MAA SmartMedic200 - The Best Medical Takaful Plan

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Key feature of MAA Takaful - SmartMedic200 hospitalisation and surgical takaful plan. The best medical takaful plan in Malaysia currently.

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  • MAA SmartMedic200 - The Best Medical Takaful Plan

    1. 1. Introducing SmartMedic 200 A Complete Solution for All Your Hospitalisation Needs.
    2. 2. Agenda 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. The 6 Pillars of SmartMedic 200 What’s New in SmartMedic 200? Competitor’s Analysis Table of Benefits Underwriting Guidelines Exclusions Table of Contribution Commission Structure Managed Care Organisation (MCO) Panel Hospitals
    3. 3. The 6 Pillars of SmartMedic 200
    4. 4. The 6 Pillars of SmartMedic 200 5 Plans for Both Standalone & Rider High Room & Board of Up to RM1,000 High Annual Limit of Up to RM250,000 No Lifetime Limit Funeral Expense of RM5,000 for both Standalone & Rider No *Co-takaful Note: *Except for Juvenile (Age 30 days to 15 years old).
    5. 5. What’s New in SmartMedic 200?
    6. 6. What’s New in SmartMedic 200? 5 Plans for Both Standalone & Rider Higher Room & Board of Up to RM1,000 Higher Annual Limit of Up to RM250,000 No Lifetime Limit Funeral Expense of RM5,000 for Both Standalone & Rider
    7. 7. 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
    8. 8. Competitor’s Analysis
    9. 9. Competitor’s Analysis MAAT Company AI Company PR Company GT Company 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 Company
    10. 10. Competitor’s Analysis Company MAAT Company AI For Juvenile Plan only. Co-takaful 10% of the balance exceeding co10% cotakaful Free takaful Amount per subject to min cert. year, max RM300 & max RM 3000 RM1000 per Plan (RM) admission 1 22,000 2 3 4 5 25,000 28,000 33,000 36,000 Company PR Company GT Yes. 10% of total expenses Min RM300, Max RM1,000 (H&S) & a Max: RM2000 (Outpatient Treatment Benefit) Yes. 10% cotakaful per disability Min RM300 Max RM1000 Company ET N/A
    11. 11. Table of Benefits
    12. 12. Table of Benefits PLAN BENEFIT Annual Limit P150 (RM) P200 (RM) P300 (RM) P500 (RM) P1000 (RM) 50,000 100,000 150,000 200,000 250,000 Lifetime Limit No Lifetime Limit Funeral Expenses RM5,000 Hospital Benefits Hospital Room & Board (max 200 days per annum) 150 200 300 500 Intensive Care Unit (max 60 days per annum) Hospital Supplies & Services Surgical Fee Anaesthetist Fee Operating Theater Age 16 years & above (adult): As charged Age 30 days to 15 years (juvenile): As charged, with 10% co-takaful subject to minimum co-takaful of RM300 and maximum co-takaful of RM1,000 per admission 1,000
    13. 13. Table of Benefits PLAN BENEFIT P150 (RM) P200 (RM) P300 (RM) P500 (RM) P1000 (RM) Hospital Benefits Pre-Hospitalisation Diagnostic Tests (within 60 days prior to 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) Age 16 years & above (adult): As charged Age 30 days to 15 years (juvenile): As charged, with 10% co-takaful subject to minimum co-takaful of RM300 and maximum co-takaful of RM1,000 per admission
    14. 14. Table of Benefits PLAN BENEFIT P150 (RM) P200 (RM) P300 (RM) Out-Patient Benefits Emergency Accidental Outpatient Treatment (within 24 hours and follow up treatment to a maximum of 31 days) Out-patient Physiotherapy Treatment (within 90 days after discharge/surgery) Ambulance Fees Out-patient Kidney Dialysis Treatment Out-patient Cancer Treatment As charged P500 (RM) P1000 (RM)
    15. 15. Table of Benefits PLAN BENEFIT P150 (RM) P200 (RM) P300 (RM) P500 (RM) P1000 (RM) 100 100 100 100 100 500 750 1,000 1,500 2,000 150 200 300 450 600 Other Benefits Daily Cash Allowance at Government Hospital (maximum 200 days per annum) Home Nursing Care (maximum per admission) Person Covered Child’s Daily Guardian Benefit (maximum per admission) Medical Report Fees Government Service Tax As charged
    16. 16. Underwriting Guidelines
    17. 17. Underwriting Guidelines Benefits New Eligibility Eligibility Maximum Person Covered 30 days Age 59 Participant 1. Minimum Age 18 No Limit Plan Basic 2. Term of Coverage Rider Expiry Age 80 Up to Age 80 (follow basic plan term, whichever is lower)
    18. 18. Underwriting Guidelines Benefits New Plan 3. Plan Code Standalone Rider Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 P150 P200 P300 P500 P1000 PR150 PR200 PR300 PR500 PR1000 Plan 4. Payment Mode Monthly Quarterly, Semi Annually & Annually Payment Channel Direct Debit/Auto Debit or Easy Contribution Payment facility All
    19. 19. Underwriting Guidelines Benefits 5. 6. New Contribution Mode Factor Mode Monthly Quarterly Semi-Annually Annually Modal Contribution 0.090 0.250 0.500 1.000 Wakalah Fee Certificate Year 1 2 3 4 5 6 7 onwards Wakalah Fee % 75 50 35 30 20 20 8
    20. 20. Underwriting Guidelines Benefits 7. Upgraded Room & Board 8. Co-takaful (Juvenile only) New • 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. • 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.
