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Author: eise

[MERGED]Medical Card/Insurance Kesihatan...... What U should know...

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aypru This user has been deleted
Post time 8-6-2006 01:02 PM | Show all posts
Juz nak tahu if kita nak masuk hospital is it necessary utk agent tolong buatkan or just tunjuk kita punya medical card?
I assume mereka tak boleh sampai on that time kita kat situ so maybe just a few simple direction je through one phone call.
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eise This user has been deleted
 Author| Post time 8-6-2006 02:17 PM | Show all posts
Originally posted by aypru at 8-6-2006 01:02 PM
Juz nak tahu if kita nak masuk hospital is it necessary utk agent tolong buatkan or just tunjuk kita punya medical card?
I assume mereka tak boleh sampai on that time kita kat situ so maybe just a ...


Sepatutnya card holder sendiri yang uruskan sepenuhnya, dan sebagai MC holder kita sepatutnya tahu procedure2 yang perlu dengan  berhubung dengan Customer service MNO/ Insurans company.Tetapi sebagai agent yang di bayar comission sepatutnya bersama2 dalam menguruskan kemasukan pelanggan ke wad sebagai services tambahan kepada pelanggannya.tak semestinya menghadirkan diri on time di hosp, maybe semua tu boleh di uruskan melalui telefon..
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Post time 8-6-2006 04:06 PM | Show all posts

Reply #76 sapubersih's post

eiii..chup..nih kalo pakai apa tu ek?insurance yg nak ke luar negara like AXA tuh..tu pun kire kena byr dulu gak claim kendian ker?
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eise This user has been deleted
 Author| Post time 8-6-2006 04:18 PM | Show all posts
Originally posted by honeybee1802 at 8-6-2006 04:06 PM
eiii..chup..nih kalo pakai apa tu ek?insurance yg nak ke luar negara like AXA tuh..tu pun kire kena byr dulu gak claim kendian ker?


Setahu saya lah..jika MC di keluakan di malaysia walaupun syarikat International still menggunakan konsep yang sama..correct if im wrong..

[ Last edited by  eise at 8-6-2006 04:19 PM ]
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Post time 8-6-2006 04:18 PM | Show all posts

Reply #74 eise's post

8) Tiada jadual pembedahan terbatas dan tiada perbezaan premium di antara lelaki dan wanita
-->eise maknanya kalo operate tuh takde limit ler..bergantung pd limit tahunan atau lifetime limit yg ada le kan?
limit2 utk setiap rawtan detail tuh pun korang kena take care.let say sakit jantung kena operate kat ijn rm20k..ngk limitnyer rm10k..huish..lagi dugdag jantung tuh...
aku ckp2 jor..but utk diri sendiri takdo lg..harap kat company jor..tp jgn igt takde limitation..ado gak aih...rm18k utk satu kes...member aku penah msk spital 2minggu kena rm12k..pehtu nak taknak keno dtg opis for14days..br insurance kire mcm admission br..
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eise This user has been deleted
 Author| Post time 8-6-2006 04:23 PM | Show all posts
Originally posted by honeybee1802 at 8-6-2006 04:18 PM
8) Tiada jadual pembedahan terbatas dan tiada perbezaan premium di antara lelaki dan wanita
-->eise maknanya kalo operate tuh takde limit ler..bergantung pd limit tahunan atau lifetime limit y ...


Ye, limitation sehingga had tahunan dan had seumur hidup mengikut plan yang di ambil setiap benda ada had nya..cuma untuk meperluaskan had tu perlu lah sedikit perbelanjaan, cth:  pilih la plan2 yang besar tapi ikutlah kemampuan kewangan kita
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Post time 8-6-2006 04:42 PM | Show all posts

Reply #81 aypru's post

Sorry guys, kuar pi carik baju ngan songkok sbb tomorrow ader press conference wif me about my company....the article will be out in The Star on 15th June.

OK...to answer your question, a good agent will be able to give you the direction and procedure how to admit into a hospital...to be wif you ni mmg agak keterlaluan lar but tak mustahil. My agent masa I got the problems nak admit to SJMC, we talk through the phone uptill when he realize ada masalah quickly he dashed to the hospital...what a super agent lar this guy...but I do believe eise is one of them and a very committed one too.

Through phones can do alot of wonders. You only need to go to the admission counter and ask for admission and when they ask for mode for payment just flashed the MC card and say Insurance or Medical card. That's all. If ada problem baru start caling2 you agent like what I did....they normally will call the insurance company to help expedite the process and bila problem besar they will avail themselves with you at the hospital....

