This is the most practical, highly actionable guide to buying the best medical card in Malaysia online, instead of just other comparison guides (which often overwhelm you with too much info until you feel confused with over-analysis paralysis)
The best part?
We are going to reveal how you can afford the best medical coverage per your budget, something that tied insurance agents and aggregator websites are unable to do for you.
Also, we respect your privacy and do not ask for your phone number when you are ready to apply online or even want to request for the quotations to compare them yourself.
(after all, aggregator sites like R-Plus & i_MY are just going to pass your contact details to random (sometimes incompetent) insurance agents who will call you day and night)
In short, if you want just the right amount of information to maximize your coverage while minimizing the premium cost, without the spam calls from aggressively pushy & sales-sy insurance agents…
…you’ll love this guide and the approach we use.
This guide has existed from 2015, 2016, 2017,2018, 2019, 2020, 2021, 2022 with 250+ comments below.
Let’s get started.
Credible: where this medical insurance guide has been featured
The published article can be downloaded HERE
- Summary: Best Medical Cards in Malaysia
- Comparison table: Allianz, AIA, Great Eastern, Manulife, Hong Leong, Prudential, Tokio Marine, AXA Affin, AmMetLife & Zurich Medical Insurance
- Allianz medical card is the Best medical insurance in Malaysia?
- AIA medical card is the Best medical insurance in Malaysia?
- Great Eastern medical card is the Best medical insurance in Malaysia?
- Manulife medical card is the Best medical insurance in Malaysia?
- Prudential medical card is Best medical insurance in Malaysia?
- Hong Leong medical card is the Best medical insurance in Malaysia?
- Comparison table: Allianz, Great Eastern, Hong Leong Assurance & Prudential Deductible Medical Insurance
- Best deductible medical card in Malaysia – which one?
- Understand basic medical card terminologies and why you must get the best health insurance for yourself
- Procedures to Utilize a Medical Card
- Standalone versus Rider Medical Card
- Overseas Medical Treatment & Coverage
The most commonly asked question are: “What is the best insurance for medical?” or “Which insurance is best in Malaysia?” or “Which medical card is the best in Malaysia” or “What medical insurance is the best?“
What is the best medical card in Malaysia?
In no particular order, they are – A Plus Health by AIA, Smart Medic by Great Eastern Life, HealthInsured by Allianz Life, Pru Million Med by Prudential & Medi Shield III by Hong Leong Assurance
How to buy the best medical card you can afford?
The best medical card you can afford should come with a high annual limit, guaranteed renewable until age 100, no co-insurance or co payment due to room upgrade, will not limit your medical treatment within Malaysia only, will not always remove hospital from its panel list and most importantly, will not dispute your medical claims without a good reason
What is a medical card insurance?
It is a unilateral contract with an insurance company which promises to pay for your inpatient hospital bill as long as you are paying the regular premiums. Or you can think of it as a Touch & Go card with a preloaded limit which refreshes every year, and only can be used at private hospitals
Why is a medical card (insurance) important?
It gives you a peace of mind when you need to seek the best medical treatment fast at private hospitals, without needing to pay hefty medical bills out of your own pocket, and minus the long queue + waiting time at government hospitals
What life insurance is best in Malaysia?
The best life insurance is the one in which you pay the lowest premium for the exact same coverage because the terms of coverage & payout are exactly the same among insurers (that is, death & total permanent disability cover)
Which insurance company is the best in Malaysia?
In no particular order, they are AIA, Allianz, Great Eastern, Hong Leong Assurance and Prudential.
Fact is, medical card products from major insurance companies in Malaysia are always evolving rapidly, ever-trying to outdo each other to become the best medical insurance or the top medical card in Malaysia, at least in the eyes of consumers.
