+ All Categories
Home > Economy & Finance > MAA SmartMedic200 - The Best Medical Takaful Plan

MAA SmartMedic200 - The Best Medical Takaful Plan

Date post: 17-Aug-2014
Category:
Upload: shahrin-haron
View: 1,097 times
Download: 7 times
Share this document with a friend
Description:
Key feature of MAA Takaful - SmartMedic200 hospitalisation and surgical takaful plan. The best medical takaful plan in Malaysia currently.
Popular Tags:
44
Introducing Introducing SmartMedic 200 A Complete Complete Solution Solution for All Your Hospitalisation Needs.
Transcript
Page 1: MAA SmartMedic200 - The Best Medical Takaful Plan

IntroducingIntroducing SmartMedic 200

A Complete Complete SolutionSolution for All Your Hospitalisation Needs.

Page 2: MAA SmartMedic200 - The Best Medical Takaful Plan

AgendaAgenda

1. The 6 Pillars of SmartMedic 2002. What’s New in SmartMedic 200?3. Competitor’s Analysis4. Table of Benefits5. Underwriting Guidelines6. Exclusions7. Table of Contribution8. Commission Structure9. Managed Care Organisation (MCO)10. Panel Hospitals

Page 3: MAA SmartMedic200 - The Best Medical Takaful Plan

The 6 Pillars of SmartMedic 200

Page 4: MAA SmartMedic200 - The Best Medical Takaful Plan

The 6 Pillars of SmartMedic 200The 6 Pillars of SmartMedic 200

5 Plans for Both Standalone & Rider

High Room & Board of Up to RM1,000

No Lifetime Limit

High Annual Limit of Up to RM250,000

Funeral Expense of RM5,000 for both Standalone & Rider

No *Co-takaful

Note: *Except for Juvenile (Age 30 days to 15 years old).

Page 5: MAA SmartMedic200 - The Best Medical Takaful Plan

What’s New in SmartMedic 200?

Page 6: MAA SmartMedic200 - The Best Medical Takaful Plan

What’s New in SmartMedic 200?

Higher Room & Board of Up to RM1,000

5 Plans for Both Standalone & Rider

Higher Annual Limit of Up to RM250,000

No Lifetime Limit

Funeral Expense of RM5,000 for Both Standalone & Rider

Page 7: MAA SmartMedic200 - The Best Medical Takaful Plan

What’s New in SmartMedic 200?

Co-takaful for Juvenile (Age 30 days to 15)

Post-Hospitalisation Treatment extended to 60 days from discharge

As Charged for Out-patient Kidney Dialysis, Cancer Treatment, Medical Report Fees & Government Service Tax

High Daily Cash Allowance and Home Nursing Care

Page 8: MAA SmartMedic200 - The Best Medical Takaful Plan

Competitor’s Analysis

Page 9: MAA SmartMedic200 - The Best Medical Takaful Plan

Competitor’s AnalysisCompetitor’s AnalysisCompany MAAT Company AI Company

PRCompany

GTCompany

ET

Product Type Standalone & Rider

Standalone & Rider Rider Rider Rider

Choice of Plan

5 Plans of up to RM1,000

5 Plans of up to RM350

5 Plans of up to RM400

5 Plans of up to RM400

5 Plans of up to RM500

Product Term

Guaranteed Renewal Up

to Age 80

Renewal Up to Age 99

Guaranteed Renewal Up to Age 25,

70, 80, & 100

Renewal Up to Age 80

Renewal Up to Age 88

Overall Annual Limit

Max RM250k Max RM190k Max RM250k Max RM200k Max RM300k

Lifetime Limit

No Lifetime Limit

No Lifetime Limit

Max RM1.5M

Max RM1.6M

Max RM1.5M

Funeral Expense

RM5,000 N/A N/A N/A N/A

Page 10: MAA SmartMedic200 - The Best Medical Takaful Plan

Competitor’s AnalysisCompetitor’s Analysis

Company MAAT Company AI Company PR

Company GT

Company ET

Plan (RM)1 22,0002 25,0003 28,0004 33,0005 36,000

Co-takaful

For Juvenile Plan only.

