AIA still exist but has been bought over by Prudential. Refer this: Prudential bought AIA

This is what I found from Tokio Marine Medic Plus Pro website:
"Medic Plus is designed to complement and provide protection as a secondary level of cover to the Hospitalisation & Surgical Insurance that you may have purchased or where you are covered by a policy arranged by your employer"

What I understand, this product is an top-up, meaning if your current medical insurance benefit (usually arranged by your employer) is exhausted, you can use TM to cover the remaining hospital bill. And of course the premium is very cheap because it has quite high deductible (RM 10,000). Maybe PJusa can correct this, seems he is very expert in medical insurance.

My opinion is, even tough you may already have medical coverage by your employer, it is always best you have your own complete coverage medical insurance policy. Because the medical coverage by your employer only cover while you are working with them. What happened after you left. The worst is you suffered an illness while you still in job. What will happened after you left and retired? Definitely you existing illness will not be covered by new insurance company. Especially if you suffered a cancer, heart condition which need continuous treatment.

My 2 sen.

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Added on March 17, 2010, 3:19 pmIt's a Personal Accident Plan. Cover only when you involved in an accident. Usually very cheap compare to other life insurance, endownment plan. This plan carry no cash value.

This post has been edited by ajau: Mar 17 2010, 03:19 PM

cannot agree more.

i am very pitty when I read newspaper, seeing people ask for donation for hundred thousand for your heart/cancer treatment. I am not sure if I can give lots to them. I am not sure others will.

Deductible, excess and co-insurance, I believe all this term may work the same. Meaning both insurance company and insured person need to bear the bill together.

I don't have experience with deductible in medical card, but I did have with excess in car insurance. I need to pay RM440 first, the rest was paid by insurance company.

I believe you are right in both cases. But let's say this scenario:
Operation cost: RM80k
Primary Insurance: Annual RM50k
Add on: TM Medic Plus

You will use RM50k from your primary insurance, the remaining 30k, I am not sure if TM Medic will pay full or you still need to pay RM10k first, and RM20 will pay by TM.

And there is also a clause in TM Medic Plus:
Renewal guaranteed after 12 months of ’claims–free’ period.

I am not so sure definition of 'claims-free' period and how long it is. I hope you better get clarification on this.

I think there is mis-understanding. Actually rockets asking about TM Medic Plus deductible term but I give further scenario what happened the total bill exceeding the annual limit and will TM pay the remaining balance, because it has deductible of RM10k.

But, I am wondering in AIA, if you exceed your annual limit of RM50k, AIA still pay the remaining RM30k and the insured only pay 10% co-insurance (RM3k)

In Prudential and PruBSN Takaful, you don't have to worry about you exceeding your annual limit. You can opt Annual Limit waiver. Meaning Prudential / PruBSN will pay the total bill (subject to co-insurance), as long as the bill within life time limit. You can choose life time limit between RM500k - RM1.5million.

Easy to say, you don't have to worry about having 2nd medical card, in case the annual limit is not enough. And it will be easy to maintain too because you only need to maintain one card. And you can attached with CI, so if you suffer 36 critical illness, you do not need to pay for premium but you still have the medical coverage (and other benefit too if any). And the medical card is guaranteed renewal.

You can apply, but it will subject to under-writer approval. But usually, it will not cover your pre-existing illness / condition.

I think it is not so expensive to have both. Depending on your age, gender, lifestyle (smoking, etc), in Prudential (PruLink) / PruBSN Takaful (Takafulink) you can have Death/TPD, CI, Medical Card, Hospital Allowance, PruPayor (to get premium waive if you suffer TPD/critical illness), and other benefit(s) starting from RM100 per month. And this plan also have cash value. But I do not want to stress about cash value because it may take at least 5 years and sometimes up to 10 years to withdraw some of the money (without interest).

The Medical Card lifetime coverage also is very high, between RM500k and RM1.5 million. From RM100 per month, you may get lifetime coverage RM500k (RM50k annual limit) with maybe RM10k - RM 50k CI/Death/TPD coverage and maybe some other benefit also. When you suffer a critical illness, your illness will be treated and at the same time, you will get a lump sum money for you to use to pay your debt such as your car/housing loan because at that time, you may not be able to work. So use your CI money to pay your debt and other guaranteed money (from Medical Card) to pay for your treatment. You may also have a cash value from your policy so that you can use for food/daily expenses.

