Group Hospitalization Scheme

MEDIGUARD PREMIER

POLICY DETAILS Product Details Description of Benefits Exclusions Special Provision & Conditions Product Disclosure Sheets

INTRODUCTION   Looking for a medical insurance that offers more than the basic hospitalization coverage? mediGUARD Premier is THE PLAN! Besides basic hospitalization coverage, it has various extended benefits, which provide you with adequate protection at an affordable price. With mediGUARD Premier, you are offered choice of plans with or without a medical card.   With A Medical Card - Hospital Admission And Discharge Will Be Hassle Free   You will be given a Kurnia Insurans  medical card. Just present your card at any of our panel hospitals to get admitted, no deposit required. Click here to search for a panel hospital. This card guarantees hassle free admission and discharge for a covered condition. You may only need to settle non-payable charges, if any.     Without A Medical Card - You Have Free Choice Of Hospital   Just settle your full bill upon discharge and submit to Kurnia Insurans for claims reimbursement for a covered condition.   You can enjoy generous additional benefits: - Out-Patient Kidney Dialysis / Cancer Treatment - Emergency Accidental & Dental Out-Patient Treatment - Out-Patient Physiotherapy Treatment - Organ Transplant - Second Surgical Opinions - AIDS - Home Nursing - Double Overall Annual Limit For Accident Occurs Overseas - Major Medical - Accidental Death - Permanent Total Disablement Due To Accidental Injury - Bereavement Benefit On Accidental Death - Out-Patient Clinical Benefit (Optional). Click here to search for a panel clinic. - Full Reimbursement for Government Hospital (up to overall annual limit) SCHEDULE OF BENEFIT   SECTION A : BENEFIT / PLAN Plan 1 (RM) Plan 2 (RM) Plan 3 (RM) Plan 4 (RM) Plan 5 (RM) Plan 6 (RM) IN-HOSPITAL BENEFITS Maximum Per Disability Accommodation: Hospital Room & Board (daily max up to 150 days) 100 150 200 250 400 600 Intensive Care Unit, ICU (daily max up to 20 days) Full Reimbursement Medical & Surgical Procedures: Surgical Fees (including post-surgery care up to 60 days from date of surgery) Full Reimbursement Operating Theatre Anaesthetist Fee Pre-Hospital Diagnostic Tests & Specialist Consultation (31 days prior to admission) In-Hospital Physician Visit (daily max up to 150 days) Post-Hospitalization Treatment (within 60 days from date of discharge) Hospital Supplies & Services Prescribed Medicines (within 150 days during hospitalization and 60 days after discharge) Ambulance Fees OUT-OF-HOSPITAL BENEFITS Out-Patient Benefits: Annual Out-Patient Kidney Dialysis Treatment 20,000 25,000 35,000 40,000 50,000 60,000 Annual Out-Patient Cancer Treatment 20,000 25,000 35,000 40,000 50,000 60,000 Emergency Accidental & Dental Out-Patient Treatment (seek treatment within 24 hours and follow-up within 31 days) Full Reimbursement Out-Patient Physiotherapy Treatment (within 60 days from discharge) EXTENDED BENEFITS Organ Transplant (per lifetime limit) Full Reimbursement Daily-Cash Allowance At Government Hospital (up to 150 days) 50 60 70 80 90 100 Medical Report 50 50 50 50 50 50 Second Surgical Opinions 50 50 70 70 100 150 Government Service Tax 5% of Hospital Room & Board Eligible Expenses Reimbursable SPECIAL BENEFITS AIDS (per lifetime limit) 5,000 5,000 5,000 10,000 10,000 10,000 Home Nursing 5,000 5,000 6,000 8,000 8,000 10,000 OVERALL ANNUAL LIMIT 50,000 70,000 90,000 110,000 130,000 150,000 DOUBLE OVERALL ANNUAL LIMIT FOR ACCIDENTAL INJURY WHILST TRAVELING OVERSEAS 100,000 140,000 180,000 220,000 260,000 300,000 MAJOR MEDICAL (per lifetime limit) 10,000 15,000 20,000 25,000 30,000 35,000 LIFETIME LIMIT 150,000 210,000 270,000 330,000 390,000 450,000 PERSONAL ACCIDENT BENEFITS Accidental Death 20,000 25,000 30,000 35,000 40,000 50,000 Permanent Total Disablement Due To Accidental Injury 20,000 25,000 30,000 35,000 40,000 50,000 Bereavement Benefit On Accidental Death Only 1,500 1,500 1,500 1,500 1,500 1,500   SECTION B : BENEFIT / PLAN Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6 OUT-PATIENT CLINICAL BENEFITS (OPTIONAL) Out-Patient GP Care (in the Physician's office or clinic) · Consultation · Medication · Diagnostic Test (for accidental injury only) Panel - Co-payment RM 5 per visit - Unlimited number of visits per annumNon-Panel - Reimburse up to 80% of the actual charges or maximum RM 20 per visit, subject to emergency basis only Out-Patient Specialist Care (in the Physician's office or clinic) · Consultation · Medication · Diagnostic Test (for accidental injury only) Co-payment RM5 per visit up to RM100 per visit (inclusive of co-payment) subject to referral by panel clinics only (reimbursement basis) Preventive Screening For Annual Pap Smear Or Prostate Specific Antigen Full Reimbursement at panel GP clinics only OVERALL ANNUAL LIMIT RM 1,500 LIFETIME LIMIT RM 4,500   Please refer to Description of Benefits for definition of terms. ELIGIBILITY   Enrolment age from 19 years old up to 65 years old. Renewal is up to age 65 at the option of the Policyholder, thereafter at the discretion of the Company up to 70 and provided that you are enrolled before 61 years old. PREMIUM   Premium is calculated based on age next birthday and type of plan.   Annual Premium Table On Age Next Birthday (RM)   Section A : With Medical Card Option Age / Plan Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6 19-25 424 484 549 670 834 971 26-35 433 493 559 682 848 989 36-45 550 629 723 886 1,109 1,301 46-55 833 970 1,133 1,400 1,772 2,094 56-60 1,123 1,328 1,561 1,937 2,473 2,932 61-65 1,452 1,738 2,050 2,545 3,268 3,889 66-70 (Renewal only) 1,962 2,389 2,830 3,501 4,539 5,446   Section A : Without Medical Card (Reimbursement Basis) Option Age / Plan Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6 19-25 382 436 494 603 751 874 26-35 390 443 503 614 763 890 36-45 495 566 651 798 998 1,171 46-55 749 873 1,020 1,260 1,595 1,885 56-60 1,010 1,195 1,405 1,744 2,226 2,639 61-65 1,307 1,564 1,845 2,291 2,942 3,500 66-70 (Renewal only) 1,765 2,150 2,547 3,151 4,085 4,902   Section A & B : With Medical Card & Out-Patient Clinical Benefit Option Age / Plan Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Plan 6 19-25 722 782 847 968 1,132 1,269 26-35 731 791 857 980 1,146 1,287 36-45 848 927 1,021 1,184 1,407 1,599 46-55 1,131 1,268 1,431 1,698 2,070 2,392 56-60 1,421 1,626 1,859 2,235 2,771 3,230 61-65 1,750 2,036 2,348 2,843 3,566 4,187 66-70 (Renewal only) 2,260 2,687 3,128 3,799 4,837 5,744