10% co-takaful

subject to minRM300 & max RM1000 per

admission

10% of the balance exceeding co-takaful Free Amount per cert. year, max RM 3000

Yes. 10% of total expenses Min RM300, Max RM1,000 (H&S) & a Max: RM2000 (Outpatient Treatment Benefit)

Yes.10% co-takaful per disabilityMin RM300MaxRM1000

N/A

Page 11: MAA SmartMedic200 - The Best Medical Takaful Plan

Table of Benefits

Page 12: MAA SmartMedic200 - The Best Medical Takaful Plan

Table of BenefitsTable of BenefitsPLAN BENEFIT

P150(RM)

P200 (RM)

P300 (RM)

P500(RM)

P1000 (RM)

Annual Limit 50,000 100,000 150,000 200,000 250,000Lifetime Limit No Lifetime LimitFuneral Expenses RM5,000

Hospital BenefitsHospital Room & Board(max 200 days per annum)

150 200 300 500 1,000

Intensive Care Unit(max 60 days per annum)

Age 16 years & above (adult): As chargedAge 30 days to 15 years (juvenile): As charged,

with 10% co-takaful subject to minimumco-takaful of RM300 and maximum co-takaful

of RM1,000 per admission

Hospital Supplies & Services

Surgical Fee

Anaesthetist Fee

Operating Theater

Page 13: MAA SmartMedic200 - The Best Medical Takaful Plan

PLAN BENEFITP150(RM)

P200 (RM)

P300 (RM)

P500(RM)

P1000 (RM)

Hospital BenefitsPre-Hospitalisation Diagnostic Tests(within 60 days prior to admission)

Age 16 years & above (adult): As chargedAge 30 days to 15 years (juvenile): As charged,

with 10% co-takaful subject to minimumco-takaful of RM300 and maximum co-takaful

of RM1,000 per admission

Pre-Hospitalisation Specialist Consultation(within 60 days prior to admission)

In-Hospitalisation Physician Visit(maximum 200 days per annum)

Post-Hospitalisation Treatment(within 60 days after discharge)

Table of BenefitsTable of Benefits

Page 14: MAA SmartMedic200 - The Best Medical Takaful Plan

PLAN BENEFITP150(RM)

P200 (RM)

P300 (RM)

P500(RM)

P1000 (RM)

Out-Patient BenefitsEmergency Accidental Out-patient Treatment(within 24 hours and follow up treatment toa maximum of 31 days)

As charged

Out-patient Physiotherapy Treatment(within 90 days after discharge/surgery)

Ambulance Fees

Out-patient Kidney Dialysis Treatment

Out-patient Cancer Treatment

Table of BenefitsTable of Benefits

Page 15: MAA SmartMedic200 - The Best Medical Takaful Plan

PLAN BENEFITP150(RM)

P200 (RM)

P300 (RM)

P500(RM)

P1000 (RM)

Other BenefitsDaily Cash Allowance at Government Hospital(maximum 200 days per annum)

100 100 100 100 100

Home Nursing Care(maximum per admission) 500 750 1,000 1,500 2,000

Person Covered Child’s Daily Guardian Benefit(maximum per admission)

150 200 300 450 600

Medical Report FeesAs charged

Government Service Tax

Table of BenefitsTable of Benefits

Page 16: MAA SmartMedic200 - The Best Medical Takaful Plan

Underwriting Guidelines

Page 17: MAA SmartMedic200 - The Best Medical Takaful Plan

Underwriting GuidelinesUnderwriting GuidelinesBenefits New

1. Eligibility

2. Term of Coverage

Eligibility Minimum Maximum

Person Covered 30 days Age 59

Participant Age 18 No Limit

Plan ExpiryBasic Age 80

RiderUp to Age 80

(follow basic plan term, whichever is lower)

Page 18: MAA SmartMedic200 - The Best Medical Takaful Plan

Underwriting GuidelinesUnderwriting GuidelinesBenefits New

3. Plan Code

4. Payment Mode

Plan Standalone Rider

Plan 1 P150 PR150Plan 2 P200 PR200Plan 3 P300 PR300Plan 4 P500 PR500Plan 5 P1000 PR1000

Plan Payment Channel

MonthlyDirect Debit/Auto Debit

or Easy Contribution Payment facility

Quarterly, Semi Annually & Annually All

Page 19: MAA SmartMedic200 - The Best Medical Takaful Plan

Underwriting GuidelinesUnderwriting GuidelinesBenefits New

5. Contribution Mode Factor

6. Wakalah Fee

Mode Modal ContributionMonthly 0.090Quarterly 0.250

Semi-Annually 0.500Annually 1.000

Certificate Year Wakalah Fee %1 752 503 354 305 206 20

7 onwards 8

Page 20: MAA SmartMedic200 - The Best Medical Takaful Plan

Underwriting GuidelinesUnderwriting GuidelinesBenefits New

7. Upgraded Room & Board

• If the Person Covered is hospitalised at a Room & Board which is higher than his/her entitlement, 10% co-payment will be waived if there is a written evidence from authorized hospital personnel to confirm on the unavailability of his/her eligible Room & Board. • The Person Covered only need to pay the

difference of his/her upgraded Room & Board.

