A-Plus MedCare

A-Plus MedCare is an optional unit deducting rider that provides Personal Medical Case Management (PMCM) benefit, focusing on ensuring that you receive the best possible treatments and personalised ongoing support throughout your medical journey when you are facing serious medical conditions. In the event that overseas medical treatment is recommended (i.e. outside of Malaysia) due to a lack of local expertise in relevant fields, and you decide to proceed with the recommended treatment, we shall reimburse the flight ticket for you and one companion, to and/or from the location of such treatment up to a combined limit of RM10,000 per lifetime.

A-Plus MedCare is available as a rider for A-LifeLink 2 and A-LifeJoy 2 policies and for insured age between 14 days to 70 years old.

A-Plus MedCare is renewable yearly up to the expiry of the basic plan that it is attached to. A-Plus MedCare will be renewed automatically on each rider anniversary.

Cost of insurance is RM10 per month. Please note that the cost of insurance is not guaranteed and the Company reserves the right to revise the cost of insurance by giving you 30 days’ prior written notice.

There are no fees and charges other than the cost of insurance.

Most second opinion services review medical reports and information to provide an independent diagnosis and recommended treatment plan. Following the second opinion, a patient is often left with questions, as well as the need to find the best doctor and hospital to administer the treatment. With A-Plus MedCare, the customer is never alone. This 24/7 service accompanies the customer at all times, throughout the journey of diagnosis, treatment, monitoring the treatment progress until recovery.

When you are eligible and decide to use the PMCM benefit, you will be required to sign the informed consent and medical confidentiality waiver form. With the form, our service provider, Medix, will obtain from you all of the relevant information and medical documents relating to your medical case. We recognise the importance and sensitivity of such personal data and will only share information that is required to accurately analyse your condition, enabling appropriate recommendations to be made.

The assessment of treatment is based on medical necessity. Generally, you will be referred to available treatment locally, but you may be recommended for consultation or treatment abroad in the rare instances where there is a lack of local expertise in relevant fields. Please note that if you decide to proceed with the treatment plan as recommended by our service provider, the cost of medical treatment may or may not be covered under your Policy or medical card with the Company. You are advised to confirm your Policy coverage with the Company before performing the treatment.

In such a situation, with your permission, our service provider, Medix, will discuss your case with the treating doctor and collectively agree upon the best course of action for you. At the end of the day, the patient will make a final decision on how to proceed with the suggested treatment plan.

The decision of treatment is always taken jointly with the patient’s treating doctor, together with the patient’s consent. It is important to note that our service provider do not treat patients directly, nor prescribe medications, nor execute treatments or procedures, and therefore would not be able to take on the responsibility of the treating doctor. However, our service provider, Medix, does have Professional Medical Liability Insurance and takes full responsibility for its medical recommendations. AIA Bhd. is not involved in the recommendations that is provided. The intent is for our service provider to provide independent opinion that is neutral.

The following conditions are excluded for coverage under the PMCM benefit:

1. Emergency care and or any medical conditions of urgent invasive and/or urgent surgical procedures;
2. Diabetes;
3. Short stature as an isolated condition;
4. Endocrine conditions that affect only fertility;
5. Isolated snoring (without sleep apnea);
6. Cosmetic/Aesthetic surgery;
7. Excluded medical conditions in the pediatric medical field:
   1. Pediatric gastroenterological diseases of the following types:
      1. Failure to thrive; and
      2. Eating disorders (e.g., anorexia, bulimia);
   2. Attention Deficit/Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD); and
   3. Any Medical Condition pertaining to premature babies during initial hospitalisation after birth or during the first six (6) months of life.
8. Excluded disorders:
   1. ADHD and ADD; and
   2. Anorexia/Bulimia and other related eating disorders
9. Fertility-related conditions or procedures, with the exception of cases of three (3) or more consecutive miscarriages;
10. Obstetrics;
11. Child, youth, and adult psychiatric and/or mental diseases;
12. Conditions related directly or indirectly to issues of looks and aesthetics, including obesity, with the exception of reconstructive breast surgery following a mastectomy;
13. Medical conditions in the fields of dentistry;
14. Fibromyalgia disease;
15. Chronic fatigue syndrome;
16. Complete and irreversible blindness;
17. Acute Cerebrovascular Accident (CVA);
18. Severe burns if patient is hospitalised;
19. Allergies;
20. Sexually Transmitted Diseases (STD);
21. Human Immunodeficiency Virus (HIV);
22. Obesity;
23. Any condition that necessitates urgent medical attention; and
24. Any condition resulting from substance, drug or alcohol addiction.

Note: The list is non-exhaustive. Please refer to the policy contract for the full details of the exclusions.