Petunjuk utk eise, what my agent did was he called up the insurance company and talk straight to the Manager and ask them to sent the confirmation...done in 15 minutes then when SJMC tunjuk lagak sombong, he was on the way to the hospital...but I tak tahan I belah dari SJMC and was on the way to Gleneagles and dia dah call hospital to inform them that I will be there and ask the insurance company to sent the confirmation letter to Gleaneagles....sampai2 jek I flashed the card everything was taken care of immediately no hassle....

Always be close to your agents and treat them like one of your family. They are your life support.
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Post time 8-6-2006 05:08 PM | Show all posts

Reply #83 honeybee1802's post

honeybee,

Even AXA yg international company pun if the claim is outside malaysia where you did not reside more than 90 days, you kena bayar dulu then claim it back with AXA in malaysia....One of the reason I rasa lar, outside Malaysia punye hospital tak recognize Malaysian Medical Card. This is very troublesome but I do believe it will improve in years to come cuma buat masa nih masih belum ada networking wif outside malaysia hospital....tu jek problem dia skang....
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Post time 8-6-2006 05:34 PM | Show all posts

Reply #85 honeybee1802's post

itu pasal I ckp jgn bergantung pd company belikan jer mmg tak cukup....lagipun kalu dah start beli skang guaranteed renewal sampai tua...tak perlu lagi risau cam i skang ni..dah ader pre existing illness baru nak cari abih suma decline....so sapa yg menyesal skang...I jugakkkk....hahahahahaha...addeehhhh..
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Post time 8-6-2006 05:38 PM | Show all posts

Reply #88 sapubersih's post

oo..iyo ko sapu..eise..like that one..just pray there's nothing happen la there ek...
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Post time 9-6-2006 09:57 AM | Show all posts

Reply #90 honeybee1802's post

I am a diabetic for 14 years..so far doctors parised me for my good control. Even my doctors gave me a wonderful report, those insurance companies declined it sbb their arguments for future complications.....ni yg terasa seolah2 a diabetic is a cancer patient or a heart disease patient.

Anyway, I am lodging a formal complaint to BNM for this and surprisingly sebelum I lodge that complaint, one very generous company offered me their MC. An international renowned company but subject to excluding the pre-existing illness and conditions relating to it....OK lar daripada takde langsung.....
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eise This user has been deleted
 Author| Post time 9-6-2006 10:19 AM | Show all posts
ooo..ye lah kita tak tahu bila penyakit akan menimpa kita kan..oleh itu sebelum apa2 terjadi elok kita bersedia dari segi perlindungan kewangan terutama kos perubatan yang mahal..

Tetapi untuk en sapu, alhamdulillah lah coz dapat juga apply MC, walaupun terdapat pengecualian tertentu..

kepada sesiapa yang dah ada penyakit mmg penyakit sedia ada tak akan di lindungi dan penyakit akibat komplikasi akibat penyakit sedia ada juga tidak di lindungi..MC ni memang cerewek ada sakit sket je, dia akan mintak macam2 medical report lah chekup lah sebab MC ni melibatkan kos dan risiko yang besar bagi Ins co..

Kesimpulannya apply lah sebelum apa2..
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Post time 9-6-2006 10:32 AM | Show all posts

Reply #92 eise's post

I agree ngan eise sbb kena batang idung sendiri...dulu masa tengah sihat mmg agak sombong ngan benda2 cam ni..tu yg tuhan tu balas balik tuh...

My advise pd yg belum ada MC lagik...cepat2 lar buat survey and buy one sbb kalau dah terlewat cam I ni mmg rasa cam cekik2 jek insurance companies yg decline...hahahahaha..

The best thing to consider are those ppl yg ader hereditary nature spt:

1. Diabetic
2. cancer
3. Hypertension
4. chronic health diseases
5. gout

Ader banyak lagi and I think eise can help list down those penyakit keturunan nih....reason nyer sooner or later jika dlm keluarga dah dpt penyakit nih kita turut akan terkena satu hari nanti...jadi bersiap sedia lar...