I do not know how much you was quoted for CI and MC. But I am not sure if you can get RM500k CI for RM100 per month.

Yup, you are absolutely correct about the basic of co-insurance. But different company has different term.

Even though the co-insurance is 10% or 20%, some has a minimum and maximum the insured need to pay.

In some company, co-insurance only apply if you stay in a room that exceeding your room's entitlement, and you need to pay 10% or 20% of the remaining bill plus the different rate for the room.
As example, your room entitlement is RM100 but you stay in a room cost RM120
Your hospital bill is RM10,000
You stay 3 days
The co-insurance you might need to pay: 10% x (RM10,000 - RM360) = RM 964
And you still need to pay RM60 for the room differences

And some company also charge 10% from total bill if you stay in a room exceeding your entitlement.

Please bare in mind that, the room's rate can be increased over the time. Last time when I stay in double bed KPJ Kajang, it was RM90 per day in 2006. Last year in 2009, when my son admitted there, it was RM 120. Please imagine how much will the room rate in 20 years from now.

Please read the product broucher and policy to know your co-insurance charges. Usually, there is a co-insurance for any medical card.

Yup. true.

Quarantine is charged RM 300 per day at KPJ Kajang.
Quad-room RM70
Double room RM 120
Double room deluxe RM 135
Single room RM 200
Single room deluxe RM 250
I forgot about VIP room charges

If you are concern about to not pay for 20% co-insurance penalty, maybe you should consider buying a plan that has Room & Board of RM300 per day. Influenza Like Illness (ILI) or H1N1 is attacking us back now. So, who know we are next need to be quarantined.

Personally, I prefer to have a plan that have co-insurance with maximum limit of co-insurance. Regardless how much the hospital bill are, I know I will only pay a maximum of certain amount, let's say RM500, RM 1000 or RM 2000. So I can plan my budget to always have emergency fund with this amount of money. And you might also need to consider a hospital allowance. If you always have budget constraint, at least you can use your hospital allowance to pay your co-insurance (usually hospital allowance is paid around 1-2 weeks depending on insurance company effectiveness, but at least if you are using credit card of borrow someone money, you know you will receive a fund to pay back). I did compare insurance charges or premium between this 2 types of co-insurance (from few insurance company), usually it is cheaper with a plan that have min, maximum limit and it has less term and condition.

It happened to me, I didn't realize my company's medical card only allow one doctor visit per day and the doctor was visiting my son twice a day. And if you are really sick, you prefer to have doctor visiting you frequently to know your progress. During dis-charge which I suppose not to pay anything, I end-up paying almost RM300 for this un-coverable item. After that I checked with my HR (she also didn't realize this), we found out there are lots term and condition compare to my personal medical card that has min and maximum limit of co-insurance.

Each product has their own uniqueness and its uniqueness sometimes suitable for this group of people and sometime it is not for other group. You just need to identify in which group you are comfortable with.

Please bare in mind also about upgrading your plan for medical insurance. Some insurer prefer to apply 30, 120 days waiting period back to your new plan. It is like buying a new medical card and subject to new underwriter. Please imagine if something happen to you during your 120 days waiting period of upgrading your policy and you are not covered. You will regret in your life for doing upgrading which suppose to upgrade your coverage.

My advice is when you are buying medical card, please plan ahead and please consider you will carry its coverage for your whole life. Does its current benefit enough for you in the next 20 years, 30 years?

Sorry, I just give an example based on my experience. It happened to me, so I hope someone else is not doing my mistake or my bad experience.

Yup. chew ronnie is right. Unless you can negotiate with hospital regarding the bill before the hospital send the bill to insurance company (I doubt you can), the insurance company will calculate how much they will pay and the rest need to be paid by you (co-insurance, etc). How much they will pay is totally depend on the policy.

For PruHealth (Prudential) and Takaful Heatlh (PruBSN Takaful), the co-insurance is 10% from the bill and subject to minimum of RM 300 and maximum RM 1000. If you upgrade your room regardless the reason, you just pay the different as exactly as what Aurora Boreali wanted.
As example, if your bill is RM20k, you just need to pay the maximum co-insurance of RM1,000, even tough 10% of RM20,000 is RM2,000. Plus the different of R&B.

