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 Great Eastern Medical Card Co-Insurance Questions

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roystevenung
post Jul 6 2012, 07:46 PM

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QUOTE(leonard73 @ Jul 6 2012, 07:11 PM)
Before you buy any of medical cards from any insurance agent, make sure you know the room rates or board charged by selective private hospital..co-insurance is something which d patient have to share the bill with the insurance company based on percentage or max charged. Another thing is make sure is renewalable after been claimed. And Annual limits is important, make sure your annual limits r big enough for your own needs as that only allow to claims for each year. If you just need a medical card, I suggested you get a term medical card instead of investment or endowment plan. Strongly advise do not bond it with other insurance as most of the agent will give you the cheapest medical protection.
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For the sake of discussion, (bear in mind I'm not saying that your post is right or wrong) but lets discuss this openly so that readers have a better understanding. The reason why I am mentioning this is because of experiences I had while talking to people who got term insurance.

1st Scenario

Suppose at age 30, an agent ask you to sign a term policy (that does not accumulate cash value or one that does but the cash values generates very slowly and is not enough to cover for the insurance charges at later years) and it'll cost you RM 100/mth. 10 years later the premium is increased by RM 125/mth and you thought, well its alright cos my agent did mentioned that insurance charges will go up by age.

However, at age 60, the premium shot to RM 200/mth, you'll start cursing the agent for selling you a plan that increases almost 100% from the original amount. Bear in mind at 60 those who is working for people has already retired and have to live with whatever investment/savings that they had accumulated during their working life.

At age 65, the same agent still have to bear the swearing + cursing because the premium now is at RM 300/mth.

2nd Scenario

Term insurance are not as flexible as the ILP product, to the extreme that if you want to increase the medical coverage 10 years later, you're not able to do so. When you want to review, the agent will have to propose another medical plan for you.

I'm not sure if you're aware but older traditional with medical are far more superior in terms of the terms and conditions. For example older plans do cover implants, (implanted pacemaker costs ~RM 43K at a private hospital at Penang) while newer plans as stated by LIAM is to be excluded.

If you get the new plan, you're not covered for implants.

3rd Scenario

Most term insurance have limited riders, the utmost being the waiver of premium if Totally & Permanently Disabled or Critical Illness happens.

As an agent, and most importantly as a human being, wouldn't it be hard if not impossible to go tell the friend that is bedridden due to stroke, with no income that he'll lose his medical cover because he had bought a plan that does not waive if CI!

Please do note that I'm just trying to view your posts in another perspective, no pun intended. If I do say anything wrong, please do forgive me as it is not my intention to do so. notworthy.gif

This post has been edited by roystevenung: Jul 6 2012, 08:08 PM
roystevenung
post Jul 10 2012, 09:36 AM

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QUOTE(davidlow7 @ Jul 8 2012, 01:31 AM)
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.
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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 1.2k 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.

This post has been edited by roystevenung: Jul 11 2012, 08:21 AM
roystevenung
post Nov 17 2012, 01:03 PM

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^ the medical costs for cancer treatment can go up to RM 300K, hence you need to buff up on the medical card 1st and then the lump sum CI.

The lump sum CI can only be paid upon diagnosis of the cancer (The cancer must be confirmed by histological evidence of malignancy)
by which would normally take a month or more after the reports had been submitted to the insurer.

However, in order for the doctor to write those reports, mammography for example has to be done and thereafter followed by the treatment eg, radio/chemo.

This is where you need to use your medical card and not the lump sum CI. Also, you do not want to claim out the CI to pay for the medical card, would you?
roystevenung
post May 1 2013, 08:13 AM

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QUOTE(candyS @ Apr 28 2013, 09:56 PM)
can pm me also with example ? thanks
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If you are worried of the amount of co insurance you need to pay if hospitalised then a better alternative is DEDUCTIBLE.

For Co insurance it is by PERCENTAGE of the bill, subject to the min and max. For example if the bill is RM3000, 10%= Rm300, but if the bill is Rm10k, then the maximum co insurance that you need to pay is Rm500.

Deductible on the other is a fixed amount that you need to pay, for example deductible RM300.

There are also plans that is without any co insurance, meaning full claim.

 

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