This is my second article for you to consider being wise about saving money when the unexpected happens, and that one way is through a medical card insurance. But first and foremost, I would want to bring your attention to a savvy article that was published by the STAR online on 1st June 2018 and captured by FPP Consultancy on their group page in FB, here is the link : https://www.facebook.com/groups/1869186686688542/permalink/2075869089353633/
A young actuary writes in concern requesting the Malaysian government to intervene and regulate the cost charged by private hospitals for medical treatment.
This is a never ending story, when I joined the life insurance industry back in year 2000 medical card insurance was not a fast moving insurance product sold. Main product line was life insurance and critical Illness policies. However, over the years that I have been in the industry, a sudden shift in demand from life policies to medical card insurance and critical Illness was very much apparent. I need not say more, as the article speaks much of why this is happening.
So, looking at PolicyStreet E-medic plan, I have come to a interesting conclusion on why Mellenials should get this medical card insurance for a start. However, making an informed buying decision is a pivotal matter for consideration. So, What I have decided to look into is for you the better understand the IMPORTANT NOTES (exclusion) printed in the brochure.
The IMPORTANT NOTES have nine (9) points stated, however point eight (8) talks about exclusions, which is what I am going to try and explain.
1. Pre- existing condition
The definition of pre-existing illness as defined by Hospitalisation and Surgical Insurance (HSI) underwriting guideline:
‘PRE_EXISTING ILLNESS shall mean disabilities before the effective date of insurance that the insured person has reasonable knowledge of. An insured person may be considered to have reasonable knowledge of a pre-existing condition where the condition is one for which:-
- A) The insured person had received or is receiving treatment;
- B) Medical advice, diagnosis, care or treatment has been recommended;
- C) Clear and distinct symptoms are or were evident; or
- D) Its existence would have been apparent to a reasonable person in the circumstances.’
In other words, the insurer is not expected to pay for illness or sickness or an injury that has occurred prior to taking up the insurance cover.
2. Specified illness
Specified illness on the other hand as defined by the hospital and surgical insurance underwriting guidelines states:
Specified illness shall mean the following disabilities and its related complications, occurring within the first 120 days of insurance of the insured person:
* Hypertension, diabetes mellitus and cardiovascular disease
* All tumors, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system
* All ear, nose (including sinuses0 and throat conditions
* Hernias, haemorrhoids, fistulae, hydrocele, varicocele
* Endometriosis including disease of the Reproduction system
* Vertebro-spinal disorders (including disc) and knee conditions.
These following information is added value knowledge to your learning curve. So read on…….
3. Acute Medical Conditions
According to the The Association Of British Insurers (ABI), acute condition is defined as ‘ A disease, illness or injury that is likely to respond to treatment which aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery.’
Example of acute illness would include:
– Appendicitis: The appendix is a narrow, tube-like piece of gut resembling a tail, which is located at one end of the large intestine, attached to the part known as the caecum. The tip of the tube is closed; the other end joins on to the large intestine. If the appendix becomes inflamed, a condition called appendicitis results and the organ may have to be removed.
– Tonsillitis: (Tonsils)These are part of a ring of lymphoid tissue which encircles the entrance to the food and air passages in the throat. Tonsillitis is caused by a viral infection, the presence of pus, or exudate, on the surface of the tonsils.
– Pneumonia: Inflammation of the substance of the lungs. Commonly occurs as a result of a bacterial infection, also arise from a viral or fungal infection, or
– Bronchiolitis: Is an inflammation of the main bronchial tubes of the lungs- the bronchi – caused by a bacterial or viral infection.
– Gastroenteritis: ‘Enteritis’ means inflammation of the large intestine. Inflammation of the stomach lining is called ‘gastritis’. When both are infected by a virus, the result is gastro-enteritis.
– Sinusitis: This infection of the air cavities in the front of the skull is a common problem. The sinuses, or sinus cavities, contain air, thus contributing to the skull’s lightness, and because they are linked with the nose and upper throat, they are vulnerable to the spread of infection from these areas.
Acute conditions are severe, have a sudden onset, and can be recovered from quickly. At times, an acute medical condition can progress and develop into a chronic condition
4. Chronic Medical Condition
Chronic medical condition on the other hand as defined by The Association of British Insurers (ABI), ‘A disease, illness or injury that has one or more of the following characteristics:
l It needs ongoing or long term monitoring, through consultations, examinations, check ups and / or tests;
l It needs ongoing or long term control or relief of symptoms;
l It requires your rehabilitation or for you to be specially trained to cope with it;
l It continues indefinitely;
l It has no known cure
l It comes back or is likely to come back.’
Example of chronic illness would include:
– Diabetes: This is a condition where there is an abnormally high level of sugar in the blood. Results from a failure in the production of insulin, one of the body’s hormones, or chemical messengers. Its job is to keep the blood’s sugar content in control.
– Cancer: This is a result of disordered and disorganised cell growth. The cell of cancer, divides and grow at their own speed and in an uncontrolled manner – and they will continue to do so indefinitely unless treatment is given. In time, they increase in numbers until enough are present for the cancer to become visible as a growth or tumour.
– Arthritis: This is an inflammation of the joints and its causes are as varied and mysterious as the condition itself. It can be mild or severe, affecting one joint or several; and the different types include rheumatoid arthritis, osteoarthritis and spondylitis.
– Psoriasis: This is when the skin forms pink-to-dull red patches covered with a characteristic silver scaling. It is usually a chronic condition with acute phases of eruption followed by remissions. There is considerable evidence to indicate a genetic inheritance of the disease.
– Renal failure: Also known as kidney failure. There are numerous causes of kidney failure, and the treatment of the underlying disease may be the first step in correcting the kidney abnormality. Some causes of kidney failure are treatable, unfortunately kidney failure maybe progressive in other situations and may be irreversible.
– Hypertension: Also known as high blood pressure. This is a disease in which pressure within the arteries of the body is elevated. If you have high blood pressure, you are at the risk of developing life threatening diseases like stroke and heart attack.
A chronic condition are long in developing and takes time to heal.
E-medic is a plan where the last age of entry is 39 years old. This means that the premium paid for this medical card insurance is much more affordable comparatively to others as morbidity rates will be lower.
The rest of the exclusion in in e-medic is common knowledge and need not have a detailed explanation. I leave you with the thought of asking yourself, is it really worth while ignoring all the forms of medical ailments a human body can contract (which are exclusion in a medical card insurance for its known fact) whether young or old and in the meantime pacify yourself in not taking early action by protecting your financial standing with a medical card insurance like e-Medic.
In fact, we are currently giving away RM50 rebate for every purchase of AXA eMedic! Further savings for your every penny! Don’t wait for the promotion to end. Act now at PolicyStreet.com!!