    21. 21. Underwriting Guidelines Benefits 9. Foreigner New Below are the group of foreigners who are eligible to participate in SmartMedic 200 Plan 1 until Plan 5. 1. Expatriates/Professional 2. 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/Standalone SM100 Standalone SM200 Standalone Subject to minimum 1 year anniversary
    22. 22. Exclusions
    23. 23. 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.
    24. 24. Exclusions 1. 2. 3. 4. 5. 6. 7. Abuse of alcohol & drugs AIDS or ARC (AIDS Related Complex) and HIV Congenital abnormalities or deformities Pregnancy related conditions Treatment related to infertility or impotence Hospitalization for investigatory purposes Suicide or intentionally self-inflicted injury while sane or insane 8. War, criminal or terrorist activities 9. Contamination by radioactivity 10. Donation of body organ
    25. 25. Exclusions 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. Cosmetic surgery Circumcision Eye examination, surgical correction of nearsightedness Dental treatment or oral surgery except as necessitated by accidental injury Private nursing Treatment of sleep disorder Hormone replacement therapy Weight control Alternative therapy such as acupuncture, reflexology, herbalist treatment, aroma therapy & etc Mental disorder Participation in dangerous sports or profession Private flying Sex changes
    26. 26. Table of Contributions
    27. 27. Table of Annual Contribution (Standalone – Male) Age/Plan 0–5 6 – 15 16 – 21 22 – 29 30 – 39 40 – 49 50 – 54 55 – 59 60 – 64* 65 – 69* 70 – 74* 75 – 79* P150 1,078 564 910 803 878 1,049 1,552 2,649 2,421 4,339 5,845 9,912 Note: *For renewal only. P200 1,402 733 1,137 1,017 1,061 1,316 1,911 3,246 2,919 5,227 7,041 11,937 Male P300 1,822 952 1,479 1,322 1,379 1,710 2,484 4,219 3,795 6,795 9,154 15,518 P500 2,369 1,238 1,922 1,719 1,792 2,223 3,229 5,485 4,933 8,834 11,900 20,173 P1000 3,080 1,609 2,499 2,235 2,330 2,890 4,198 7,131 6,413 11,484 15,469 26,225
    28. 28. Table of Annual Contribution (Standalone – Female) Age/Plan 0–5 6 – 15 16 – 21 22 – 29 30 – 39 40 – 49 50 – 54 55 – 59 60 – 64* 65 – 69* 70 – 74* 75 – 79* P150 1,078 564 951 839 919 1,102 1,599 2,696 2,421 4,339 5,845 9,912 Note: *For renewal only. P200 1,402 733 1,189 1,063 1,111 1,381 1,968 3,304 2,919 5,227 7,041 11,937 Female P300 1,822 952 1,546 1,382 1,444 1,796 2,559 4,296 3,795 6,795 9,154 15,518 P500 2,369 1,238 2,009 1,796 1,877 2,334 3,326 5,584 4,933 8,834 11,900 20,173 P1000 3,080 1,609 2,612 2,335 2,440 3,035 4,324 7,259 6,413 11,484 15,469 26,225
    29. 29. Table of Annual Tabarru’ Rate (Standalone – Male) Age/Plan 0–5 6 – 15 16 – 21 22 – 29 30 – 39 40 – 49 50 – 54 55 – 59 60 – 64* 65 – 69* 70 – 74* 75 – 79* P150 734.04 390.00 621.00 549.96 585.00 675.00 951.00 1,523.04 2,045.04 3,660.00 4,929.00 8,352.96 Note: *For renewal only. P200 954.00 507.00 777.00 696.96 708.00 846.96 1,172.04 1,866.96 2,466.00 4,410.00 5,937.96 10,059.96 Male P300 1,239.96 659.04 1,010.04 906.00 920.04 1,101.00 1,524.00 2,427.96 3,206.04 5,733.00 7,719.00 13,077.96 P500 1,611.96 855.96 1,313.04 1,176.96 1,197.00 1,431.96 1,980.96 3,156.00 4,167.96 7,452.96 10,035.00 17,001.00 P1000 2,094.96 1,113.00 1,707.00 1,530.96 1,556.04 1,860.96 2,574.96 4,103.04 5,418.00 9,689.04 13,044.96 22,101.96
    30. 30. Table of Annual Tabarru’ Rate (Standalone – Female) Age/Plan 0–5 6 – 15 16 – 21 22 – 29 30 – 39 40 – 49 50 – 54 55 – 59 60 – 64* 65 – 69* 70 – 74* 75 – 79* P150 734.04 390.00 648.96 575.04 612.96 708.96 980.04 1,550.04 2,045.04 3,660.00 4,929.00 8,352.96 Note: *For renewal only. P200 954.00 507.00 812.04 728.04 741.00 888.96 1,206.96 1,901.04 2,466.00 4,410.00 5,937.96 10,059.96 Female P300 1,239.96 659.04 1,056.00 945.96 963.96 1,155.96 1,569.96 2,471.04 3,206.04 5,733.00 7,719.00 13,077.96 P500 1,611.96 855.96 1,373.04 1,230.00 1,253.04 1,503.00 2,040.96 3,213.00 4,167.96 7,452.96 10,035.00 17,001.00 P1000 2,094.96 1,113.00 1,784.04 1,599.96 1,629.00 1,953.96 2,652.96 4,176.96 5,418.00 9,689.04 13,044.96 22,101.96