If your medical card is using 20% penalty if you are upgrading your room, as Aurora Boreali calculated in given scenario, yes, you need to pay RM 18,400 if there is no maximum limit. But you may also need to pay more because so far, I have not found any medical card with R&B RM150 per day has annual limit of RM92,000. Usually it is around 60k-70k annual limit.

As a customer, you better to get clear about the co-insurance of your policy so that you will not blaming your agent when you need to pay some amount before you are discharged from your ward. Please double check when you receive your policy and you have 15 days to return your policy and get all your money back if you are not satisfy with the policy.

chew ronnie,

"Policy Owner to pay the difference in Room & Board and 20% of other eligible benefits described in the Table of Benefits subject to maximum of RM1,000 for any disability if the Life Assured is hospitalised at a Room & Board rate higher than the entitled benefit."

Have you experienced being hospitalised or your client was hospitalised at R&B higher than eligible? I am not really understand no co-insurance on surgical fees and expenses but co-payment of 20% up to max RM1000. Your wording is more confusing than reading your broucher.

Maybe you can give few scenario.

Thanks.

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Added on March 22, 2010, 5:28 pmI am also very interested to know what is reasonable and customary charge?

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Added on March 22, 2010, 5:34 pmFor PruHealth, upgrading R&B does not effect the co-insurance. The co-insurance 10% is charged regardless the situation but with maximum cap RM1000. If you upgrade the R&B, you just pay the difference. I have experienced when my son was hospitalized but no R&B is within my plan at that time. So, I need to pay the co-insurance plus the differences of R&B which is RM20 per day.

This post has been edited by ajau: Mar 22 2010, 05:34 PM

ok. thanx ronnie.

I assume reasonable and customary charge is a charge that sound normal maybe something like market price. Means Allianz will not pay something that sound very ridiculous.

I just want to check with you guys and share information. I am not here to offend anybody and I think my involvement only to provide information and up to people out there to choose which product are best for them. I never said Pru is the best but so far what Pru had is best suit me and I foresee it will suit for me in the future. Everybody need is different and nothing in this world can be best for everybody in this world.

I am also here to educate people, you should have insurance, regardless with which company and I am happy to share my experience. Even though you hold lots of policy and broucher with you, it doesn't mean you are the best. There are too many details in each product and I dare you 'hafal' all the terms. I was asking you the term because it keeps highlighting in your brouchure and I just want a short and quick answer from you. But you do not reply straight to me. And I believe you just do your home work only after I ask you the question, 2nd time. But maybe 3rd time because mfitri did ask earlier.

I become an agent is not for me to make lots of money from commission. I found it is good to have insurance after my sons and I need to be hospitalized and at that time I used my company's medical card. Since most agent is not so transparent (mostly just want to collect commission regardless which company), I decided to become an agent so that I can access lots of information and learn more about insurance. And I love to share something good with others. Sorry if my habit disturbing you. I did compare few insurance company especially its medical card (but not AIA - I wish I can learn more from AIA) and at the end I choose Pru because of its flexibility to upgrade policy and its service in making claim and also Pru has Takaful.

We are here no to offend anybody. I believe we are here to share and the most important thing for people outside to have more information regarding the insurance. There is no competition here to be won.

This post has been edited by ajau: Mar 23 2010, 04:04 PM

Sorry mfitri. I am from pru also like you. So, the story for Q1 is the same.

Q2:
As you said earlier, every case is unique and it is sometimes based on your luck on that particular case. Usually, we don't have problem in getting GL. 1-2 hour is average waiting time for a GL.

At first, I am also worried of getting GL. But now, depending on doctor first diagnosis, if normal case like high fever and the customer need urgent treatment to control the fever, and the customer policy status is good, I will advice the customer to admit first and pay deposit if required. Kinda a gamble but so far I don't have problem to get the GL. My priority is to ease the client burden as much as I can and get them good treatment to cure the illness.

In one case, I wait for more than 6 hours and no GL. And I found out, the doctor has not fill in the form. Very frustrated.

Just call PruHAS for any enquiry regarding the GL.

Q3:
Beside co-insurance, the customer also need to pay non-hospital services, such as registration fee. I don't know why hospital prefer to put this separately. Previously, the hospital also would like to charge laundry, thermos, separately from R&B charges. Then, if this item appear in the bill, it is not covered also.

