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 Insurance Talk V7!, Your one stop Insurance Discussion

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Ramjade
post May 7 2026, 08:20 AM
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QUOTE(Cyyap95 @ May 6 2026, 04:47 PM)
Guys please advice, so I had an old policy with low limit, about RM220/mo right now, 150k annual limit, 600k lifetime limit from GE.

It's too low for current medical cost, so I had apply medical insurance from AIA and Generali, but I had disc slipped at my lower back few years ago.

Now both offer include quite broad exclusion for my lower back/lumbar spine, the exclusions basically also include any disease, tumor, new accidents, etc.

One agent tell me I should still accept the offer first and re-appeal later with new mri and doctor report for revision on these exclusions.

But i wonder if that's true, anyone had any chance on getting these exclusions narrow down or even remove it? My disc slipped is one-off, from weight lifting, fully recovered no surgery done.
*
Unlikely will be remove or narrow down. Why?
Insurance is a for the company to make money and their goal is pay out as little as possible. Their goal is company first, you as customer is second.
Hence you are a marked person already. Your case can happen again (I think). So ask yourself if you as insurance company, will I want to take a client with previous back problem?
Of course no. I am not going to cover the back problem so that I can minimise payout and maximise profit. Do I want to pay out for back problem in the future knowing this person have some back problem. Of course no.

Harsh but sad reality of life. No advise here but showing you the sad reality of life.

This post has been edited by Ramjade: May 7 2026, 08:22 AM
Haloperidol
post May 7 2026, 08:20 AM
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QUOTE(Ramjade @ May 6 2026, 04:29 PM)
What is there liability. I telling him don't buy ILP. If he really wants life insurance, go buy a standalone insurance. Do not not touch ILP. Do not buy and pay for 2 insurance. Like that also so difficult to understand?

I am no insurance agent and I got nothing to sell. But I am person who banks and insurance company won't like me as their customer as I don't give free money to banks or insurance.
*
True true , i'm also a part of the group where if i want insurance, just give me insurance.
I dont need ILP.
I know you try to find a living but they give so much smoke screen

- buy ILP so your premium wont rise in future
* YET if you say is it confirmed that your premium is fixed for the rest of the years, they will say High probability and try to explain the mechanism where your premium offset by the Investment side.

- buy big huge limit like 1 million per year in future
* Chances are, you wont be able to use it properly
* Insurance are subject to fair usage policy like your telco (ie Umobile say unlimited but actually after 200GB your speed is capped)
* Statistic shown : Most (80%++) of the admission for small to medium case range from 20k to 40k (i.e Appendicitis/ Trauma case )
* 1 day stay of ICU with insurance fair usage policy around 20k per day IIRC
* What do you mean experimental treatment like Biomarker targeted therapy ? That is most probably not covered in your insurance.
* I think even Semaglutide / Ozempic / Mounjaro is not even covered in Obesity clinic

On a bright side, the increase in premium is lesser and lesser as you expand your limit, so maybe 100 for 100k , 150 for 130k, 200 for 1m , 250 for 2m
- for my personal own insurance, i just put some 120% to 140% of total price of a Cabbage (heart bypass) package as limit, if i really need beyond that, i'm just literally cooked, just let me die then.

- I'm just gonna wait for BNM MHIT policy.
I have big hopes for that.

This post has been edited by Haloperidol: May 7 2026, 08:25 AM
Ramjade
post May 7 2026, 08:26 AM
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QUOTE(Haloperidol @ May 7 2026, 08:20 AM)
True true , i'm also a part of the group where if i want insurance, just give me insurance.
I dont need ILP.
I know you try to find a living but they give so much smoke screen

- buy ILP so your premium wont rise in future
* YET if you say is it confirmed that your premium is fixed for the rest of the years, they will say High probability and try to explain the mechanism where your premium offset by the Investment side.

