How to Choose the Best Policy (explained). THE FOLLOWING IS A BRIEF DESCRIPTION OF THE IMPORTANT FEATURES YOUR HOSPITAL & SURGICAL POLICY SHOULD IDEALLY HAVE :- "GUARENTEED RENEWABLE" Very important feature in every medical insurance policy. Means your renewal is guaranteed regardless of what medical conditions or illness you may develop in the future. Premium however is not guaranteed. This guarantee will cease upon the occurrence of any of the following :- non payment of premium or premium not made on time fraud or misrepresentation of material fact during application the policy is cancelled at the request of the policyholder total claims of the policy have reached the lifetime limit specified on the death of the insured Person the insured person ceases to qualify as a dependant based ont he definition of the policy the insured Person attains the coverage age limit specified the insured Person ceases to be domicile in Malaysia termination of coverage for all policies in a certain market the Company withdraws the policy completely from the market in accordance with the Portfolio Withdrawal Conditon Insurers for policies that do not have this feature reserve the right to exclude the disability upon renewal in the event of a claim. If the disability is severe enough, the insurers may even decline your renewal. When this happens you may not be able to find any medical cover elsewhere. "AS CHARGED" Refers to actual charges incurred for reasonable, necessary and customary medical care provided in the treatment of an insured disability. Policies that do not have this feature usually have inner cappings, i.e., up to RM30,000 for Surgical Fees, etc. Policies that have this feature will pay in full on "As Charged" items stated in the policy schedule of benefits up to the disability/annual limit. This ensures more complete way of hospital bill reimbursement, so that you don't have to bear a significant portion of the hospital bill in the event of a major claim. "HASSLE-FREE CASHLESS HOSPITAL ADMISSION AND DISCHARGE" This is a very important feature in modern-day medical insurance coverage. This feature is provided by MCOs (Managed Care Organisations, or Third Party Administrators, TPAs) for medical policyholders. They will help policyholders place guarantees (in the form of Guarantee Letters, known as GLs) to the hospitals in the event of a hospital admission. They will also help policyholders to settle their final hospital bills upon discharge, compile all relevant claim documents and pass them on to the insurers for reimbursement. Due to the ability of such MCOs to place guarantees, many policyholders are able to get treatments in private hospitals and many lives have been successfully saved because many of these policyholders do not have the financial resources to settle exhorbitant medical bills even when they can file in their claims later. This feature is given subject to the policy terms and conditions. Some examples where guarantees cannot be given :- fraud and non-disclosure is proven. admission to hospital is for observation and diagnostic purposes. admission to hospitals arising from policy exclusions. and many more, please refer to "Hospital Admission". Depending on the plans selected, such feature are also available to overseas admission due to medical emergency. HIGH DISABILITY/ANNUAL OR LIFETIME LIMITS This feature is very relevant to item "1" above. Based on similar principles of life insurance coverage, a high disability/annual or lifetime limits ensures higher chances of sufficient coverage for a major disability that may require quality financial aid up to old age. Cost of medical treatment has escalated during recent years, e.g., a heart by-pass may cost in the region of RM30,000 to RM50,000 today. We are unable to predict how much the same procedure will cost in 10-20 years. How high such limits should be for you depends very much on your affordability, general rule of the thumb is to get the highest your budget will allow you, and still pay the minimum premium. If you are considering a family program, ensure all members of your family gets maximum coverage within your budget. Get it from an EXPERIENCED MEDICAL INSURER WITH A PROVEN TRACK RECORD. Medical insurance underwriting is a very specialized field and quite a difficult field of insurance to manage. Apart from expertise in this area, an insurer must also have sufficient experience managing a profitable portfolio and most importantly a proven track record. There is one medical insurance underwriter in Malaysia that we have observed satisfied these criteria and this insurance company is managing the Hospital & Surgical insurance portfolio for the MCO we have identified. The insurer must have a profitable medical insurance portfolio to ensure continuity of benefits to its policyholders and still remain profitable. MINIMUM PREMIUM, MAXIMUM PROTECTION Medical insurance by itself (either stand-alone or attached to a life or investment-linked policy) do not give you a cash return regardless of how long the policy is renewed. It is therefore prudent to find a way of paying minimum premiums and getting maximum coverage for such a policy. Today such a way exist, i.e., join a very big group and take advantage of the policies that are arranged for the members of such big group. This is the primary reason for the existance of this website. You will get more information in later sections.