| "Even if you have a
general understanding of terms, they could be defined differently
under different contacts" |
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| Differentiating policies |
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Health-related insurance covers a variety of
policies. A critical illness cover pays you a lump sum when you
are diagnosed with any of the stated dreaded diseases. Disability
income plans usually provide you with an income in the event that
you are incapacitated.
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A hospitalization benefit plan will entitle
you to some cash for the duration of your stay in the hospital,
aiming to deflect the extra costs that you incur while hospitalized.
Personal accident plans have a certain measure of coverage for
hospital bills relating to your accident, while long-term care
plans may include an allowance if you require prolonged care out
of the hospital.
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However, if it's dealing with hospital bills
its hospitalization and surgical (H&S) plan that you require. The
H&S, as evidenced by its name, takes care of the costs of hospitalization
and surgery.
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When choosing an insurer, remember that there
is no point in being insured for a large sum when you have to fork
out cash first and you don't have the money.
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What to do when buying a policy
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Always make sure you read and understand the
terms of a policy you purchase. Even if you do go through it, weaving
through the various terms and attempting to compare benefits between
policies can be difficult. Even if you have a general understanding
of terms, they could be defined differently under different contacts.
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To aid policyholders better, Bank Negara Malaysia
has directed a move towards standardization of terms used in policies.
The life insurance and general insurance associations of Malaysia,
LIAM and PIAM are drawing up a common underwriting guide, which
will have common definition of contract wording and minimum standards,
especially for terms like pre-existing illnesses, co-insurance
and excess. Although some say that this will hinder free competition,
standardization will reduce confusion among policyholders.
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It is important for you to know what kind of
policy you need or else it could fail to support you when you need
it the most. It is recommended that an individual obtain 3 kinds
of medical insurance:
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hospitalization and surgical (H&S),
which covers reimbursement for medical expenses
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critical illness plan which provides a
lump sum for replacement of lost income
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| c. |
disability income benefit for the duration
of disability or until the age of 65 or 70
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If you travel overseas frequently and your policy
does not cover treatment there, it is important that you get a
travel insurance policy that covers the higher costs of medical
care. When comparing policies, it is always human nature to just
look at the first line, which is usually coverage on room and board.
But one has to note that that particular item may not necessarily
comply with the rest of the policy.
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The amount of insurance taken into consideration
should not just be for room and board, but benefit amount for items
such as surgical expenses, in-hospital expenses, and pre-hospitalization
diagnosis, post-hospitalization treatment, major organ transplant,
outpatient cancer treatment and outpatient kidney treatment. Every
insurer may issue the same room and board amount, but have totally
different amounts for all the other items.
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On top of that, you would need to look out for
areas such as:
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definitions and limitations to payment
of benefits
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how a disability defined
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how soon after a claim can one claim again
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special provisions (succeeding policy
holder after the first policyholder dies to avoid the hassle
of declaring their health again)
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does the policy have guaranteed renewability-
to ensure protection is available throughout and premiums
are maintain despite recent diagnosis of illness
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| What if you are already covered? |
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These days, many companies cover their employees
under group medical insurance. Does this mean that you don't need
a separate policy for yourself?
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Note that one cannot make double claims with
H&S policies- so make sure that your needs are covered. If
it isn't, you can claim the balance from your other policy, depending
on how the multiple insurers work things out.
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Find out the cover provided by your employers
and then you can proceed to top up the difference to improve your
coverage. If the cover is sufficient, then there should be no reason
to add on.
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Depending on your own needs and wants, you may
want to take on your own policy with a higher limit of benefits.
(e.g. instead of a shared hospital room, you may choose to have
a private room).
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However, if you rely on your employer for your
medical insurance needs, you will have to know that once you leave
your place of employment, the coverage ceases. Therefore, you will
need to make provisions before leaving the company by picking up
a policy a year before you retiring or resigning as most policies
have a one-year waiting period for certain illnesses.
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Generally, it is wrong to think that picking
up a policy later will cost you more. Generally the premiums you
pay are related to the age band you fall into (e.g. 21-25 years,
26-30 years) and will increase as you grow older although rates
for children can be higher than young adults. The premiums you
pay will increase as you enter the age band, regardless whether
you are renewing a policy or picking up a new one.
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The definite good thing about picking up a policy
when you are younger is that you are usually healthier. Age is
a barrier, with most insurers limiting entry age at 60, with renewals
up to 70 years. Once you are diagnosed with an illness or deemed
high-risk, you may no longer be insurable. Most policies do not
cover pre-existing conditions, or if there is a waiting period
before they are covered. If the insurer does accept you, there
may be exclusions and in some cases, pay more in terms of a load.
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| Making your decision |
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The only way of to keep healthcare costs down
for the average person is preventive care by having regular medical
check-ups and taking the proper medication early on.
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Concerns rise as healthcare costs increase day
by day. Better technology and new equipment and techniques translate
into higher costs. Drug companies, seeking to recoup their high
research and investment costs as well as make some profit for their
shareholders, price their drugs accordingly.
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Whether you are male or female, an athlete,
white-collar worker or millionaire, healthcare is something we
need to think about. Ensuring sufficient funds for medical costs
is an essential part of financial planning.
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