Diabetic i ni keturunan so, mmg tak leh lari cuma control. Cancer especially breast cancer skang ni dah ada findings yg mengatakan ianya hereditary (keturunan), jadi berhati2 lar pd wanita2 di luar sana. Perlu di ingat, kajian terbaru mendapati bahawa org lelaki juga terdedah kepada breast cancer walaupun takde breast....it's tru and they are already cases.

penyakit jantung juga ada kaitan ngan keturunan..jadi kalu ader keluarga terdekat yg dah kena cepat2 lar bersiap sedia ngan pembelian MC sebelum di diagnose kan....

Kena banyak sikit membaca journal science nih...or kalu malas baca..leh tengok kat Discovery channel on medical sciences...

nasihat I jgn amik mudah ngan kesihatan diri sekarang dan akan dtg...kita tak tau bila malang akan menjelma.....

call lar si eise wat appointment utk teliti plan2 yg dia ader...kalu korang nak wat comparisan, i leh rekomen 2 agent I yg leh bagi diaorg punya produk utk you buat comparison. then baru decide. lagi satu point bila pilih mana plan yg bagus, korang jugek kena teliti agent yg korang pilih samada leh percaya atau tidak, leh bekerja atau tidak, leh provide that super service atau tidak.....ini jugek memainkan peranan penting sbb kita sure tak nak agent yg dha dpt comission terus hilang tah kemana....

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eise This user has been deleted
 Author| Post time 9-6-2006 11:20 AM | Show all posts
Originally posted by sapubersih at 9-6-2006 10:32 AM
I agree ngan eise sbb kena batang idung sendiri...dulu masa tengah sihat mmg agak sombong ngan benda2 cam ni..tu yg tuhan tu balas balik tuh...

My advise pd yg belum ada MC lagik...cepat2 lar bu ...


Dalam borang permohonan, akan tanya adakah ahli keluarga terdekat meninggal akibat penyakit pun kena disclose jugak penyakit apa sebab di bimbangi penyakit keturunan dan kemunkinan underwriter akan exclude atau loading kalau penyakit keturunan dari keluarga terdekat seperti mak atau ayah..tapi semua ni kita serahkan kepada Insurans company untuk menilai..

Betul elok bandingkan dulu apa-apa plan yang ingin di ambil, berbagai jenis plan yang di kluarkan oleh Insurans general dan Insurans hayat..Genaral dan Hayat di benarkan untuk underwrite Insurans perubatan..so pilih la yan terbaik dari segala segi,,ciri2 tu seperti en sapu ceritakan sebelum ini..

MC ni boleh di pohon menggunakan dua cara iaitu stand alone polisi dan rider (iaitu attach dengan Life insurans biasa)..

[ Last edited by  eise at 9-6-2006 11:24 AM ]
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Post time 9-6-2006 02:50 PM | Show all posts

Reply #94 eise's post

errr...eise, general ins. company punyer proposal form tak tanya pasal historic family medical conditions. cuma Life company punya proposal form jek..
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eise This user has been deleted
 Author| Post time 9-6-2006 02:59 PM | Show all posts
Originally posted by sapubersih at 9-6-2006 02:50 PM
errr...eise, general ins. company punyer proposal form tak tanya pasal historic family medical conditions. cuma Life company punya proposal form jek..


I penah tengok satu Gen Ins co Lxxxxx punya proposal, simple je form dia MAA punya memang banyak, Ins hayat lain i tak sure..salah satu sebab nya sebelum Feb lepas, Ins Hayat boleh letakkan khairat kematian dan personal accident dalam plannya,,tapi selepas Bank Negara selaraskan semua MC Gen & Hayat,,dah tak de PA dan Khairat kematian,,tetapi form yang di gunakan masih sama, malah ada pertambahan lagi dari segi form maklumat untuk menjaga kepentingan pengguna, supaya lebih memahami Info penting MC..
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Post time 9-6-2006 03:19 PM | Show all posts
aku ada Medical Card..
Selain dari guna tuk cover bila masuk spital..
apa kegunaan lain pun aku tak tau....:kant:
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eise This user has been deleted
 Author| Post time 9-6-2006 03:22 PM | Show all posts
Originally posted by polaris_girlz at 9-6-2006 03:19 PM
aku ada Medical Card..
Selain dari guna tuk cover bila masuk spital..
apa kegunaan lain pun aku tak tau....:kant:



Pola tak clear lagi ke,, kalau nak tau lebih lanjut pasal Pru you leh tanya ACE..MC ni untuk masuk hosp je Pola untuk cover bill perubatan..
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Post time 9-6-2006 03:29 PM | Show all posts

Reply #98 eise's post

kalo tak masuk spital seumur hidup rugi lah kan.....
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eise This user has been deleted
 Author| Post time 9-6-2006 04:13 PM | Show all posts
MEDICAL CARDS

2nd June 2003

Your view on Malaysian medical cards' market. Do you think the market lacks order?

