SmartMedic 200 ~ A Complete Solution for All Your Hospitalisation Needs
We treasure the importance of staying as fit as a fiddle for ourselves and those we love. And if ever there’s a need for urgent medical attention or hospital admission, we want to be assured of a swift recovery without the financial and emotional strain on our family.
Imagine having a medical plan that provides hassle-free hospital admission and takes care of your medical bills upon discharge at our panel hospitals. That’s what SmartMedic 200 is all about. It offers comprehensive and affordable medical coverage that puts you and your family first, wherever you are.
Can You Afford to Fall Sick These Days?
Advanced medical development and technology that deal with the rapid emergence of new and complicated illnesses come at a price. It is estimated that the global medical inflation averages about, 10%* each year. In Malaysia, medical inflation is estimated to be around 15%. More than 36,000** Malaysians failed to settle their high medical debts and had to refer to the Credit Counselling and Debt Management Agency (AKPK).
(Source: The Star*, 14th March 2009 & Utusan Malaysia**, 20th September 2011)
Adding to the escalating costs of living and children’s education, you and your loved ones could suffer tremendous financial hardship if you do not plan for your hospitalization expenses now. The truth is, a completely unforeseen and unavoidable operation may sometimes dry up your entire savings.
SmartMedic 200 is a cashless* medical card which gives you and your family a peace of mind with high quality and comprehensive coverage when you need it the most!
Why Choose SmartMedic 200?
SmartMedic 200 provides you invaluable coverage and guaranteed renewable up to age 80 years old. It also assures you of protection against the unexpected when you renew your coverage with an unlimited lifetime limit! Apart from that, SmartMedic 200 provides you a Funeral Expense benefit of RM5,000, which is payable upon death due to any causes.
SmartMedic 200 is smartly engaged with a reliable and trusted Managed Care Organization (MCO) which is providing you with 24-hour hassle free assistance in:
• Admission to the hospital
• Settlement of your hospital bill upon discharge*
Note:
*Subject to eligibility and benefit limit of the plan. Please refer to the schedule of benefit.
How SmartMedic 200 Can Benefit You…
1. Enjoy the Unlimited Lifetime Limit
With SmartMedic 200, you do not need to worry on the lifetime limit. We offer you UNLIMITED lifetime limit which allows you to enjoy quality medical treatments and services always.
2. 5 Choices of Comprehensive Medical Takaful Plans
With SmartMedic 200, you are given 5 choices of plans. All you have to do is to select the most suitable and comprehensive one, while we will take care of your needs accordingly.
3. Enjoy Higher Daily Hospital Room & Board Benefit
With SmartMedic 200, you are entitled with the daily hospital room & board benefit up to the maximum of
RM 1,000 subject to your chosen medical plan.
4. Funeral Expense Benefit
With SmartMedic 200, you will be provided Funeral Expense Benefit of RM 5,000, which is payable upon death due to any causes.
5. Enjoy Worldwide Coverage
With SmartMedic 200, you can travel with peace of mind, knowing that you are protected anywhere in the world. The additional services are:
• International Medical Assistance Programme
Emergency medical evacuation, medically supervised repatriation, dispatch of essential medication not available locally, repatriation of mortal remains, return of dependent children, 24-hour assistance on medical referrals and etc.
• Travel Assistance#
Provides information concerning inoculation, visa requirement assistance, assists in location of lost luggage,
documents and personal items, weather information, foreign exchange information, arrangement of flights and
flights information, legal referral to interpreter/translator and emergency message relay.
• Car Assistance#
24-hour emergency towing and minor roadside repair, car rental assistance, arrangement of hotel
accommodation and referral to service centre.
• Home Assistance#
Plumbing, locksmith, general repair and pest control assistance.
Note:
#Referral services only. Any expenses and/or liabilities incurred shall be borne by certificate owner. These services are provided by a third party and continuation of these services is subject to the agreement between the MAA Takaful Berhad and services provider.
Eligibility
Person Covered: Anyone from the age of 30 days up to 59 years old.
Participant/Applicant: Anyone from the age of 18 years old and above.
Wakalah Model
MAA Takaful Berhad operates under the principle of Wakalah, whereby the Takaful Operator acts as an agent to the Participant for managing the operations of the Takaful business. A Wakalah Fee will be charged up-front from the contributions paid. The remaining of the contributions will be allocated in Participant Risk Investment Account (PRIA) as Tabarru’ (donation), where it will be used for mutual aid and assistance, based on the concept of Takaful. The benefits are paid from the PRIA only upon a covered loss, and not upon expiry or termination of the certificate. Surplus sharing (if any) at the end of each financial year will be shared between the Participant and MAA Takaful Berhad at 50:50 ratio to all eligible participants as approved by Shariah Committee and Board of Directors. In the event of deficit in PRIA, it would be met through a benevolent loan (Qardhul Hassan) from the Takaful Operator. The repayment of the loan will be made as a first charge on the future surplus arising from the PRIA.
IMPORTANT NOTES
1. This article provides a summary of the main features of the product and does not constitute a Takaful Certificate. This article is published for information only and does not have regard to the specific financial objectives, situation and needs of any specific person. Please refer to your Takaful Certificate for more details and exact terms and conditions.
2. You are given a grace period of 31 days from the due date for payment of each subsequent contribution. If contribution remains unpaid at the end of this grace period, the certificate will lapse.