8. Co-takaful (Juvenile only)

• The Person Covered will have to pay 10% of the cost of an eligible hospital benefit, subject to minimum co-takaful amount of RM300 and maximum co-takaful amount of RM1,000. • The remaining balance of the eligible benefit will be

paid by MAA Takaful Berhad up to the Overall Annual Limit.

Page 21: MAA SmartMedic200 - The Best Medical Takaful Plan

Underwriting GuidelinesUnderwriting GuidelinesBenefits New

9. Foreigner

Below are the group of foreigners who are eligible to participate in SmartMedic 200 Plan 1 until Plan 5.1. Expatriates/Professional2. With PR status (except for manual workers)3. Malaysia My Second Home (MM2H)

10. Payment Grace Period 31 days

11. Take Over Option

MTL1 with SM100 SM200 Standalone MTL2 with SM100 SM200 Rider/StandaloneSM100 Standalone SM200 StandaloneSubject to minimum 1 year anniversary

Page 22: MAA SmartMedic200 - The Best Medical Takaful Plan

Exclusions

Page 23: MAA SmartMedic200 - The Best Medical Takaful Plan

Exclusions

What are the major exclusions that you should know?

Any medical or physical conditions arising within the first thirty (30) days of the Person Covered’s cover or Reinstatement Date, whichever is the later, except for accidental Injuries.

Pre-existing Illness. Specified Illnesses occurring during the first one hundred

and twenty (120) days of continuous cover.

Page 24: MAA SmartMedic200 - The Best Medical Takaful Plan

Exclusions

1. Abuse of alcohol & drugs2. AIDS or ARC (AIDS Related Complex) and HIV3. Congenital abnormalities or deformities4. Pregnancy related conditions 5. Treatment related to infertility or impotence6. Hospitalization for investigatory purposes7. Suicide or intentionally self-inflicted injury while sane or

insane8. War, criminal or terrorist activities9. Contamination by radioactivity10. Donation of body organ

Page 25: MAA SmartMedic200 - The Best Medical Takaful Plan

Exclusions11. Cosmetic surgery12. Circumcision13. Eye examination, surgical correction of nearsightedness14. Dental treatment or oral surgery except as necessitated by

accidental injury 15. Private nursing16. Treatment of sleep disorder17. Hormone replacement therapy18. Weight control19. Alternative therapy such as acupuncture, reflexology,

herbalist treatment, aroma therapy & etc20. Mental disorder21. Participation in dangerous sports or profession22. Private flying23. Sex changes

Page 26: MAA SmartMedic200 - The Best Medical Takaful Plan

Table of Contributions

Page 27: MAA SmartMedic200 - The Best Medical Takaful Plan

Table of Annual Contribution (Standalone – Male)

Age/Plan MaleP150 P200 P300 P500 P1000

0 – 5 1,078 1,402 1,822 2,369 3,0806 – 15 564 733 952 1,238 1,609

16 – 21 910 1,137 1,479 1,922 2,49922 – 29 803 1,017 1,322 1,719 2,23530 – 39 878 1,061 1,379 1,792 2,33040 – 49 1,049 1,316 1,710 2,223 2,89050 – 54 1,552 1,911 2,484 3,229 4,19855 – 59 2,649 3,246 4,219 5,485 7,131

60 – 64* 2,421 2,919 3,795 4,933 6,41365 – 69* 4,339 5,227 6,795 8,834 11,48470 – 74* 5,845 7,041 9,154 11,900 15,46975 – 79* 9,912 11,937 15,518 20,173 26,225

Note: *For renewal only.

Page 28: MAA SmartMedic200 - The Best Medical Takaful Plan

Table of Annual Contribution (Standalone – Female)

Age/Plan FemaleP150 P200 P300 P500 P1000

0 – 5 1,078 1,402 1,822 2,369 3,0806 – 15 564 733 952 1,238 1,609

16 – 21 951 1,189 1,546 2,009 2,61222 – 29 839 1,063 1,382 1,796 2,33530 – 39 919 1,111 1,444 1,877 2,44040 – 49 1,102 1,381 1,796 2,334 3,03550 – 54 1,599 1,968 2,559 3,326 4,32455 – 59 2,696 3,304 4,296 5,584 7,259

60 – 64* 2,421 2,919 3,795 4,933 6,41365 – 69* 4,339 5,227 6,795 8,834 11,48470 – 74* 5,845 7,041 9,154 11,900 15,46975 – 79* 9,912 11,937 15,518 20,173 26,225

Note: *For renewal only.