- buy big huge limit like 1 million per year in future
* Chances are, you wont be able to use it properly
* Insurance are subject to fair usage policy like your telco (ie Umobile say unlimited but actually after 200GB your speed is capped)
* Statistic shown : Most (80%++) of the admission for small to medium case range from 20k to 40k (i.e Appendicitis/ Trauma case )
* 1 day stay of ICU with insurance fair usage policy around 20k per day IIRC
* What do you mean experimental treatment like Biomarker targeted therapy ? That is most probably not covered in your insurance.
* I think even Semaglutide / Ozempic / Mounjaro is not even covered in Obesity clinic

On a bright side, the increase in premium is lesser and lesser as you expand your limit, so maybe 100 for 100k , 150 for 130k, 200 for 1m , 250 for 2m

- I'm just gonna wait for BNM MHIT policy.
I have big hopes for that.
*
I got nothing to sell and just poking at insurance agents saying all is fine and world is full of flowers and rainbows who doesn't even know about ETF or if they know about ETF, advise them to invest instead in insurance unit trust when they know it is rubbish* Lol.

*if they even know if it is rubbish.

I got no hope for BNM MHIT. I follow what a FIRE blogger said. Self insured when the times come so that you won't be binded to any terms and conditions or some exclusions.

This post has been edited by Ramjade: May 7 2026, 08:28 AM
Haloperidol
post May 7 2026, 08:32 AM
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QUOTE(Ramjade @ May 7 2026, 08:26 AM)
I got nothing to sell and just poking at insurance agents saying all is fine and world is full of flowers and rainbows who doesn't even know about ETF or if they know about ETF, advise them to invest instead in insurance unit trust when they know it is rubbish* Lol.

*if they even know if it is rubbish.

I got no hope for BNM MHIT. I follow what a FIRE blogger said. Self insured when the times come so that you won't be binded to any terms and conditions or some exclusions.
*
Younger me will argue with them about details
Now i just wave and say har har yeah yeah, but i have my own, and i'm not interested. TQ

True, self insured is the best.

Same applies to Saving plan etc.

This post has been edited by Haloperidol: May 7 2026, 08:33 AM
contestchris
post May 7 2026, 10:42 AM
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QUOTE(Haloperidol @ May 7 2026, 08:32 AM)
Younger me will argue with them about details
Now i just wave and say har har yeah yeah, but i have my own, and i'm not interested. TQ

True, self insured is the best.

Same applies to Saving plan etc.
*
I agree, self insured is the best but only up to a point.

The best of both worlds, is a high deductible medical plan. Up to rm20k or rm30k, touch wood, we should be able toncover ourselves. But for tail risk events, it is better to have some insurance coverage. Insurers usually will deny or reject smaller procedures, but bigger ones generally not so much an issue (unless you have preexisting).


JIUHWEI
post May 7 2026, 12:22 PM
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QUOTE(Ramjade @ May 6 2026, 04:29 PM)
What is there liability. I telling him don't buy ILP. If he really wants life insurance, go buy a standalone insurance. Do not not touch ILP. Do not buy and pay for 2 insurance. Like that also so difficult to understand?

I am no insurance agent and I got nothing to sell. But I am person who banks and insurance company won't like me as their customer as I don't give free money to banks or insurance.
*
1. Do you know his Loan Tenure?
2. Do you know his MRTA Tenure?

If your answer is "No" for the above 2 questions, how did you deduce that "in actual fact" that he did not need life insurance? This is the part I believe you gta clarify sikit.

Nobody is trying to push ILP to him. Why did you even bring it up in this context?

Every charge by any and all financial institutions are clearly recorded.
Who do you know gives free money to banks and insurance?

This post has been edited by JIUHWEI: May 7 2026, 01:12 PM
JIUHWEI
post May 7 2026, 12:36 PM
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QUOTE(Cyyap95 @ May 6 2026, 04:47 PM)
Guys please advice, so I had an old policy with low limit, about RM220/mo right now, 150k annual limit, 600k lifetime limit from GE.

It's too low for current medical cost, so I had apply medical insurance from AIA and Generali, but I had disc slipped at my lower back few years ago.

Now both offer include quite broad exclusion for my lower back/lumbar spine, the exclusions basically also include any disease, tumor, new accidents, etc.

One agent tell me I should still accept the offer first and re-appeal later with new mri and doctor report for revision on these exclusions.

But i wonder if that's true, anyone had any chance on getting these exclusions narrow down or even remove it? My disc slipped is one-off, from weight lifting, fully recovered no surgery done.
*
For now, keep your current GE policy alive.

