensemy) and follow our Malaysia Instagram Page (@dnsmalaysia) as we bring you the latest finance content in Malaysia!
Street Smart
7 Common Online Scams That Malaysians Fall For