Page 29: MAA SmartMedic200 - The Best Medical Takaful Plan

Table of Annual Tabarru’ Rate (Standalone – Male)

Age/Plan MaleP150 P200 P300 P500 P1000

0 – 5 734.04 954.00 1,239.96 1,611.96 2,094.966 – 15 390.00 507.00 659.04 855.96 1,113.00

16 – 21 621.00 777.00 1,010.04 1,313.04 1,707.0022 – 29 549.96 696.96 906.00 1,176.96 1,530.9630 – 39 585.00 708.00 920.04 1,197.00 1,556.0440 – 49 675.00 846.96 1,101.00 1,431.96 1,860.9650 – 54 951.00 1,172.04 1,524.00 1,980.96 2,574.9655 – 59 1,523.04 1,866.96 2,427.96 3,156.00 4,103.04

60 – 64* 2,045.04 2,466.00 3,206.04 4,167.96 5,418.0065 – 69* 3,660.00 4,410.00 5,733.00 7,452.96 9,689.0470 – 74* 4,929.00 5,937.96 7,719.00 10,035.00 13,044.9675 – 79* 8,352.96 10,059.96 13,077.96 17,001.00 22,101.96

Note: *For renewal only.

Page 30: MAA SmartMedic200 - The Best Medical Takaful Plan

Table of Annual Tabarru’ Rate (Standalone – Female)

Age/Plan FemaleP150 P200 P300 P500 P1000

0 – 5 734.04 954.00 1,239.96 1,611.96 2,094.966 – 15 390.00 507.00 659.04 855.96 1,113.00

16 – 21 648.96 812.04 1,056.00 1,373.04 1,784.0422 – 29 575.04 728.04 945.96 1,230.00 1,599.9630 – 39 612.96 741.00 963.96 1,253.04 1,629.0040 – 49 708.96 888.96 1,155.96 1,503.00 1,953.9650 – 54 980.04 1,206.96 1,569.96 2,040.96 2,652.9655 – 59 1,550.04 1,901.04 2,471.04 3,213.00 4,176.96

60 – 64* 2,045.04 2,466.00 3,206.04 4,167.96 5,418.0065 – 69* 3,660.00 4,410.00 5,733.00 7,452.96 9,689.0470 – 74* 4,929.00 5,937.96 7,719.00 10,035.00 13,044.9675 – 79* 8,352.96 10,059.96 13,077.96 17,001.00 22,101.96

Note: *For renewal only.

Page 31: MAA SmartMedic200 - The Best Medical Takaful Plan

Managed Care Organisation (MCO)

Page 32: MAA SmartMedic200 - The Best Medical Takaful Plan

Managed Care Organisation (MCO)

Note: *For renewal only.Note: *For renewal only.

Metronic iCares (MiCares)

Page 33: MAA SmartMedic200 - The Best Medical Takaful Plan

Hospital Admission WorkflowNote: *For renewal only.Note: *For renewal only.

Hospital updates interim bills (if exceeds

GL limit)

Person Covered arrives at hospital, produces IC &

Medical CardHospital verifies card and

name via our 24x7 call center / web-system

Hospital faxes relevant docs with Admission Request

Form

Our Call Center validates & authenticate info, issues GL/DL upon

receipt of relevant documents

Person Covered gets admitted into hospital

Our Call Center issues Top-up GL

Page 34: MAA SmartMedic200 - The Best Medical Takaful Plan

Hospital Discharge WorkflowNote: *For renewal only.Note: *For renewal only.

Person Covered ready to be discharged

Hospital prepares payment notice breakdown with details

Hospital faxes all relevant docs & medical report

Our Call Center validates, Audits & processes payment

notice, issues final GL upon receipt of full

documents

Hospital receives final GLPerson Covered pays

for uncovered charges (if any)

Person Covered discharged

Page 35: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel Hospitals

Page 36: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel HospitalsNote: *For renewal only.Note: *For renewal only.

State Hospital Name

Wilayah Persekutuan Kuala Lumpur

Pantai Cheras Medical CentreDamai Service Hospital

Hospital Universiti Kebangsaan Malaysia (HUKM)Institut Jantung Negara (IJN)

Kampung Baru Medical Centre (Al-Islam Specialist Hospital)Hospital Pantai Indah Kuala Lumpur

Hospital Pusrawi (Formerly Pusat Rawatan Islam)KPJ Sentosa Medical Center

Sentul Medical Centre Tung Shin Hospital

Damai Service Hospital ( Melawati)Gleneagles Intan Medical CentreKPJ Tawakal Specialist Hospital

Taman Desa Medical CentreUKM Specialist CentrePantai Medical Centre

Prince Court Medical CentreUM Specialist Centre

Page 37: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel HospitalsNote: *For renewal only.Note: *For renewal only.