I still maintain the small medical insurance from my youth, 90k annual limit.
Why leh?
Sebab that one got no exclusions. Cantik2 wan.
Whereas the current one does not cover for my right shin, and my nasal tract.

Have I attempted to appeal for it, yes. And failed.
So from a risk perspective, just maintain the old policy who also covers for it.
This is my risk to live with. No point for name-calling and blame the insurer.

We go to a bar at 8pm, happy hour from 7pm-9pm. Heng, just in time.
Now it's 10pm, you request the server to still charge you happy hour promo. Server say x boleh.
You still get your drinks but without the happy hour promo.
The server evil or just doing their job? Or the bar owner yang jahat?


This post has been edited by JIUHWEI: May 7 2026, 01:00 PM
JIUHWEI
post May 7 2026, 12:50 PM
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QUOTE(Ramjade @ May 7 2026, 08:20 AM)
Unlikely will be remove or narrow down. Why?
Insurance is a for the company to make money and their goal is pay out as little as possible. Their goal is company first, you as customer is second.
Hence you are a marked person already. Your case can happen again (I think). So ask yourself if you as insurance company, will I want to take a client with previous back problem?
Of course no. I am not going to cover the back problem so that I can minimise payout and maximise profit. Do I want to pay out for back problem in the future knowing this person have some back problem. Of course no.

Harsh but sad reality of life. No advise here but showing you the sad reality of life.
*
Every company that was ever registered is a for-profit entity.
Same like your company(s), or the ones you work for.
Otherwise, where does the profits from your ETF investments come from?

And you speak as if insurers are not regulated.
Did you know insurers also have to justify denying coverage/imposing exclusions?
There are rigid compliance guidelines put in place by our gov (and all govs wherever insurers operate) to protect their own markets.
If ikut suka saja... Lesen gantung je lah.
Maximise profit by denying claim... Maybe you can consult with Prudential Singapore on how that is going for them?
Then process improvement that every company is doing is just... to create jobs? Pay salaries out of the goodness of their hearts?


I just find it strange to champion self-insure when you can transfer the risk for pennies on the dollar.
If the amounts that you pay for insurance is going to impact your investments, you're gambling!
And nobody in their right mind is asking you to choose between insurance and investments.
I do my own investments too, and I have other FAs that I work with and I am a client as well.

We don't live on an island bro. I encourage you to stop being a victim.
Simply because you're not.
Ramjade
post May 7 2026, 01:35 PM
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QUOTE(JIUHWEI @ May 7 2026, 12:22 PM)
1. Do you know his Loan Tenure?
2. Do you know his MRTA Tenure?

If your answer is "No" for the above 2 questions, how did you deduce that "in actual fact" that he did not need life insurance? This is the part I believe you gta clarify sikit.

Nobody is trying to push ILP to him. Why did you even bring it up in this context?

Every charge by any and all financial institutions are clearly recorded.
Who do you know gives free money to banks and insurance?
*
Yes, I do not and don't want to know. Why? It does not concern my finances.

However if you see his post the agent ask him to take up a ILP with MRTA and life insurance and you are actually saying it's ok to take up or something similar. Are you mad?

Why should I be paying for 2 more or less same insurance and just to get the life insurance with ILP when I can just buy life insurance directly, pay for 1 MRTA only?

QUOTE(JIUHWEI @ May 7 2026, 12:36 PM)
For now, keep your current GE policy alive.

I still maintain the small medical insurance from my youth, 90k annual limit.
Why leh?
Sebab that one got no exclusions. Cantik2 wan.
Whereas the current one does not cover for my right shin, and my nasal tract.

Have I attempted to appeal for it, yes. And failed.
So from a risk perspective, just maintain the old policy who also covers for it.
This is my risk to live with. No point for name-calling and blame the insurer.

We go to a bar at 8pm, happy hour from 7pm-9pm. Heng, just in time.
Now it's 10pm, you request the server to still charge you happy hour promo. Server say x boleh.
You still get your drinks but without the happy hour promo.
The server evil or just doing their job? Or the bar owner yang jahat?
*
At least your are being honest here that the new insurance will likely exclude that illness. 🫡

QUOTE(JIUHWEI @ May 7 2026, 12:50 PM)
Every company that was ever registered is a for-profit entity.
Same like your company(s), or the ones you work for.
Otherwise, where does the profits from your ETF investments come from?