Anyway, at this point of time…
Summary: Best Medical Cards in Malaysia
- Allianz Life Insurance – HealthInsured series medical card
- AIA – A Plus Health series medical card
- Great Eastern Life – Smart Medic series medical card
- Hong Leong Assurance – Medi Shield III series medical card
- Prudential Assurance – Pru Million Med series medical card
Note: you should flip your device horizontally if you’re using a phone/tablet
|AIA||A-Plus Health||▪️ high annual limit even for lower tier plan,|
▪️ no lifetime limit, high post hospitalization days,
▪️ as charged outpatient treatments,
▪️ unique ‘Health Wallet’ feature
|Allianz||HealthInsured||▪️ high annual limit|
▪️ no lifetime limit,
▪️ as charged outpatient treatments,
▪️ covers alternative outpatient treatment,
▪️ covers Singapore & Brunei,
▪️ International 2nd medical opinion available
▪️ configurable as deductible medical card w/ retirement option
▪️ a parallel solution available to cover for hospitalization & surgical procedures globally without geographical restrictions, up to U$ 2 million yearly
|Great Eastern||Smart Medic Shield||▪️ auto increase room rate|
▪️ high annual limit,
▪️ no lifetime limit
|Hong Leong Assurance||Medi shield III||▪️ customizable deductible levels,|
▪️ auto-convert from deductible to full coverage upon retirement,
▪️ outpatient physiotherapy treatment per AL & LL,
▪️ auto room rate increase
▪️ no claim refund as % of insurance charges
|Prudential||Pru Million Med||▪️ annual cash value if no claim has been incurred during the preceding annexure year|
▪️ auto increase annual limit
The best in this sense refers to competitiveness in features and costs; so it is actually very good for us as policyholders.
As you notice, the Best Insurance Medical Cards in Malaysia come from major life insurance companies, brands which you already know.
The best part of being an industry practitioner, as a licensed, independent financial adviser, is that we are NOT tied to any insurance company.
Meaning, we are not obligated or limited to only recommend 1 single product, like an insurance agent.
Licensed, independent financial adviser possess ‘super-license’ from Bank Negara Malaysia and hence is authorized to source the best medical insurance from major insurers on client’s behalf.
Clients literally adore us (see proof here) for being able to source & compare objectively – the best life and health insurance products which suit their needs without being pushy to fulfill sales quota like a tied agent.
Moreover, it comes with a high level of personal touch, unlike aggregator websites like R-Plus or i_MY.
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Watch a series of lessons on buying the best medical cards for yourself
Watch our videos on TikTok where we answer your questions on health insurance claims
Comparison table: Allianz, AIA, Great Eastern, Manulife, Hong Leong, Prudential, Tokio Marine, AXA Affin, AmMetLife & Zurich Medical Insurance
**The indicative annual premium, whenever available, was generated based on a 35 years old Male, non-smoker. It does not represent absolutely the expensiveness or cheap-ness of a medical card from an insurer across all age ranges.
Allianz medical card is the Best medical insurance in Malaysia?
Allianz medical card commentary
- Reimburses the charges incurred for alternative treatments such as Chiropractic, Chiropody, Homeopathy, Osteopathy and Acupuncture up to one (1) visit per day, within thirty (30) days from the hospital
- Allianz HealthInsured covers treatment in Singapore but following Reasonable & Customary Charges equivalent to local treatment in Malaysia. Also, compared to its predecessor, there is no co-payment if you are hospitalized at a Room & Board which is higher than your eligible benefit. You only bear the difference in the upgraded room & board charges.
- Another best thing about Allianz medical card is that it specifically states, in the quotation, to include consultation, examination tests and take home drugs for outpatient treatments.
- It also has the highest combination of pre & post hospitalization coverage, and matches the room & board + ICU coverage of 150 days for each
- Its outpatient kidney dialysis and cancer does not have separate limits; it follows the overall annual limit and lifetime limit of the R&B rate chosen
- Organ transplant coverage – Reasonable & customary charges
- It comes with a Value Added Service called International Second Medical Opinion, a third party service which gives you, access to top experts from around the world to facilitate the medical decision making. A licensed doctor will be assigned to conduct a thorough clinical conversation, collect all available medical information and identify top experts to provide independent assessment.
- Allianz Diabetic Essentials enable you to obtain a medical plan protection up to 70 years old even though you have diabetes.
What About Allianz MediAdvantage Medical Card?
Only if you need to get the best overseas medical treatment for severe illnesses (refer to Overseas Medical Treatment section below). It does provide generous annual limit of up to USD 4 million but limited to these diseases:
- -Heart valve surgery
- -Intracranial and specific spinal cord surgery
- -Coronary artery bypass surgery
- -Live-donor organ transplant
- -Bone marrow transplant
What About Allianz Care Individual Medical Card?
You should not get this because:
- -Annual limit too low (RM 35k – RM 125k)
- -Only 60 days per disability of coverage
- -Pre & post hospitalization coverage days too low (60/60)
What About Allianz Booster Care Medical Card?
