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HOSPITAL ROOM & BOARD - Reimbursement of the room accommodation and meals
during confinement in a hospital as an in-patient.
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INTENSIVE CARE UNIT - Reimbursement of the actual room and board incurred
during confinement as an in-patient in the Intensive Care Unit of the Hospital.
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SURGICAL FEES - Reimbursement of the charges for a surgery by the Specialists,
pre-surgical assessment, Specialist's visits and post-surgery care from the date
of surgery.
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OPERATING THEATRE - Reimbursement of operating room charges incidental to
the surgical procedure.
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ANAESTHETIST FEE - Reimbursement of fees charged by the Anaesthetist for
the administration of anaesthesia.
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PRE-HOSPITAL DIAGNOSTIC TESTS - Reimbursement of fees charged for ECG, x-ray
and laboratory examinations recommended by a qualified medical practitioner for
the determination of an illness or injury. Medications and consultation charged
by the medical practitioner will not be payable.
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PRE-HOSPITAL SPECIALIST CONSULTATION - Reimbursement of the first consultation
fees charged by a Specialist in connection with a Disability and provided that such
consultation has been recommended in writing by the attending general practitioner.
Payment will not be made for clinical treatment (including medications and subsequent
consultation after the illness is diagnosed).
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IN-HOSPITAL PHYSICIAN VISIT - Reimbursement of fees charged by the attending
physician for visiting an in-paying patient while confined for a non-surgical Disability,
subject to a maximum of 1 visit per day.
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POST-HOSPITALIZATION TREATMENT - Reimbursement of charges for follow-up treatments
following discharge from a hospital for a non-surgical confinement administered
by the same physician.
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HOSPITAL SUPPLIES & SERVICES - Reimbursement of charges made by the Hospital
for general nursing, dressings, splints, plaster casts, x-ray, laboratory examinations,
electrocardiograms, physiotherapy, basal metabolism tests, intravenous injections
and solutions, administration of blood and blood plasma but excluding the cost of
blood and plasma.
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PRESCRIBED MEDICINES - Reimbursement of charges for medicines that are dispensed
by a Physician, a Registered Pharmacist or a Hospital and which have been prescribed
by a Physician or Specialist in respect of treatment for a covered Disability during
in-patient stay and following hospitalization.
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AMBULANCE FEES - Reimbursement for necessary domestic ambulance services
(inclusive of attendant) to and/or from the Hospital of confinement.
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ANNUAL OUT-PATIENT KIDNEY DIALYSIS TREATMENT - Reimbursement of the charges
incurred for out-patient kidney dialysis treatment which performed in a Hospital
or registered dialysis treatment centre for end stage chronic kidney failure. Benefit
will not be payable for any Insured Person who has developed chronic renal diseases
and/or is receiving dialysis treatment prior to the effective date of Insurance.
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ANNUAL OUT-PATIENT CANCER TREATMENT - Reimbursement of the charges incurred
for out-patient cancer treatment in a hospital or registered cancer treatment centre.
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EMERGENCY ACCIDENTAL & DENTAL OUT-PATIENT TREATMENT - Reimbursement of
expenses incurred as a result of a bodily injury/to sound natural teeth arising
from an ACCIDENT for treatment as an out-patient at any registered clinic or hospital
within 24 hours.
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OUT-PATIENT PHYSIOTHERAPY TREATMENT - Reimbursement of the expenses for out-patient
physiotherapy treatment which is recommended in writing by attending physician or
surgeon.
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ORGAN TRANSPLANT - Reimbursement of charges incurred on transplantation surgery
for the Insured Person being the recipient of the transplant of a kidney, heart,
lung, liver or bone marrow. Payment for this benefit is applicable only once per
lifetime. The costs of acquisition of the organs and all costs incurred by the donors
are not covered.
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DAILY-CASH ALLOWANCE AT GOVERNMENT HOSPITAL - Pays a daily allowance for
each complete day of confinement for a covered Disability in a Malaysian Government
Hospital provided confinement in a Room and Board rate that does not exceed the
plan chosen.
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INSURED DAILY GUARDIAN BENEFIT - Reimbursement of the expenses for meals
and lodging incurred to accompany an Insured Person (aged 56 years and above) in
the hospital.
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MEDICAL REPORT - Reimbursement of expenses for pursuing the medical report.
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SECOND SURGICAL OPINIONS - Reimbursement of the consultation fees with a
second Specialist to determine necessity of a surgical operation.
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GOVERNMENT SERVICE TAX - Reimbursement of the charges imposed by the Malaysian
government for service tax levied on Hospital Room & Board charges.
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HOME NURSING - Reimbursement of charges for home nursing care plan established
and periodically reviewed by a registered medical practitioner and is only payable
after a minimum of 3 days hospitalization beginning within 7 days of hospital discharge.
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GERIATRIC BENEFIT - A lump sum payment as stated in the Schedule of Benefit
shall be payable once during the Insured Person lifetime upon diagnosis with hospitalization
treatment of deterioration or loss of intellectual capacity illnesses specifically
Alzheimers, Parkinson, Senile Dementia or Dementia diagnosed by an appropriate consultant.
Payment will not be made for presentation of signs and symptoms of ageing solely.
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MAJOR MEDICAL - Increase of annual benefit limits on top of the Overall Annual
Limit if the Insured Person suffers from one of the Major Disability (Stroke or
Cerebrovascular Accident, Heart Attack, Kidney Failure, Cancer, Coronary Artery
Disease Requiring By-Pass, Chronic Liver Disease, Fulminant Viral Hepatitis, Coma,
Paralysis/Paraplegia, Major Burns, Chronic Lung Disease, Encephalitis, Major Organ
Transplant, Brain Surgery, Heart Valve Replacement, Multiple Sclerosis, Open Heart
Surgery, Total Blindness, Total Loss of Hearing/Deafness, Bacterial Meningitis).
Major Medical is subject to the Lifetime Limit.
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OUT-PATIENT GP CARE - Reimbursement of charges for general practitioner (GP)
consultation during normal clinical hours including basic medications and treatment
for an illness or injury as an out-patient.
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OUT-PATIENT SPECIALIST CARE - Reimbursement of charges for specialist consultation
(SP) during normal clinical hours including basic medications and treatment for
an illness or injury as an out-patient with a Panel Doctor's referral.
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PREVENTIVE SCREENING (PAP SMEAR / PROSTATE SPECIFIC ANTIGEN) - Reimbursement
of fees charged for an annual pap smear examination or prostate specific antigen
(PSA) test performed by a Panel Doctor.
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