    31. 31. Managed Care Organisation (MCO)
    32. 32. Managed Care Organisation (MCO) Note: *For renewal only. Metronic iCares (MiCares)
    33. 33. Note: *For renewal only. Hospital Admission Workflow Person Covered arrives at hospital, produces IC & Medical Card Hospital 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 Our Call Center issues Top-up GL Hospital updates interim bills (if exceeds GL limit) Person Covered gets admitted into hospital
    34. 34. Note: *For renewal only. Hospital Discharge Workflow 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 Person Covered discharged Person Covered pays for uncovered charges (if any) Hospital receives final GL
    35. 35. Panel Hospitals
    36. 36. Note: *For renewal only. Panel Hospitals State Hospital Name Pantai Cheras Medical Centre Damai 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 Wilayah Persekutuan Kuala Sentul Medical Centre Lumpur Tung Shin Hospital Damai Service Hospital ( Melawati) Gleneagles Intan Medical Centre KPJ Tawakal Specialist Hospital Taman Desa Medical Centre UKM Specialist Centre Pantai Medical Centre Prince Court Medical Centre UM Specialist Centre
    37. 37. Note: *For renewal only. Panel Hospitals State Selangor Hospital Name Assunta Hospital Darul 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 Centre Sime 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 Centre Alpha Specialist Centre KPJ Damansara Specialist Hospital Colombia Asia Medical Centre Puchong
    38. 38. Note: *For renewal only. Panel Hospitals State Kedah State Pulau Pinang Hospital Name KPJ Kedah Medical Centre Metro Specialist Centre Putra Medical Centre Strand Hospital & Retirement Home Hospital Name Gleneagles Medical Centre Hospital Pantai Mutiara Island Hospital Mount Miriam Hospital Lam Wah Ee Hospital Tanjung Medical Centre Penang Adventist Hospital & Clinic Services KPJ Penang Specialist Hospital Bagan Specialist Hospital
    39. 39. Note: *For renewal only. Panel Hospitals State Melaka State Perak Hospital Name Pantai Ayer Keroh Melaka Medical Centre Putra Specialist Hospital Melaka (formerly The Southern Hospital Melaka) Mahkota Medical Centre Hospital Name Fatimah Hospital Kinta Medical Centre Hospital Pantai Putri Ipoh Perak Community Specialist Hospital Taiping Medical Centre KPJ Ipoh Specialist Hospital Sri Manjung Specialist Centre Columbia Asia Hospital Taiping
    40. 40. Note: *For renewal only. Panel Hospitals State Negeri Sembilan State Johor Hospital Name Columbia Asia Medical Center, Seremban Nilai Cancer Institute Senawang Specialist Hospital KPJ Seremban Specialist Hospital NS Chinese Maternity Hospital Hospital Name Hospital Pantai Batu Pahat Medical Specialist Centre KPJ Johor Specialist Hospital Columbia Asia Nusajaya KPJ Puteri Specialist Hospital KPJ Hospital Penawar Putra Specialist Hospital, Batu Pahat (formely The Southern Hospital, Batu Pahat) Pusat Pakar Kluang Utama Kempas Medical Centre Regency Specialist Hospital
    41. 41. Note: *For renewal only. Panel Hospitals State Kelantan State Pahang State Terengganu Hospital Name Kota Bharu Medical Centre KPJ Perdana Specialist Hospital Hospital Name Hospital Pakar PRKMUIP Sdn. Bhd KPJ Kuantan Specialist Hospital Darul Makmur Medical Centre Kuantan Clinical Diagnostic Centre Kuantan Medical Centre Hospital Name Kuala Terengganu Specialist Hospital
    42. 42. Note: *For renewal only. Panel Hospitals State Sabah State Sarawak Hospital Name KPJ Damai Specialist Centre Sabah Medical Centre Rafflesia Medical Centre Hospital Name KPJ Kuching Specialist Hospital Normah Specialist Medical Centre Timberland Medical Centre Columbia Asia Medical Center, Miri Rejang Medical Centre Miri City Medical Centre Sibu Specialist Medical Centre Bintulu Medical Centre
    43. 43. 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.
    44. 44. Thank You

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