You should not get this because:
- -Annual limit too low (max RM 200k only)
- -Lifetime limit is capped at RM 1 million (not future-proof)
- -only covers you up to 80 years old
- -Pre & post hospitalization coverage days too low (60/60)
What About Allianz Diabetic Essential Medical Card?
Only apply for this medical card that provides RM 500k – RM 1.4 million annual limit and RM 1.5 million – RM 4.2 million lifetime limit, if you have Type 2 Diabetes in which application to the normal medical card will usually get rejected.
It offers similar coverage like your normal medical card, on top of diabetes management benefits, where once a year, you will have access to a health screening benefit, claimable up to RM250, Specifically, they are:
- -Medical examination by a Doctor
- -Glycated Haemoglobin (HbA1c)
- -Urine FEME
- -Renal Function test
- -Lipid Profile
Apart from that, Allianz Diabetic Essential Medical Card comes with a premium discount benefit that is applicable subject to the results of your Health Screening Benefit tests.
For example, when you are first approved for the plan and have a good medical report, you enjoy 20% discount on your premium.
Subsequently, by submitting your annual medical reports, you stand to receive 10% discount even if your medical report results aren’t perfect.
But if it shows improvement, you may receive premium discount of up to 40%, although the premium discount rates are not guaranteed and the rate given may vary from policy year to policy year.
Last entry age at 60 but it can only be renewed up to age 70.
AIA medical card is the Best medical insurance in Malaysia?
AIA medical card commentary
- A Plus Health medical insurance replaced A Plus Med as its flagship medical card in Q4 ’18.
- It has upgraded to 150 days of normal Room & Board (R&B) and Intensive Care unit (ICU), totaling 300 days/year
- There is also provision for Organ/Bone Marrow transplant (receiver’s coverage only) – as charged, subject to Reasonable and Customary Charges up to Overall Annual Limit, once per lifetime.
- Singapore & Brunei are not considered as overseas medical insurance coverage (which is good!)
- It also provides Emergency Medical Evacuation and Repatriation up to USD 1 mil (do not mistakenly think this is international health insurance coverage)
- Lifetime limit for outpatient kidney dialysis and cancer treatment has been upgraded to no lifetime limit.
- Only covers for once a lifetime organ transplant event (as an organ recipient)
- Unique Health Wallet, Prevention Benefit and Protect Boost feature, making it priced higher than average compared to other medical cards compared.
What About AIA A-Life Med Regular Medical Card?
We opined that this standalone (term) medical card pales in comparison to its medical rider counterpart due to inferior annual limit (RM 100k to 150k only) and room & board rate (RM 250 is the top option available). A shared outpatient cancer & kidney dialysis treatment up to RM 375k per lifetime is too low for comfort.
What About AIA Public Takaful A-Plus Med-I Or Booster-I Medical Card?
It is just a Takaful version of AIA A-Plus Med with Booster medical card, so it is subject to the weaknesses stated above.
What About AIA A-Plus Med Medical Card?
It has been succeeded by the newer AIA A-Plus Health medical card (flagship product).
Its weaknesses of standalone lifetime limit for outpatient cancer & kidney dialysis and 2 mil lifetime limit for Plan 200 makes it unfavorable among the other options available now.
What About AIA Public Takaful A-Life Medik Famili Medical Card?
It is just a Takaful version of AIA A-Life Med Regular Medical card, so it is subject to the weaknesses stated above.
Great Eastern medical card is the Best medical insurance in Malaysia?
Great Eastern medical card commentary
- The base medical insurance plan SmartMedic Xtra 99 has been enhanced with SmartMedic Million and SmartMedic Million Extender, thereafter Smart Medic Shield & Smart Medic Shield Extender
- It has no limit days of hospital confinement but 200 days ICU (intensive care unit)
- Comes with increased annual limit, adds outpatient imaging (MRI/PET) up to RM 5,000 per year and dengue/Zika virus coverage. However, it now comes with a fixed RM 300 co-insurance per disability, and comes with ‘10% increase in R&B limit every 3 years; up to a cumulative total of 100% R&B limit’
What About Great Eastern Great Medic Shield 2?
This standalone (term) medical card is comparable, although its room & board rate is capped at RM 200 (RM 200 is the top option available). Great Medic Shield Extender boosts its low RM 150k annual limit by RM 1.5 million
Manulife medical card is the Best medical insurance in Malaysia?