3. This Takaful plan will not provide benefit amount from the Participant Risk Investment Account (PRIA) upon termination or expiry of the Takaful Certificate.
4. If you wish to surrender your Takaful Certificate, we will refund a certain percentage of contribution that you have paid according to the terms and conditions stated in the Takaful Certificate.
5. You should satisfy yourself that this product will best serve your needs and you can afford the contribution payable under this certificate.
6. During Waiting Period, Person Covered will not receive any coverage for any medical disability occurred or claims submitted during the duration. Waiting Period for Hospital & Surgical Benefit is:
i. 30 days from Contract Commencement Date or Reinstatement Date; or
ii. 120 days from Contract Commencement Date or Reinstatement Date for Specified Illnesses.
The Waiting Period is not applicable to claims arising from Accidental cause.
7. For SmartMedic 200, you are entitled for a medical tax relief in respect of your contribution of up to RM3,000 a year. The tax relief is subject to terms and conditions of Inland Revenue Board (IRB) and subject to change.
8. Your actual contribution amount shall depend on your age, gender, plan type, health status and occupational class.
9. It is important that you provide sufficient and accurate information to enable us to advise you on the suitability of our SmartMedic 200, taking into consideration the appropriateness of the product to your needs and circumstances.
10. You must inform MAA Takaful Berhad of any changes in your occupation, avocation or sports activities because it may affect the contributions, terms, conditions and benefits.
11. You should continue paying your contributions regularly until the expiry of your plan to ensure that you are fully protected under the plan at all times. Failing to do so may cease your coverage prematurely.
12. SmartMedic 200 is a guaranteed renewable plan with contribution that varies on renewal according to your attained age. MAA Takaful Berhad reserves the right to revise the contribution rates and/or Tabarru’ by giving a 90-day notice. Any changes in contributions and benefits will only take effect on the next certificate anniversary.
13. For claims made by juvenile lives, where the age is between 30 days to 15 years old, a co-takaful will be imposed. You 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.
14. The Person Covered shall bear a 10% co-payment of the other eligible benefits if the Person Covered is hospitalised at a Room & Board rate which is higher than his/her eligible benefit, described in the schedule of benefits for each and every claim.
15. Total benefits payable in a year may not exceed the Overall Annual Limit.
FREQUENTLY ASKED QUESTIONS
Am I eligible to be covered by this plan?
Anyone from the age 30 days to 59 is eligible to be covered by this plan provided that the proposed Person
Covered is able to meet our underwriting requirements.
What are the options do I have?
You may choose either to participate in SmartMedic 200 standalone or SmartMedic 200 rider. SmartMedic 200 standalone provides you benefits as described in this brochure whereas SmartMedic 200 rider is an additional plan/benefit that you can attach to any of our Takafulink Series Plan.
How much contribution do I need to pay?
It is based on the Person Covered’s age, gender and theselected medical plan and the contribution is payable up to age 79. You will have the flexibility to pay the contributions either monthly, quarterly, half-yearly or annually. Kindly refer to the Table of Indicative Contributions.
What will happen if I fail to pay my contribution?
You are given a grace period of 31 days from the contribution due date and if the contribution remains unpaid at the end of the grace period, the certificate shall lapse.
How do I submit claims?
SmartMedic 200 is a cashless* medical card where you do not need to worry about preparing and submitting claims as all expenses under SmartMedic 200 will be paid directly to the hospital.
However, you are required to pay in advance all the necessary bills and charges and claim for reimbursement
later in the event of hospitalisation at a non-panel hospital or cashless is not granted as further investigation need tobe carried out.
Please submit a complete Reimbursement Form (available on Our website) together with the original bills and receipts to MAA Takaful Berhad or directly to MCO for usto process the claim accordingly.
* Subject to the terms and conditions stated in the Takaful Certificate.
Who to contact if I am interested in SmartMedic 200?
For further enquiries, please call me at 6019-7500021 or email me at shahrulzam21@gmail.com. I shall direct you to one of our Takaful consultants to advise you on the most suitable plan that meets your needs.
EXCLUSIONS
Any injuries/illnesses arising from the following are not covered:
1. Pre-existing conditions
2. Specified Illnesses occurring during the first 120 days of continuous cover
3. Any person who resides outside Malaysia for more than 90 consecutive days while the certificate is in force
4. Any medical or physical conditions arising within the first 30 days
5. Self inflicted injuries and illegal acts
6. Wars, strikes and riots
7. Any armed forces or military operations
8. Pregnancy, miscarriage or child births
9. Mental or nervous disorder
10. Alcoholism and drug abuse or its related conditions
11. Cosmetics, elective or plastic surgery, or congenital abnormalities
12. Dental treatment unless necessitated by accidental injury
13. Routine health checks and any investigations not directly related to admission
14. Treatment which is not medically necessary
15. Medical Expenses which is payable by any laws, medical program of insurance/ Takaful certificate
16. Private nursing, rest cures or sanitaria care, illegal drugs, intoxication, sterilization, venereal disease and its sequel, AIDS or ARC (AIDS Related Complex) and HIV related diseases and any communicable disease requiring quarantined by law
Note:
The above exclusions are not exhaustive and cross reference may be made to the Exclusion clause of the Takaful Certificate.