And you speak as if insurers are not regulated.
Did you know insurers also have to justify denying coverage/imposing exclusions?
There are rigid compliance guidelines put in place by our gov (and all govs wherever insurers operate) to protect their own markets.
If ikut suka saja... Lesen gantung je lah.
Maximise profit by denying claim... Maybe you can consult with Prudential Singapore on how that is going for them?
Then process improvement that every company is doing is just... to create jobs? Pay salaries out of the goodness of their hearts?
I just find it strange to champion self-insure when you can transfer the risk for pennies on the dollar.
If the amounts that you pay for insurance is going to impact your investments, you're gambling!
And nobody in their right mind is asking you to choose between insurance and investments.
I do my own investments too, and I have other FAs that I work with and I am a client as well.

We don't live on an island bro. I encourage you to stop being a victim.
Simply because you're not.
*
You don't understand what I meant. Of course everyone is for profit. However come on la. Person already symptoms free for how many donkey years, cover je la the person. Nope. Once you got certain illness you are a marked man or woman for life and exclusion will continue to apply.

You know right no insurance agent will tell their clients don't take ILP? Majority of them always push ILP and tell you don't buy standalone. Then promise you that the ILP investment sure will cover you so you no need to pay in the future. You have no idea how many times I heard this script. Then when tell them that ETF returns are like 4-5x the ILP returns they act like blur. If the ILP returns are good, ok. But it is not.

I think they are winning as the policy does not have keyhole surgery and only open surgery so if you follow the contract word by word, good luck to the one initiating the lawsuit against prudential. All insurance company same one. Try their best not to pay you money. Try every trick in their book. Once they have exhaust their excuses, then no choice lo. Payout lo. Until then delay, deny, defend.

Again you don't understand where I am coming from. I pay so much for insurance and for them to deny me when I need it most and when I need to use it. Come on. Where got fair? I pay you and expect you to furfilled the end of the bargain and then suddenly don't want to cover me. See my point? If I self insurance, guaranteed no denial of claims. Guaranteed to have some payout without any terms and conditions. See my point. Rather than paying the insurance so much money and got denied or no coverage, better to pay myself and when I need to use it, the money is there. No own going to say oh you go for keyhole surgery, this one not covered becauase contract only said open surgery.

I said buy standalone and avoid ILP at all cost.
JIUHWEI
post May 7 2026, 02:15 PM
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QUOTE(Ramjade @ May 7 2026, 01:35 PM)
Yes, I do not and don't want to know. Why? It does not concern my finances.

However if you see his post the agent ask him to take up a ILP with MRTA and life insurance and you are actually saying it's ok to take up or something similar. Are you mad?


*
How did it become about you?

Where did I say what you claim I said?
Can show me?

QUOTE(Ramjade @ May 7 2026, 01:35 PM)
Why should I be paying for 2 more or less same insurance and just to get the life insurance with ILP when I can just buy life insurance directly, pay for 1 MRTA only?

*
Would it make sense when I asked "What's the objective?"
Is it a fair question for anyone rational to ask?
Or is it because an insurance agent is asking so you triggered?

I curious.

QUOTE(Ramjade @ May 7 2026, 01:35 PM)
At least your are being honest here that the new insurance will likely exclude that illness. 🫡
You don't understand what I meant. Of course everyone is for profit. However come on la. Person already symptoms free for how many donkey years, cover je la the person. Nope. Once you got certain illness you are a marked man or woman for life and exclusion will continue to apply.
*
So doctors' reports on the conditions are irrelevant then? Insurers just like to give people assignments?
Like I mentioned countless times, any counter offers has to be justified and based on guidelines set out by the regulators, the government.
And are you a doctor? You did tests on him and read his reports, and hence you know for a fact that his appeal on waiving the exclusions down the road will be denied?
You can also tell the future in no uncertain terms?
So forumers here should take your word for it and not even try?