Manulife medical card commentary
- Manulife Health Saver medical insurance replaced its predecessor, ManuHealth Elite
- Technically, Manulife Room & Board rate is in a class of its own because after R&B 250, the next Room & Board rate is titled “As Charged”.
- What it means by this is that if you are in “As Charged” R&B rate, you are entitled for the amount for reimbursement is limited up to 2 basic categories of Single-bedded Room available in the hospital.
- This mean it is inflation-proof to a certain extent because you are guaranteed a single room no matter what in the future.
- No limit on the number of annual confinement days and high annual limit plus having outpatient stroke coverage which none other medical card in comparison has this benefit.
- It has a unique feature that covers non-medical related expenses on your hospital bill, up to 2x your room & board rate, per policy year
- No mention of organ transplant coverage though
What About Manulife ManuEZ-Med Medical Card?
The standalone (term) medical card only has room & board rate from RM 150 to RM 250, with available annual and lifetime limit of RM 150k-RM250k & RM 1.5 million – RM 2.5 million respectively. Other medical riders including Manulife ManuHealth Elite has ‘As Charged’ room & board rate and unlimited lifetime limit, with annual limit up to RM 2.2 million.
Prudential medical card is Best medical insurance in Malaysia?
Prudential medical card commentary
- Prudential most affordable medical card does not use the the term annual limit or lifetime limit. Instead, it replaces them with this – Med Value Point.
- Med Value Point is defined as – if the total claims that exceed the stipulated Med Value Point amount, the Prudential will still be liable to pay 80% of the total cost of the eligible benefit while policyholder bear the remaining 20%.
- Prudential also has another 2 older medical card range – PruHealth and PruFlexi Medi, on top of PruMedicOverseas providing coverage in Singapore, Hong Kong and China.
- Has the capability to customize the hospital room & board rate and Med Value Point (1, 1.5 or 2 million). It also has has an optional co-insurance like feature, called Med Saver, which policyholder needs to pay RM 300 co-insurance for hospitalization, even though it is a cashless admission. For objective comparison, we remove this co-insurance feature. Finally, the no co-payment clause is always welcomed.
- Higher end (newer) medical card range called PruMillion Med has Outpatient Cancer Treatment and Outpatient Kidney Dialysis which is not separated capped, like PruValue Med. Pru Million Med, though, comes with a non-removable RM 300 co-insurance, aka Med Saver.
- Organ/bone marrow transplant coverage as charged, no limit per lifetime.
- No claim bonus/incentive exists, plus annual limit auto-increase yearly
What About Prudential PruValueMed Medical Card?
It has been succeeded by the newer PruMillion Med medical card (flagship product). Its weaknesses of standalone lifetime limit for outpatient cancer & kidney dialysis makes it unfavorable among the other options available now.
What About Prudential Prusenior Med Medical Card?
You need to be over 45 years old to buy this, nonetheless, avoid this standalone medical card unless you are really strapped for budget because lifetime limit is notoriously low at RM 225k. Coverage also expire at age 80.
What About Prudential PruHealth Medical Card?
There’s no reason to consider this when you can afford PruMillion Med. Furthermore, because it is an older product, annual limit is maxed out at RM 250k while lifetime limit is capped at RM 2.6 million although you can opt for room & board rate as high as RM 600. Be warned that medical card coverage terminates at age 80!
Hong Leong medical card is the Best medical insurance in Malaysia?
Hong Leong Assurance commentary
- Hong Leong Assurance has a separate number of days for ICU coverage (75 vs 150 days), the lowest among those compared.
- If this is not a deal breaker, then you’ll be glad to know it does not have co-insurance or co-payment due to room & board upgrade
- It also does not have a separate limit for outpatient cancer treatment and kidney dialysis.
- With the addition of the Million Extra III rider, its annual limit skyrockets
- Organ transplant coverage per Annual & lifetime limit is included
- An extremely flexible medical card where you can configure it as a humble Honda City or a Ferrari if you have the budget. Highly configurable, only matched by Allianz.
How About HLA MedGlobal IV Plus Medical Card?
You should avoid this because:
- Low annual limit (RM 75k to RM 240k)
- Max lifetime limit capped at RM 1.2 million
Comparison table: Allianz, Great Eastern, Hong Leong Assurance & Prudential Deductible Medical Insurance
Best deductible medical card in Malaysia – which one?
Best deductible medical card in Malaysia – which one is it?