Many medical cards are being marketed in Malaysia, some by larger companies and some by smaller companies. The facilities provided vary greatly. Since there are great discrepancy, some kind of order is needed.

Your view on medical card service, do you think card companies can deliver the services to consumers or card holders can get full hospitalization protection from medicard company?

There a lot of unhappiness in the use of medical cards because all medical cards have limitations, e.g. many cards to not pay for the many diseases in the first year and many cards do not pay for pre-existing medical conditions. Consumers must understand these limitations or else they will get angry and frustrated. Most cards only provide in-patient services and exclude outpatient services. Consumers should ascertain whether a particular card is acceptable by all or only selected private hospitals or clinics.


Since the healthcare system in Malaysia is incomplete, do you suggest the public to acquire health insurance or medicard to get better cover? Any advice to the consumers?

Government hospitals provide basic medical care. If patients want better room facilities and more personal attention as well as faster service, it is advisable to purchase a medical card. Consumers are advised to check whether companies offer the services they need.


Do you encourage the public to buy a medical card?

Yes. It is better for the public to purchase a medical card if they can afford it as it gives them a wider choice of medical care.


As we know, medical card company is a third party between consumer and general insurance company, do you think they have the value to exist in the market? What role health card company can play for the consumers?

Medical cards and medical insurances are necessary because all services cannot be offered by a government hospital. Government hospitals can offer emergency and essential medical care but usually there is a long waiting list. Possession of a medical card will give a person more choices and faster see.


Your view on private hospitals' fees, do you think the fees are becoming higher and higher? (Because this is one of the reason the MCOs and insurance companies' claims and fees increased.)

Private hospitals are able to do more and more medical and surgical procedures. Therefore, there is a need to purchase up-to-date machines. The cost of procedures have increased because of the usage of newer techniques, machines and medicines. For example, a few years ago, kidney and heart transplants cannot be done but now it can be done and is all very expensive. Having said this, it must be pointed out that cost of medical treatment here is much cheaper than the other countries around our region.

Therefore, the MMA feels that stringent rules for the setting up of medical card companies ought to be imposed similar to the setting up of insurance companies and governed by Bank Negara.

Since the MMA is one of the members of The Healthcare Programme Complaints Bureau (HPCB), what role does the MMA play in this bureau?

The HPCB was formed on 12th April 2002 with the support of the Ministry of Domestic Trade and Consumer Affairs. It was formed to provide an independent platform for aggrieved healthcare programme consumers to lodge any complaints which they may have against any healthcare programme companies. The HPCB will review the complaints to assess its validity and will resolve such complaints in an independent, fair, efficient, cost-effective and professional manner.

The HPCB consists of representatives from the Ministry of Domestic Trade and Consumer Affairs, Ministry of Health, Business Ethics Institute of Malaysia, Malaysian Direct Distribution Association, Healthcare Programme Group and the MMA.

The MMA's role in HPCB is to give input on medical related matters.

Since there are lots of complaints about medicard companies, what is the MMA's advice to the doctors?

The MMA's advice to patients and doctors. Patients ought to be aware of the features of the card and to read the prospectus carefully before purchasing any card. They should not rely on what the card agent says. Doctors ought to check the eligibility of the patient before treatment is offered to avoid problems later.



Since there is a lack of control for the medical card market, would you suggest a single authority to control the market? Which department would have the responsibility on this issue?

The MMA feels that there ought to be some form of coordination between the Ministry of Domestic Trade and Consumer Affairs and the Ministry of Health in monitoring the medical cards' market and strict guidelines need to be imposed on these companies so that there is no abuse.

How to provide a better healthcare system to the public? What roles can be played by both the government and private sectors?

Since there is an increase in the demand for medical care and cost of medical treatment, the present system is unable to cope. The government has discussed the possibility of setting up a national health financing scheme.

In essence, functional integration of the private health care sector with the public sector, so that both sectors complement each other in the distribution of medical technological facilities and services and in the regulation of a uniform fee structure, which would help to reduce income inequalities and stabilize the workforce in both sectors.





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Copyright © 2002 by Malaysian Medical Association.
Send all questions and comment regarding this site to MMA

[ Last edited by  eise at 12-6-2006 10:46 AM ]
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