QUOTE(Ramjade @ May 7 2026, 01:35 PM)
You know right no insurance agent will tell their clients don't take ILP? Majority of them always push ILP and tell you don't buy standalone. Then promise you that the ILP investment sure will cover you so you no need to pay in the future. You have no idea how many times I heard this script. Then when tell them that ETF returns are like 4-5x the ILP returns they act like blur. If the ILP returns are good, ok. But it is not.
*
Standalone plans have higher commissions. Why would I shy away and push a lower commissions product?
Maybe because you've been meeting subpar insurance agents from around your circles.
Then you generalize and say all insurance agents same wan.
Has it crossed your mind to ask why is it that those are the only ones you're meeting?
Seeing how you are comparing ETF returns and ILP... you've lost the plot my friend.
Come back to the bright side of life. The right side of life.

QUOTE(Ramjade @ May 7 2026, 01:35 PM)
I think they are winning as the policy does not have keyhole surgery and only open surgery so if you follow the contract word by word, good luck to the one initiating the lawsuit against prudential. All insurance company same one. Try their best not to pay you money. Try every trick in their book. Once they have exhaust their excuses, then no choice lo. Payout lo. Until then delay, deny, defend.
*
So not paying a few hundred thousand and consequentially losing millions in existing and new business = winning?
Think, my friend. Broaden your horizons. Wake up. Smell the coffee.

QUOTE(Ramjade @ May 7 2026, 01:35 PM)
Again you don't understand where I am coming from. I pay so much for insurance and for them to deny me when I need it most and when I need to use it. Come on. Where got fair? I pay you and expect you to furfilled the end of the bargain and then suddenly don't want to cover me. See my point? If I self insurance, guaranteed no denial of claims. Guaranteed to have some payout without any terms and conditions. See my point. Rather than paying the insurance so much money and got denied or no coverage, better to pay myself and when I need to use it, the money is there. No own going to say oh you go for keyhole surgery, this one not covered becauase contract only said open surgery.
*
I don't want to understand where are you coming from. I'll be very worried if I did.
In my world, my savings, investments, emergency funds, insurance, commitments, are kept separate. I encourage you to do the same with some structure and discipline.

Nobody in their right mind saves and invest just to potentially pay for their medical bills. Or how do you decide what portion is allocated for potential medical fees? Is it a percentage or a whole figure? <<< Need some clarity for reference.
A policy contract is a legally binding document. There's nothing to be surprised about.
So Prudential denied the claim is the only thing that matters in the entire episode. AIA paying the claim is just... marketing? Goodwill? Or insurance at work?
Was it also a gimmick that in 2020 AIA took the headlines as the only insurer that does not exclude communicable diseases?

When you self insure, guaranteed you have to foot the whole bill, also with no uncertain terms because your name is on the invoice.


QUOTE(Ramjade @ May 7 2026, 01:35 PM)
I said buy standalone and avoid ILP at all cost.
*
You did.
tweakity
post May 7 2026, 02:34 PM
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I think Question Starter (not TS) situation. It is like a cold call. Not specifically pushing him to buy or to Add On MRTA. Is like brief intro, so ohhhh One of the additional benefit is if you buy 1 more apartment or something in the future, you can use this as the MRTA or something.
Just additional benefit
JIUHWEI
post May 7 2026, 03:00 PM
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QUOTE(tweakity @ May 7 2026, 02:34 PM)
I think Question Starter (not TS) situation. It is like a cold call. Not specifically pushing him to buy or to Add On MRTA. Is like brief intro, so ohhhh One of the additional benefit is if you buy 1 more apartment or something in the future, you can use this as the MRTA or something.
Just additional benefit
*
Yaloh. Hence I question what is the objective.

Lidat also someone triggered, and somehow made it about him.
MUM
post May 7 2026, 04:27 PM
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QUOTE(rocketm @ May 3 2026, 11:17 AM)
Hi guys, my agent introduce me a life+investment link plan.

It comes with loyalty bonus at the 30th policy year or when policyholder at 64 year old, whichever later. The plan will auto-renew till 100 year old. No withdrawal until the distribution of loyalty bonus.