Not having a full medical card after retirement could potentially be deadlier than the silent killer – inflation, when it actually hits. I’ve talked to individuals in their fifties who admitted to me they overlooked of getting their own medical card when they were in employment. Then, just before the mandatory retirement, it struck them – nobody is going to cover his post retirement medical bills.
If you are reading this, then I don’t want this to happen to you. Yet, I know what you are thinking – you probably don’t want to get a redundant medical card while you are covered by your company.
If this is your concern, then Second Medical Card aka Deductible aka Top Up medical card is the best for you. See below
When you are employed before age 60:
It could well be a good complement to your company-provided group medical card.
For example, if your company medical card coverage is RM 30k/year, you could get a RM 30k deductible medical card, with minimum premium (RM 1,200). Which means, only RM 30k and above medical expenses will be covered by this second card. (by the way, the deductible amount is configurable from RM 2k up to RM 30k)
When you retire after age 60:
What it means, when you reach age 60, this health care insurance will convert to become a zero deductible card – which means any medical expenses can be charged under this card – at the time when your company medical insurance coverage ceases. This happens without needing you to prove your health condition at age 60. Besides, it also has:
Cheaper? Yes. Peace of mind when you retire? Absolutely.
Understand basic medical card terminologies and why you must get the best health insurance for yourself
If you are totally new to the concept of a medical card or medical insurance, you may wonder:
“What does a medical card cover?” or “What does a medical card do?” or “What is medical card insurance?”
The intricacies of the best medical insurance is not to be underestimated, especially if you plan to retire in Malaysia for long term. Since health insurance, just like any other insurance, is essentially an unilateral contract, knowing the terms and conditions of your medical coverage is absolutely critical.
To prevent the hassle of dispute with the insurer on what it is not covered or reimbursable when you thought they are covered.
Otherwise, nasty situation like this may happen.
The other health insurance features you definitely want to take note on are:
- Daily Room & Board rate – determines the type of hospital room you can choose to stay in without topping up the difference. It is very normal to go for a minimum RM 200 R&B nowadays, which could be a twin-sharing room. If you want basic single room or above, a R&B of RM 300 and above is recommended. Some hospitals like Pantai Hospital Bangsar or Sunway medical center ever offers suite room which can cost you up to 4 figures per night. Upgrading R&B rate higher than what you are entitled for in your health insurance policy may trigger a certain co-payment clause in the insurance contract. This render you needing to share a certain percentage of the total medical bill with the insurer, aside from paying the difference in room & board rate.
- Lifetime Limit (if any) – specifies the limited sum of medical expenses which can be exhausted throughout the duration of health insurance coverage (usually up to age 100). It does not refresh every year but the best medical cards usually have no limit lifetime coverage.
- Annual Limit (if any) – specifies the limited sum of medical expenses which can be exhausted within any 1 policy year as long as the health insurance is in-force. No worry, it will be refreshed upon your policy anniversary date. If you actual cost of medical treatment exceed your medical card annual limit though, you have no choice but to cover the exceeded amount.
- As charged – covers hospitalization expenses which are deemed medically necessary, and as per reasonable and customary charges according to the schedule set by MMA (Malaysian Medical Association). If a medical procedure was being overcharged by hospital, then you need to top up the difference of amount for which the insurer doesn’t cover.
- Deductible – an amount that you will have to pay for your medical treatment before your medical insurance plan will begin to pay for you.For example:
Deductible level of RM 5,000 means when Ali got admitted to hospital and the medical bill costs RM 9,000, Ali has to pay RM 5,000 first before his insurer pays the balance, up to the medical card annual or lifetime limit.
- Co insurance – an amount, usually in percentage (10%, 20%) of the total medical bill which you have to fork out on your own, regardless of the medical bill amount. The insurance company does not cover for this amount. Usually, the best medical card in Malaysia comes with zero co insurance.
- Pre or post hospitalization coverage – could include two or all of these: diagnostic tests (x-ray scans or lab tests), specialist consultation, treatment, prescribed medication and second medical opinion
- Home Nursing Care coverage – a public or private residential facility providing a high level of long-term personal or nursing care for persons (such as the aged or the chronically ill) who are unable to care for themselves properly.
Co insurance of 10% means when Ali got admitted to hospital and the medical bill costs RM 9,000, Ali has to pay RM 900 while his insurer pays the remaining amount, up to the medical card annual or lifetime limit.