Q4:
I agree with ronnie_chew. As long as the policy holder disclose everything, claim should not be an issue.

I found this web site which give List of Medical Insurance in Malaysia. It give general overview but not so detail and I think some also out-dated. It was last updated 03/11/09. Please consult respective agent for details. We have few agents here.

There are also link about anything you want to know about medical insurance. I think most of us can found useful idea there.

Go back to your enquiry, I think most of us will recommend looking for guaranteed renewal medical policy because you can still use your medical card after you make any claim.

Personally, I will also recommend to buy a policy that can attached with something like PruPayor in Prudential which will waived your policy once you are diagnosed with a critical illness. This is good because at that time, you are unable to work and you need your medical card for your illness treatment. Other company also provide the same, but the name is different.

Get as much coverage you can get according to your budget. We will never know you might need it in the future. There are argument do we need high annual limit or high lifetime limit. Go find out what is the most likely risk you may get and how much is the treatment. Cancer and heart attack, I think among the most expensive treatment and it may cost more than 50k. And if you have budget, you may need a rider that can solve this annual vs lifetime limit. In Prudential you can choose annual limit waiver, meaning you may use all your lifetime limit (between 500k to 1.5 million) in a year.

Check also list of panel hospital and double check if your preferred hospital in the list. However, bare in your mind that list might be different in the future.

Please check about co-insurance/co-payment/deductible/excess. Different insurance company charge differently.

If you have time, go back to few posting earlier. I think this question has been answered few time. But feel free to ask any specific question that you might want to know further.

The co-insurance is troublesome. But have you compared the insurance charges with other company? I am not boldly agree with Pru, but I think they put co-insurance so that the insurance charges is cheaper. Why we need to pay more when we are not using the benefit? Even though 1000 is quite much, but at least another 90% or more of the bill has been paid. I am not saying it is good to have credit card, but it help me in this co-insurance, and hopefully I will get the HB and PruMed in time to pay of the co-insurance. And we also always need to have our emergency fund to this kind of situation. At least with medical card, it helps a lot, even tough is not helping in full.

However, why there is a co-insurance? It is to ensure a genuine claim is made. We need to ensure our pool of fund is really uses by people that really need to be hospitalized. We do not want people to abuse our money.

Regarding pay extra 120 per year but get back 100. I think it depending with age. In some age, I found like that but with some other age and maybe with upgrading plan, you will get more.

Regarding HB, I think the cheque arrive after 1 month because the hospital is late sending medical report and claim to Pru. I experience getting the cheque within 2 week.

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Added on April 1, 2010, 12:34 pmCo-insurance limit 2k only for outpatiend. For hospitalization it is 1k.

They give some and take some

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Added on April 1, 2010, 12:51 pmI believe, they need it as an alternative. My wife is government servant.

I would like to share my experience. One night my son was keep vomiting, firstly each 1-2 hour, then every half an hour. I went to Hospital Putrajaya because it is nearest to my home. The doctor said my son condition is not critical, come back 2-3 days if the condition persist. Take note 2-3 DAYS. They gave a normal treatment for this case. After I go home, my son condition still like that. Then I go to KPJ Kajang, the doctor said this is serious and my son need to be warded. My son has no energy even before I go to Hospital Putrajaya. He was totally flat. When the nurse want to put IV at KPJ Kajang, he cannot struggle even though I know it was hurt. He was totally weak. My son was diagnosed with rotavirus which kill thousand children yearly because of de-hydration.

If I follow the government hospital's advice, I probably lost my son. Can you imagine I need to come back 2-3 DAYS, I don't think my son can survive next day.

Furthermore, to be admitted to government hospital, you must be seriously ill. For dengue cases (I got twice), it depend with which government hospital. In Putrajaya, you will be admitted if your platelet below 50. Others I heard below 20. Can you imagine, you have high fever (but not critical), but you still need to queue at the clinic everyday for blood test (of course the queue is so long, I experience this, I come at 8am, but I go home around 1pm everyday).

If you have a choice, be warded, the nurses will come to your bed everyday taking your blood while you are watching television, or queue from 8am to 1pm everyday, which will be your choice?