State Hospital Name

Selangor

Assunta HospitalDarul Ehsan Medical Centre Kajang Plaza Medical Centre Kelana Jaya Medical Centre

Pantai Klang Specialist Medical Centre Sunway Medical Centre

Puteri Klang Medical Centre (Sentosa Medical Centre)Tropicana Specialist Centre (Damansara Woman Specialist)

QHC Medical CentreSime Darby Medical Megah

KPJ Kajang Specialist Hospital (Sentosa Medical Centre)Sri Kota Specialist Medical Centre

Sime Darby Medical Centre (Subang Jaya Medical Centre)The Tun Hussein Onn Eye Hospital

Arunamari Specialist Medical CentreAlpha Specialist Centre

KPJ Damansara Specialist HospitalColombia Asia Medical Centre Puchong

Page 38: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel HospitalsNote: *For renewal only.Note: *For renewal only.

State Hospital Name

Kedah

KPJ Kedah Medical Centre Metro Specialist Centre

Putra Medical CentreStrand Hospital & Retirement Home

State Hospital Name

Pulau Pinang

Gleneagles Medical CentreHospital Pantai Mutiara

Island HospitalMount Miriam HospitalLam Wah Ee Hospital

Tanjung Medical CentrePenang Adventist Hospital & Clinic Services

KPJ Penang Specialist HospitalBagan Specialist Hospital

Page 39: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel HospitalsNote: *For renewal only.Note: *For renewal only.

State Hospital Name

Melaka

Pantai Ayer Keroh Melaka Medical CentrePutra Specialist Hospital Melaka (formerly The Southern

Hospital Melaka) Mahkota Medical Centre

State Hospital Name

Perak

Fatimah HospitalKinta Medical Centre

Hospital Pantai Putri IpohPerak Community Specialist Hospital

Taiping Medical CentreKPJ Ipoh Specialist Hospital

Sri Manjung Specialist CentreColumbia Asia Hospital Taiping

Page 40: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel HospitalsNote: *For renewal only.Note: *For renewal only.

State Hospital Name

Negeri Sembilan

Columbia Asia Medical Center, SerembanNilai Cancer Institute

Senawang Specialist HospitalKPJ Seremban Specialist Hospital

NS Chinese Maternity Hospital

State Hospital Name

Johor

Hospital Pantai Batu PahatMedical Specialist Centre

KPJ Johor Specialist HospitalColumbia Asia Nusajaya

KPJ Puteri Specialist HospitalKPJ Hospital Penawar

Putra Specialist Hospital, Batu Pahat (formely The Southern Hospital, Batu Pahat)

Pusat Pakar Kluang UtamaKempas Medical Centre

Regency Specialist Hospital

Page 41: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel HospitalsNote: *For renewal only.Note: *For renewal only.

State Hospital Name

Kelantan Kota Bharu Medical CentreKPJ Perdana Specialist Hospital

State Hospital Name

Pahang

Hospital Pakar PRKMUIP Sdn. BhdKPJ Kuantan Specialist HospitalDarul Makmur Medical Centre

Kuantan Clinical Diagnostic CentreKuantan Medical Centre

State Hospital NameTerengganu Kuala Terengganu Specialist Hospital

Page 42: MAA SmartMedic200 - The Best Medical Takaful Plan

Panel HospitalsNote: *For renewal only.Note: *For renewal only.

State Hospital Name

SabahKPJ Damai Specialist Centre

Sabah Medical CentreRafflesia Medical Centre

State Hospital Name

Sarawak

KPJ Kuching Specialist HospitalNormah Specialist Medical Centre

Timberland Medical CentreColumbia Asia Medical Center, Miri

Rejang Medical CentreMiri City Medical Centre

Sibu Specialist Medical CentreBintulu Medical Centre

Page 43: MAA SmartMedic200 - The Best Medical Takaful Plan

What medical surgeons can do for you is to cure your physical and some

mental sicknesses. But what they certainly cannot do is

to solve your financial illnesses. One especially caused by your

deteriorating health conditions if not monitored and planned for

wisely.

Page 44: MAA SmartMedic200 - The Best Medical Takaful Plan

Thank You


Recommended