- Last entry age – the last age where you can buy a medical insurance policy. Normally it could be at 60, 65 or 70.
- Exclusions – illnesses or medical conditions that are not covered by a medical card or medical insurance. Common exclusions include pre-existing conditions, specified illness occurring during the first one hundred twenty (120) days of upon policy being in-force (hypertension, cardiovascular disease, diabetes mellitus, all tumors, cancers, cysts, nodules, polyps, stones of the urinary and biliary system, all ear, nose (including sinuses) and throat conditions, hernias, hemorrhoids, fistulae, hydrocele, varicocele, endometriosis including disease of the reproductive system, vertebro-spinal disorders (including disc) and knee conditions), cosmetic treatments, dental conditions, congenital abnormalities, pregnancy-related conditions, AIDS or sexually transmitted disease, self-inflicted injuries, drug addiction, mental or nervous disorders
- Pre-existing Condition – illnesses that a policy holder has a reasonable knowledge of on or before the effective date of insurance. Policy holder may be considered to have a reasonable knowledge of a pre-existing conditions if he or she had received or is receiving treatment, medical advice, diagnosis…and/or there is a clear and distinct symptoms and/or the symptoms of an illness would have been apparent to a reasonable person.
Also, do you agree that medical costs will carry one or more of the characteristics below:
- Most unexpected
- Most unavoidable
- Possibly long term & recurring
- Most impactful to retirement nest egg
How impactful, you asked?
For minor condition like cataract or appendicitis, the cost of such treatments may hardly dent your retirement nest egg. But what if major conditions like below hit you?
Medical costs have escalated around the world and this is no different in Malaysia. Medical inflation averages about 10% each year and is projected to rise due to advancement in medical technology.
How to Apply for the Best Medical Card for yourself & Family, Fast
Obtain Quotations to Compare
Engage 3 to 5 insurance agents from top insurers to request for quotations, or alternatively, engage a single independent financial adviser to get the same quotations in one place
Compare the premium pricing among insurers’ quotations based on the coverage features you need while weighing the pros and cons of each options. Filter real advice from sales talk.
Once you have decided on the best medical card option that fits your budget, the authorized intermediary will need you to fill in questionnaire declaring your lifestyle and health condition / history.
Together with your filled in questionnaire, submit your personal details online via the insurer’s portal to kick-start application. Underwriter may approve your application promptly or he may require you to do additional medical check or request more details on your medical history before offering you a standard acceptance offer, or conditional acceptance offer with loading or exclusion.
Procedures to Utilize a Medical Card
When you want to seek medical treatment due to illness/accident at private hospitals, you should try to go to a hospital that is covered by the medical card.
Hospitals that are covered by the medical card are also called Panel Hospital. Panel hospitals will be able to provide cashless hospital admission hassle free.
Of course, you still can get admitted to other hospitals, but you will then need to settle in full your medical bill upon discharge and then later file claim to reimburse the medical expenses from the insurance company, usually within 30 days.
Admitting to a panel hospital saves you these paperworks because the insurance company will pay directly the hospital provided a Letter of Guarantee (GL) is issued by the insurer to the hospital upon your hospital admission.
Bear in mind hospital may still need to charge you some deposits upfront to cover for items not covered by your medical card.
In order to minimize any unnecessary delays, it is the norm to follow some pointers below as part of the claims process:
- Before undergoing any non-emergency medical treatment, call the customer care helpline of your insurance company and confirm whether your doctor’s proposed treatment is covered in your medical insurance policy and whether your hospital of choice is panel hospital
- Request your doctor or specialist to fill in and sign your claim form. He or she may charge a small administration fee which may not be covered by your medical card
- If you are admitted to a non-panel hospital, remember to submit a written notice to your insurance company as soon as possible, or within 30 days of the treatment period if you are diagnosed with a condition or illness that is claimable under your medical insurance policy
- Attach all filled claims documents with the original bills and receipts, investigation or diagnostic reports if any, full doctor’s medical reports, physician’s cost summary of treatment and referral letter, if any.
Understand the Common Reasons your Medical Claims can get Rejected
Your servicing intermediary can assist you with the claim although there is really nothing stopping you from doing it yourself by submitting the claims using snail mail or walking into insurer’s servicing office.
Furthermore, most insurers also have their electronic portal (or app) to submit your claims paperless and you will be paid via direct online banking – it is much faster and convenient so check this option before you hastily submit a claim the manual way.
