Group Medical Insurance
Protection For Your Employee

Yes, all benefits are applicable worldwide for twenty-four (24) hours a day. However, if the Covered Member chooses to or is referred to be treated outside Malaysia by the attending doctor, benefits payable will be based on the reasonable and customary and medically necessary charges for such an equivalent to treatment in Malaysia excluding the cost of transport to the place of treatment.

For outpatient care, the Covered Members are covered up to max limit per visit of RM40 for General Practitioner (GP) and RM150 for Specialist Care (SP).

If a deductible amount of RM300 for hospitalisation is selected for example, the Covered Member/Master Certificate Owner will need to pay for the first RM300 incurred per disability, while we will take care of the eligible expenses balance. For example, if a Covered Member incurs a RM1,000 medical bill, the Covered Member/Master Certificate Owner would pay a RM300 deductible and the Takaful plan would pay for the remaining RM700.

If "GH only" plan is selected, the Covered Member is entitled to maximum overall limit of RM20,000 per certificate year and the maximum cost of Room and Board that he/she can claim is RM80 per day. For Specialist Care (SP) benefit, the maximum overall limit is RM1,000 per certificate year.

"Per Member Limit" is referring to the maximum amount of money AIA PUBLIC will pay for covered claims for each covered individual. This means, the employee and his/her dependents will each have a separate limit. In case of a claim by one member, the limit available for other members remain intact.

"Per Family Limit" means the employee and his/her dependents is covered under one single limit per certificate year. This means, the limit can be utilised by any or all members including the employee and his/ her eligible spouse and children and not restricted to one individual as in the case of "Per Member Limit". Please note that "Per Family Limit" is applicable only for In Hospital Care Benefits.

"Standalone Limit" means the Outpatient General Practitioner (GP) Care and Outpatient Specialist (SP) Care will have its own limit. For example, RM2,000 for GP and RM1,000 for SP. Whilst, "Combined GP & SP Limit" means it is a shared limit for GP and SP. The minimum requirement for a "Combined GP & SP Limit" is RM2,000. In this instance, if the "Combined GP & SP Limit" is RM2,000, the Covered Member can claim up to RM2,000 in full for GP or SP or combination of GP and SP.

You need to take up the hospitalisation plan for your employees in order to enroll them for Group Medcare - Personal Medical Case Management. Only your employees are eligible for this benefit and not their dependents.

Our service provider, Medix, will appoint a dedicated and personal medical case management team ("PMCM team"), led by a personal medical case manager, to reassess and manage your medical condition. The PMCM team will first help you to gather and review your existing medical information and test results. The PMCM team will also consult leading specialists around the world, across multiple disciplines, to reach the correct diagnosis for your medical condition, monitor your progress and support you throughout your medical journey until recovery. Please contact AIA PUBLIC Care Line at 1300 88 8933 to check your certificate eligibility.