What does medical and health insurance cover?

Medical and Health Insurance (MHI) is designed to reimburse the cost of private medical treatment, which can be very expensive, especially with hospitalisation and surgery. There are different types of medical plans available in the market, such as hospitalisation and surgical plans or critical illness plans: – Hospitalisation and surgical insurance plan generally covers your room and board in the hospital, laboratory fees, use of special facilities, nursing care, and certain medicines and supplies. Critical illness plan is typically where the insurance company makes a lump sum cash payment to the policyholder if he or she is diagnosed with one of the critical illnesses listed in the policy.

Want to Understand Medical Insurance? You’re in the Right Place!

This page breaks down the basics of medical insurance, also known as health insurance, in simple terms. From what’s covered to how to make a claim, we’ve got your most common questions answered!

Understanding Medical Insurance

With the premiums you pay every month, you get in return long-term financial protection, in which the insurance company will pay a portion of your medical expenses if you get hospitalised or a sum of money to your loved ones in the event of death and permanent disability.

There are mainly two types of insurance, namely life insurance and general insurance which cover different aspects in your life.

Medical and Health Insurance (MHI) is designed to reimburse the cost of private medical treatment, which can be very expensive, especially with hospitalisation and surgery.

There are different types of medical plans available in the market, such as hospitalisation and surgical plans or critical illness plans: –

Hospitalisation and surgical insurance plan generally covers your room and board in the hospital, laboratory fees, use of special facilities, nursing care, and certain medicines and supplies.
Critical illness plan is typically where the insurance company makes a lump sum cash payment to the policyholder if he or she is diagnosed with one of the critical illnesses listed in the policy.

Our Hospital Alliance Services (HAS) is a value-added service to facilitate insurance claims for our medical policyholders, at no extra charge.

For more information, click here.

The Supplementary Schedule that you receive contains details of the revision and a summary of the projected insurance charges / premium rates for your medical plan. It forms part of your existing Policy upon the respective effective date(s) indicated and supersedes the provisions in the existing schedule(s).

It is important for you to note that if any part of your Policy in connection with the provisions in the Supplementary Schedule varies after the date of the Supplementary Schedule but before your policy anniversary date, the provisions in this Supplementary Schedule will not apply.

Deductible is usually a fixed amount you pay out of your pocket for medical expenses before your medical and health Insurance plan starts to pay out. In the case of a RM300 Deductible amount, you will have to pay a fixed amount of RM300 of total expenses covered under your policy for a disability (excluding the cost of daily room & board). The remaining balance of eligible benefits will be paid by Prudential up to the annual and lifetime limits, subject to reasonable and customary charges. Please refer to your policy document for more details.

We encourage you to review your insurance coverage at least once a year. This is because as you progress in life, your needs and priorities may change over time; and with healthcare costs consistently outpacing inflation, it is all the more important to ensure that you are always adequately insured.