Communicate with the servicing intermediary and review claim submission again before filing an appeal.
Seek advice from PIAM Information Centre and Ombudsman for Financial Services (OFS) if you opined that your claim has been unfairly rejected.
Standalone versus Rider Medical Card
What is the difference between a medical rider and a term (standalone) medical card?
Read below –
Compared to guaranteed renewal clause in medical rider, some standalone medical cards have conditional renewable clause whereby – if you are hit with a long term/ critical illnesses, insurer will likely impose unfavorable terms & conditions like premium loading, coverage exclusion from the illness and even rejection at your next renewal cycle. Think of it like renewing your car insurance after a major accident.
On the other hand, rider medical card is confirmed to have “Guaranteed renewable” clause whereby as long as you pay for the policy on time, insurer is obliged to renew the policy (provided the lifetime claim limit, if any, has not been exceeded).
The question you need to ask yourself is this:
Am I getting this medical card today for short-mid term or for long term? And will I be able to upgrade to or rebuy another medical card in the future given my current health condition?
For both types of medical cards, cost of insurance or insurance charges, however, is not guaranteed. That means insurer can hike the insurance charges which may affect your premium directly or indirectly.
This scenario normally requires approval from central bank and it affects every policy holders having that medical card (does not discriminate or single anyone out)
Overseas Medical Treatment & Coverage
By the way, visitors to this page also frequently ask – “Can I buy a medical card which covers me in foreign countries?” or “Can foreigner buy medical insurance in Malaysia?”
The answer to the first question lies in the video below, while for the second question, the answer is YES, provided you at least have long term residency visa like MM2H visa. See more details in our other article – Retiring in Malaysia : Get the Best Health Insurance & Prevent Medical Costs from Touching your Retirement Nest Egg.
Do I even need an overseas medical card or health insurance coverage?
Answer = Yes if you have a rare medical condition that healthcare providers in Malaysia do not possess the expertise or equipment for treatment.
But then the next question is – how would you know that beforehand? You don’t, agree?
So by the time you realize this (the insufficiency of local healthcare services for your medical condition), you won’t be able to get yourself insured already for overseas medical coverage.
However, if you really have deep pockets and are concerned about the inadequacy of Malaysian medical expertise or want to have that options to be treated overseas, then this is for you. But then again, you could have probably gotten yourself a pure international medical coverage instead of a quasi-international medical card from any Malaysian insurer because some of them only offers coverage a pre-defined set of critical medical conditions.
Answer = No if you are not a globe-trotting executive or nomad. Even if you are on frequent business trips, as long as you are not outside of Malaysia for 90 days consecutively, you likely don’t need an overseas medical coverage.
No doubt that overseas medical card comes access to well-know global healthcare providers, with very high annual and/or lifetime limit (usually in US Dollar), not only to account for the cost of insurance but also travel-related expenses costs. And that comes with a cost in the form of higher premiums than a standard Malaysian medical card.
Can I use my Malaysian medical insurance overseas?
Aside from coverage in Brunei and Singapore (for some Malaysian medical card), all standard Malaysian medical cards do not offer direct (cashless) coverage for elective overseas medical treatment, although they may provide a value-added services such as a second opinion benefit.
For that matter, if you are hospitalized outside Malaysia for any emergency medical procedure, do not expect you will be reimbursed in full for your medical bill.
Insurers are not stupid; they will only reimburse you an amount that is up to what is defined in Malaysian Medical Association’s (MMA) Schedule of Fees when it comes to medical procedures, and what’s reasonable and customary for other medical expenses such as prescriptions and medical supplies.
see below as we explain more.
Insurance company will use this information to determine the amount they are willing to pay for a particular service in a particular area.
As an example, assume stroke treatment at a private hospital is around RM40,000, but when you were in United States, you had a stroke and it set you back for US$50,000 for an emergency medical procedure.
How much do you think your Malaysian insurer is going to reimburse you?
Now It’s Your Turn
Phew! We put A TON of work into this guide. So we hope you enjoyed it.
Now we’d like to hear what you have to say.
Which medical card feature that is the most important to you?
It is Annual Limit or Hospitals Room and Board rate?
Or something else.
Let me know by leaving a comment below.
Author: CF Lieu
CF Lieu is an independent financial adviser (IFA) with CFP qualification and licensed by the Securities Commission of Malaysia to conduct regulated financial planning activities.