Medical card notes

Contents

Bahasa Malaysia

1. Boleh claim: kemasukan wad & surgery ✅ kecuali:
   • kehamilan & penyakit berkait kehamilan ❌
   • penyakit mental ❌
   • gigi ❌ (boleh claim kalau accident)
   • prosedur kosmetik ❌ (boleh claim kalau accident)
2. Tak boleh claim: rawatan pesakit luar samada ke clinic/specialist ❌ kecuali:
   1. sebelum kemasukan wad/surgery ✅
   2. selepas kemasukan wad/surgery ✅
   3. accident, walaupun tak perlu masuk wad ✅
   4. dialisis buah pinggan ✅
   5. rawatan pesakit luar cancer ✅
3. Tempoh menunggu
   1. eksiden: 0 hari (tiada)
   2. diseases (covid, denggi dsb): 30 hari
   3. lain-lain (specified illness): 120 hari
4. Cara claim
   1. cashless menggunakan Guarantee Letter (GL)
   2. reimbursement (pay and claim). senarai pay and claim:
      • 2a, 2b, 2c, dan 2d
      • hospital non-panel, contohnya hospital kerajaan
      • 3a & 3b apabila polisi < 90 hari
      • 3c apabila polisi < 2 tahun. klik sini untuk sebab
5. Berkenaan deductible, klik sini: Deductibles & SMART Deductible
6. Klik di sini untuk Claims abroad - Claim di luar negara

Ada soalan lain?

English

1. Covered: all admission/ surgery ✅

   Except:

   • Pregnancy ❌
   • Mental illness ❌
   • Dental ❌ (can be claimed if accidental)
   • Cosmetic procedure ❌ (can be claimed if accidental)

2. Not covered: outpatient (clinic/ specialist) ❌

   Except:

   1. Pre hospitalisation ✅
   2. Post hospitalisation ✅
   3. Accident ✅
   4. Dialysis ✅
   5. Outpatient cancer ✅
3. Waiting period:
   1. Accidents: 0 days
   2. Communicable disease: 30 days
   3. Others: 120 days
4. How to claim
   1. Cashless via guarantee letter (GL)
   2. Reimbursement (pay & claim) for:
      • 2a, 2b, 2c and 2d
      • non-panel hospital, for example government hospitals
      • 3a & 3b when policy < 90 days
      • 3c when policy < 2 years
5. On deductibles, click here: Deductibles & SMART Deductible
6. Click here for Claims abroad - Claim di luar negara

Any questions?