The 3 cases above turning my point from becoming a policy holder to insurance/takaful agent. (my first dengue experience with no warded, the 2nd was warded at SJMC)

This post has been edited by ajau: Apr 1 2010, 03:04 PM

As an agent, I should not advice you to cancel your current policy. But sometimes, losing few thousand today is better than you lose more in the future.

Anyway, you can still do not need to cancel your current policy. You can take another policy which can compliment what you do not have in the existing policy.

The best is you go through your current policy with other agents to check your needs and give any recommendation. Get opinion from several agent from several company perhaps can give you more option.

PM me if you need my help.

For personal medical card, there is always something like co-insurance, sometime people called it co-payment, or what ever it is. So far I never see any insurance company that will pay everything without any condition. Co-insurance or co-payment, it is just a name that make marketing looks nice.

Why you need to pay all this? It is to avoid non-genuine claim made by the client. And it will be unfair to other people. I mean non-genuine is something like you get sick but it is not so serious that need you to be warded. Since you want things for free, you asked the doctor to hospitalise you so that you can ask the insurance company pay for the bill.

Different company have their own way to make this so called co-insurance, co-payment, etc. And they have their own reason to make such policy. As far as I am concerned, there is 4 ways:
1. Co-insurance of 10%, but usually with maximum limit of RM500, RM1000, RM3000 - e.g. Prudential, GE, (if not mistaken etiqa)
2. Co-insurance of 10% or 20% apply when you upgrade your R&B beyond your entitlement - e.g Allianz, (if not mistaken MCIS, MAA)
3. Co-insurance of 10% apply after you exceed the 'Co-insurance Free Amount per year", e.g. AIA
4. Fix co-insurance per admission, e.g. ING pay only RM50 regardless your hospital bill.

You can opt to have hospital allowance so that you can use the allowance to pay for this co-insurance. So you can still get something like the insurance company pay everything for you.

There is always pro and cons any way of the above mention co-insurance. You must always ask yourself, what is your need and what is your budget and think also for the future. The policy will be with you until your age 70, 80 or 100. Can it cover your today and future need? How about the possibility of upgrading the plan? Any impact? Is there an option to use beyond your annual limit? Does lifetime limit and annual limit enough for you? Prepare for the worst - check how much usually cancer or heart problem will cost you? How about the outpatient benefit for cancer, dialysis treatment?

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Added on April 16, 2010, 4:57 pmIt depend with the bank, but as far as I am concerned MRTA/MLTA is not mandatory. My first housing loan I took without MRTA. My refinance loan also put it as optional but I took MRTA. And as far I am concerned also, you need to get your loan approve first before applying for MRTA.

Mind to share which bank you talk about?

This post has been edited by ajau: Apr 16 2010, 04:57 PM

Prudential family plan (it is actually called by Pruguard My Family) is a family plan that something looks like Group H&S when you are employed. It falls under General Insurance and it do not carry any cash value. So you need to buy another education policy for your child.

Do you know about Prulink Assurance or PruMy Child? It is a investment link product that you can attach with medical card and few other rider as per your requirement listed earlier from RM100 (Definitely RM100 can't get all). It has cash value, and you can also dedicate some portion of your money only for saving/investment. As example, you can put RM50 from your monthly premium for this saving, after 5% deduction for management fee, the remaining RM47.50 is invested in a fund that you choose. Therefore, with one policy you can get medical card and also education fund for your child. And you can put PruPayor benefit, so that in the event of parents TPD/CI/Death, the premium is FREE. And you can also opt for double parents PruPayor. Any TPD/CI/Death happen to either you or spouse, the premium is FREE, BUT if it happens to both, Prudential will pay double the premium that goes to your child education fund.

Wish you all the best. Hope you can find what you are looking for here.

This post has been edited by ajau: Apr 20 2010, 06:39 PM

Thank you for asking.

The premium paid is divided into 3 account.
1. Basic Unit Account. This account to maintain your sum assured (Death and TPD benefit), Critical Illness and Accidental Death & Disablement
2. Protection Unit Account. This account to pay other benefit, such as PruHealth (Medical Card), PruMed, Hospital Benefit, PruPayor, PruPayor Double Parent, etc.
3. Investment Unit Account. This is where you can choose PRUsaver (min RM10 monthly) or PRUedusaver (min RM50 monthly) for you child saving.