Compare to traditional life plan, ILP is cheaper in premium. Just curious whether all these ILP can sustain in long term ( i think the below links may has some answers to your this concern)

as the policy will auto renew meaning policyholder need to continue to pay premium when they are retire or have sickness unless add premium waiver (but this is an additional cost to premium), otherwise need to top-up premium when policy not sustain.
*
Your objective is as below,
QUOTE(rocketm @ May 4 2026, 10:07 PM)
As a life insurance also a MRTA for my house although I already have.
*
Since you got your objective for the need of a "new" life insurance plan. (Additional to currently available life insurance coverage that met your objectives)
Even though unknown to why you needed an additional life insurance plan,
Hopefully you can determine if standalone or ILP suit you better with that said objectives.

Perhaps reading some of these can help you decide better,

How to choose between investment-linked vs traditional insurance products?
https://www.prudential.com.my/en/knowledge-...onal-insurance/

which plan is right for you?
https://www.fwd.com.my/blog/protection/inve...-one-right-you/

Is an ILP the right plan for you?
https://www.manulife.com.my/en/individual/k...-insurance.html

Which insurance policy should you choose?
https://www.imoney.my/articles/term-whole-life-ilp-insurance

Which one would you pick?
https://loanstreet.com.my/learning-centre/i...onal-insurance-




Haloperidol
post May 8 2026, 11:24 AM
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QUOTE(contestchris @ May 7 2026, 10:42 AM)
I agree, self insured is the best but only up to a point.

The best of both worlds, is a high deductible medical plan. Up to rm20k or rm30k, touch wood, we should be able toncover ourselves. But for tail risk events, it is better to have some insurance coverage. Insurers usually will deny or reject smaller procedures, but bigger ones generally not so much an issue (unless you have preexisting).
*
High Deductible plan is good if you plan to stay with your company and your company gives a big chunk of insurance coverage.
Eg. Rm 40k hospitalization coverage.
If exceed, then use your own insurance.
Janji u didn't jump company / get fired etc

------------
Refer to my post.
The super expensive treatment is usually are experimental therapy/latest gen treatment which may not covered under Fair Usage Policy.

eg multiple resistant organism infection (MRO), insurance will cover for Unasyn.
But u flip the US guide, there is new drug called Fetjora, 1 week antibiotic cost 1 Myvi, you think the insurance will approve meh.

Usage of Da Vinci machine etc already getting questioned as why this latest method of operation is so more expensive than old conventional treatment.
TPA/Insurance companies instruct try to do procedure under Local Anaethesia instead of General Anaesthesia.
It's very fair for their point of view, but base on what they going to do, the tall risk part is gonna cut throat soon.

This post has been edited by Haloperidol: May 8 2026, 11:28 AM
JIUHWEI
post May 11 2026, 11:03 AM
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QUOTE(contestchris @ May 7 2026, 10:42 AM)
I agree, self insured is the best but only up to a point.

The best of both worlds, is a high deductible medical plan. Up to rm20k or rm30k, touch wood, we should be able toncover ourselves. But for tail risk events, it is better to have some insurance coverage. Insurers usually will deny or reject smaller procedures, but bigger ones generally not so much an issue (unless you have preexisting).
*
There are always options for high deductible plans to reduce back down to a very low deductible upon insured reaching age 60 (perceived retirement age).
This lowers the Cost of Insurance during the productive years.

It is an option taken up by many under MNC employment
dragon528
post Yesterday, 09:57 AM

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Hi everyone, I have a questions. People usually say as long as admit and do surgery, then insurance is cover.

My case is, baby age 2 need general anesthesia to remove some tooth, crown and filling, so called Early Childhood Caries.

So in my case, if get letter from dentist and admit hospital that can perform dental surgery, does insurance cover?
JIUHWEI
post Yesterday, 10:08 AM
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QUOTE(dragon528 @ May 19 2026, 09:57 AM)
Hi everyone, I have a questions. People usually say as long as admit and do surgery, then insurance is cover.

My case is, baby age 2 need general anesthesia to remove some tooth, crown and filling, so called Early Childhood Caries.

So in my case, if get letter from dentist and admit hospital that can perform dental surgery, does insurance cover?
*
Such dental procedures are not covered ya.

 

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