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 Great Eastern Medical Card Co-Insurance Questions

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davidlow7
post Jul 5 2012, 12:47 AM

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QUOTE(klnaj @ Jul 4 2012, 08:09 PM)
Hi all, I were approached by one of my friends who just recently join Great Eastern. As I don't have any medical card yet and he advise me to have one. Maybe he is new in this field, after the explanation, I still have some doubts in my mind which I hope someone over here can help me to clear it out.

On the quotation, it stated subject to 10% co-insurance, subject to a maximum of RM500

20% co-insurance, with no max cap for plan sm100 & sm150 if upgrade room and board

20% co-insurance, subject to a max of RM3000 for plan sm200/300/400, if upgrade room and board

So, exactly how much co-insurance I need to pay if i admitted to hospital? If have a kidney failure treatment, the co-insurance apply to the total bill or some of the charges?

I appreciate if someone can help me on this or perhaps provide some example for easy understand. Many thanks.
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Get the product disclosure sheet.

Are they proposing SmartProtect Essential ILP?

This post has been edited by davidlow7: Jul 5 2012, 12:48 AM
davidlow7
post Jul 8 2012, 01:31 AM

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Let's us discuss here about co-insurance

Some companies say that although co-insurance is not included in their plan, but the insurance charges shall also be higher.

I supposed we need to have a proposal to carefully study the details and decide.

Every insurance companies are good and they have their plus points. End of the day it is the buyers find some more suitable to their needs.

I once talked to my insurance agent before, that if there is any disease that require you to seek medical treatment on a frequent basis then co-insurance will be pain in the ass since it is counted based on per visit.

Maybe we can list out what are the possible diseases that require you to seek medical treatment on a frequent basis and the frequent is a long term or short term. Some frequent basis, perhaps bi-weekly but maximum 7 times then you are doomed to recover or "bye-bye".

I think we need to list out the type of diseases and how frequent + how long.

Secondly, we can then compare on the insurance charges especially at later year.

Buyers can then do their own judgement to see.


My personal view is...
After all, a high RM300/500 co-insurance may appear to be scary but if we look into a longer term, it may not be so bad.

Still a B&W comparison speaks louder than everything.

I am not insurance agent but I do find having NO co-insurance certainly is an advantage, but neither having co-insurance means disadvantage as well.

I personally already have 1 with co-insurance but will for sure go with 1 without co-insurance if I am going for my 2nd medical card and will use any of them base on the current circumstances.

Although I hope I have a good long life and won't need using them so maybe at later years when I am old, I can choose to surrender 1 of them and get back a decent cash returns. If it does break even during that time or at least close to it, then I know I made a good planning to myself for being protected at that time without even the need of paying.

I hope your insurance agents are sharing to you whatever you need to know such as what can be claimed using medical card and what cannot, what are the necessary riders ...

However all these will really depends on the quality of agent where I have met a lot, either they apply fear factor or they just draft up a simple one (as they try not to confuse you in order to close your sales fast), so problem will be later on for you to face but thankfully for ILP being a flexible product, however still subject to underwriting if you were to increase protection or so on.

So make sure you really know what you are buying. But LYN is always here.

My 2 cents.

This post has been edited by davidlow7: Jul 8 2012, 07:23 PM
davidlow7
post Jul 10 2012, 10:56 AM

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QUOTE(roystevenung @ Jul 10 2012, 09:36 AM)
Hi David, sorry for the late reply, been sick these few days....

Tit for tat, hence for medical card that is without co-insurance, in a long run you end up paying more premium but of course if you do claim many many times, especially if need to do chemo or worst kidney dialysis for life the co-insurance thingy might come as a hassle.

This is why our PRUhealth plan (for inpatient: 10% co insurance, min Rm 300 max Rm 1000, for outpatient: 10% max RM 2000) was implemented. Under this plan suppose the chemo cost RM 12K, the client will need to absorb RM 1K for each chemo done.

This is different from our newest PRUflexi med plan (deductible RM 300 or zero deductible (ZD)), if you choose RM 300 deductible, the deductible is applied after 90 days of the last treatment. If you choose ZD then the client don't have to pay anything. The premium for RM 300 deductible is more expensive than PRUhealth but is cheaper than PRUflexi med ZD.

If one had claim many times, declaration is important if you intend to get a second medical card as this may falls under exclusions for pre-existing illness. Some clients do opt for double medical card and you're able to claim from both cards for example one has PRUhealth & PRUflexi med.

The claim was made on PRUhealth and the co-insurance is RM 1K. He/she can claim the RM1k from the second medical card of PRUflexi med. This is also applicable if you are having GE medical card with co-insurance & PRUflexi med. Documentation required is a summary bill of what is covered and what is not covered along with the discharge note.
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Thanks..

You made a very good point on kidney dialysis for life and I really see the importance of without co-insurance/

I was trying to figure out what kind of issue require frequent treatment that co-insurance can kill you off really.

QUOTE(jack2 @ Jul 10 2012, 09:59 AM)
Soon this thread will become thread of PM-ing by insurance agent to TS.

Suggest to lock / close / delete the thread.
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Every new thread even in an existing thread, there will be agent also PM to get sales. This is their job as an insurance agent and TS will usually aware of this when he decided to query his issue in a public forum like LYN.

End of the day if the agent is doing a good job and providing a good service to the client, I think this is not really a bad thing. Either way, TS has his rights to exercise to either reject or accept.

This post has been edited by davidlow7: Jul 10 2012, 10:56 AM

 

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