Blog Series Title: The Malaysia Insurance Planning Guide
-
Table of Content
Introduction
Part 1: Needs or Wants
Part 2: Comprehensiveness of Coverage
2.1 Personal Accident
2.2 Medical and Hospitalization Insurance
2.3 Malaysia Critical Illness Insurance Coverage
2.4 Endowment Insurance
This is another coverage that you should already have in your risk management portfolio. Let?? face it, after the probability of meeting with an accident, the next most possible misfortunate event would be landing up in the hospital and having to stay overnight for observations. Your stay in the hospital could be due to an unknown cause, accident-related and probably common symptoms such as dengue or appendix removal, but rest assure it?? going to cost you money. If you are admitted to a private hospital, it?? going to cost you LOTS of money.
So, what exactly is covered under this category of insurance?
For start, the core coverage would be the Standard Room & Board (R&B) package, not unlike a hotel room package. A typical medical insurance package would look like this:
(i) Room & Board RM150
(ii) Room & Board RM200
(iii) Room & Board RM300
(iv) Room & Board RM400
Room & Board RM 200 means that the coverage entitles you to stay in wardroom package of RM 200. However, you can still request the hospital to upgrade your room to a better package, but there would be terms and conditions applied according to respective insurance companies.
The Annual & Lifetime Limits is tied to the R&B. Generally, the following R&B packages will have the following Annual & Lifetime Limits:
(i) Room & Board RM 100: RM 90,000 (Annual) and RM 360,000 (Lifetime)
(ii) Room & Board RM 150: RM 120,000 (Annual) and RM 480,000 (Lifetime)
(iii) Room & Board RM 200: RM 160,000 (Annual) and RM 640,000 (Lifetime)
(iv) Room & Board RM 300: RM 200,000 (Annual) and RM 800,000 (Lifetime)
Source: www.insuranceonline.my
You should refer to your policy?? actual schedule of benefits to find out the exact figures. The annual & lifetime limits are deducted as you make claims.

Co-insurance is a commonly used phrase in medical insurance packages. It simply means that you as the policyholder need to pay a certain percentage from the total claims made. If your policy did not mention anything on co-insurance, it would usually mean that the fee is 100% borne by the Company.
For instance, you are hospitalized for 3 days, and used up a total of RM 6,780.24. Assume that the co-insurance of your medical package is 10%, capped at RM 500, you will need to fork out:
RM 6,780.24 x 10% = RM 678.02
Since the co-insurance is capped at RM 500, you will only need to fork out RM 500, instead of RM 678.02.
Here are some other important elements in the medical coverage that you should be concerned about:
(i) Pre-hospitalization and Post-hospitalization claims, where you need to find out how many days of pre-hospitalization and post-hospitalization is claimable.
(ii) Limits payable for outpatient treatments; for Accident, Cancer and Kidney Dialysis respectively
(iii) Room & Board and Intensive Care Units (ICU) with coverage usually upto 90 days.
Prosthetics, equipments and accessories such as wheel chairs or artificial teeth used during your stay in the hospital are usually not claimable. In most instances, government tax and service tax imposed in your bill are not claimable either.
{openx:50}Handy tips for Medical Insurance Policy:
(i) You should always keep the Original Receipts to ensure a speedy claim.
(ii) Declare all your health and medical track records when you are applying to ensure that you will not have problem with your claims later on. Ask your parents about any hereditary diseases that you might have inherited.
(iii) Always keep your Medical Card by your side, together with your girlfriend/boyfriend photo.
(iv) You will probably need to foot a deposit even if you have a valid Medical Card, so it’s best to have a credit card to avoid any problems with the profit-oriented health institutions.
(v) Go for the best possible medical insurance package you can afford, as it is easier to downgrade your package than it is to upgrade. Nonetheless, as long as you have a good health record, upgrading should not be a problem, except that you most likely have to pay for the medical check-ups yourself.
To conclude, due to the high possibility of you landing in a hospital, a medical insurance plan should be in your priority especially when you??e shopping for your first insurance policy.
Until banks or private hospitals are ready to provide medical loans which you can pay by installments, it?? a good idea to ensure your entire family is protected at least with a minimal amount.
In the next section, I will talk about the importance of Critical Illnesses Coverage, and why it is important in your risk management strategy. Unlike the medical plan coverage mentioned here, a Critical Illnesses Coverage is where all the common big tickets illnesses are covered.
You might want to read these too...
- How Much Insurance Should You Buy?
- Comprehensiveness of Coverage
- Malaysia Personal Accident Coverage
- Investment-Linked Insurance Policy: An Overview- Part 1
- The Malaysia Insurance Planning Guide Part 1: Needs or Wants
- Malaysia Health Insurance and H1N1
- Malaysia Critical Illness Insurance Coverage
- Malaysia Endowment Insurance