Premium Allocation for Basic Unit Account and Protection Unit Account to purchase units in the investment linked fund is
Year 1: 40%
Year 2: 50%
Year 3: 60%
Year 4: 70%
Year 5 & 6: 90%
Year 7 and above 100%

While Premium Allocation for Investment Unit Account is 95% every year.

Please refer here (PRUmy Child Broucher) and turn to page 4, Item no 4.

The above also apply to Prulink Assurance Plan for adult (Turn to page 5 and 6).

One good thing about PRUmychild, you can take up this plan for your unborn child as early as 18 weeks into your (for mother) pregnancy. In the event your child die before 30 days from birth, the benefit payable is the total premiums paid or the total value of units in the account, whichever is higher. You can also take this plan for your child who is between 1 - 18 years of age on his / her next birthday.

And on top of the normal 36 Critical Illness, you can also opt for Child Specified Illness (Severe asthma, Leukaemia, Insulin-dependent Diabetes Mellitus, Rheumatic fever with valvular impairment, Kawasaki Disease with heart complications, Severe juvenile rheumatoid arthritis, Glomerulonephritis with Nephrotic Syndrome, Severe epilepsy, Severe epilepsy). However this benefit will cease when the child reaches age 25.

And if you as a parent and do not currently have any insurance, you can also opt for Parent Cover Benefit that will pay out a lump sum in the event that the insured parent suffers from TPD before age 70, passes away or is diagnosed with a critical illness. And you can also opt for Income Cover that will pay a monthly income in the event that child's parent suffer TPD, CI or Death.

I hope this clarify your queries.

This post has been edited by ajau: Apr 21 2010, 10:09 AM

It's not complicated. It's a plan that you can have as much protection as you require based on your current need and budget and you can change your protection when the times and money come.

PRUmy child is for unborn child and also for a born child under 18 years old. It is designed to protect your child for every stage of his/her life - during birth (if you buy the policy during pregnancy), during education, during employment where they may have commitment such as car/house, during marriage to protect their family and also for retirement.

The rider, I think its all apply to any insurance, it is an optional. Nothing is hidden. If you want, you can take it, if you don't, just leave it. Why there is lots of rider? Even though some rider sound like duplicating, because every people have different need and have their own budget. Prudential try to entertain everybody needs and budget. It may sound duplicating for you, but actually it's don't because one is basic, another one is advance. Some people has more money and can effort to pay for advance protection but some people can only effort to pay for basic protection.

PruHealth = Medical Card
PruMed = Hospital Allowance + ICU Allowance + Surgical Allowance
Hospital Benefit = Hospital Allowance only (you can combine both PruMed and Hospital Benefit, PruMed premium is higher than Hospital Benefit)
Enhanced PruPayor Basic = To pay your policy premium (excluding PruSaver) in the event the INSURED person suffer TPD or diagnosed with CI
PRUparent payor basic = To pay your policy premium (excluding PruSaver) in the event the PARENT of insured person suffer TPD or diagnosed with CI
PRUparent double payor basic = To pay your policy premium (excluding PruSaver) in the event EITHER PARENT of insured person suffer TPD or diagnosed with CI. The premium will be paid DOUBLE if BOTH PARENT suffer either TPD or CI (you can only take either PRUparent payor basic or PRUparent double payor basic)

You can't learn only from reading book. You certainly need guru because sometime we can't understand from the reading. The policy is a contract and it is legal. There is no manipulation. If there is, definitely Prudential cannot survive in the industry. What you do is correct. You come here and ask for other people opinion to get better understanding before you take any policy.

"Very misleading and didn't specify enough detail on sub rider. All the sub rider names just pop up of no where to inform the client in a main rider"
Can you give which rider you said is misleading and what sub rider you are talking about? The rider is mentioned in quotation with its definition and coverage and the detail also certainly in policy which is binding document in law.

I also confuse what do you mean by "paying RM 50-60K for something i don't need" and "A policy that only cost RM 30K plus could end up paying RM 80K plus". Usually, you can always have quotation from an agent and you will know exactly how much for every benefit you take will cost you. And the quotation also explain briefly each benefit you take and its coverage.

This post has been edited by ajau: Apr 26 2010, 01:30 AM