Group Medical Insurance Policy
Group Medical Card in Malaysia is a type of health insurance policy that provides coverage for a group of individuals, typically employees of a company or members of an organization. It is offered by employers or organizations as part of employee benefits or membership benefits. Here are some features and coverage of group medical cards in Malaysia:
- Coverage for Hospitalization: Group medical cards typically offer coverage for hospitalization expenses, including room and board charges, surgical fees, doctor’s fees, and medication costs. The coverage may extend to both government and private hospitals, depending on the policy.
- Outpatient Benefits: Some group medical cards also provide coverage for outpatient treatments and consultations. This may include coverage for specialist visits, diagnostic tests, medication, and other outpatient procedures.
- Maternity Benefits: Group medical cards may include coverage for maternity-related expenses, including prenatal care, delivery, and postnatal care. It may include coverage for both normal and cesarean deliveries.
- Pre- and Post-Hospitalization Coverage: Group medical cards often offer coverage for medical expenses incurred before and after hospitalization. This includes coverage for pre-hospitalization diagnostic tests and post-hospitalization follow-up consultations or treatments.
- Emergency Assistance: Group medical cards may offer emergency assistance services, such as 24/7 helpline, medical advice, and coordination of emergency medical services.
- Cashless Hospitalization: Many group medical cards provide cashless hospitalization facilities, allowing policyholders to avail treatment without upfront payment. The insurance company directly settles the bills with the hospital, subject to policy terms and conditions.
- Network of Providers: Group medical cards often have a network of panel hospitals, clinics, and healthcare providers. Policyholders can access preferential rates and benefits when seeking treatment from these network providers.
- Pre-existing Conditions: Group medical cards may provide coverage for pre-existing medical conditions. However, there may be waiting periods or limitations on coverage for pre-existing conditions, depending on the policy terms.
- Premium Sharing: In the case of group medical cards offered by employers, the premium is usually shared between the employer and employees. The employer may contribute a certain percentage of the premium, and the remaining amount is deducted from the employees’ salaries.
- No Individual Underwriting: Group medical cards typically do not require individual underwriting or medical examinations for each member. This makes it easier and quicker to enroll in the group policy.
It’s important for employees or members to review the terms, coverage limits, exclusions, waiting periods, and other policy details of the group medical card. Understanding the coverage and limitations of the policy can help individuals make informed decisions regarding their healthcare needs. Employers or organizations offering group medical cards should communicate the policy details to their employees or members to ensure they are aware of the coverage and benefits available to them.