Look For These 8 Facts When Choosing The Right Medical Takaful Plan

Look For These 8 Facts When Choosing The Right Medical Takaful Plan

great eastern takaful

The best takaful plan gives you the security that you need for your present and future. If you already have one that covers you medically, that’s great! But how do you know whether it is adequate to cover what you may need in the future, in the event that you’re hospitalised, require surgery, or even after you’ve been discharged?

You may be healthy now and would prioritise cost more than coverage. But the future can always bring unforeseen problems that can burn a hole in your pocket.

So, how do you choose the best medical takaful plan? Here are some questions you should ask to assess what you need.

1. How much does treatment cost?

No matter how healthy or careful you are, you’re always susceptible to an unintended illness or accident. Even those who have had dengue fever before are at risk due to a new dengue virus being spread around! It’s not an ideal situation to be in, but being in denial of the possibility of falling ill in the future is even more dangerous especially with the current rising cost of medical treatments.

With this in mind, you have to consider how much coverage is sufficient for you should you require hospitalisation and treatment.

If you’re showing symptoms of dengue fever, you will have to take a blood test at a clinic. According to a retired public health consultant, a blood test costs between RM100 and RM200. If your blood test comes out positive for dengue, you will have to be admitted to a hospital.

According to this report, a patient who was treated in a private hospital for dengue fever had to pay RM6,000 in 2014 for Intravenous (IV) drips, paracetamol and blood checks. The cost is likely to go up with time and if it is serious with haemorrhage, you may be required to stay in an Intensive Care Unit (ICU). This automatically brings up your medical bill significantly.

All in all, you could be looking at spending thousands for the treatments, and that’s just for dengue fever. What if you get other more serious chronic illnesses? Here are some common ones among Malaysians and how much the estimated treatment costs:

Estimated Cost of Treatment
Heart attack
(Coronary angioplasty)
RM25,480 – RM33,090
Treatment for kidney failure
RM90 – RM200 per session
Breast cancer
Up to RM65,000 per year

2. What’s the Hospital Room and Board?

One of the most common factors most people consider when they are choosing a medical protection plan is the hospital Room and Board. Unfortunately, most people tend to choose their plan according to this factor alone.

The Hospital Room and Board coverage refers to the maximum cost of your room and board that you can claim for one day.

The i-Great MediMax by Great Eastern Takaful has a hospital room and board coverage range from RM150 to RM300, and this is offered for up to 180 days per certificate year.

So if you go for their lowest plan T GMM150 that gives you the limit of RM150 per day, the takaful plan will cover the cost of the Room and Board up to RM150 per day. Any amount higher than that, you will have to top up the difference.

Note: Terms and Conditions Apply

To ensure you select the right plan according to your preference of room and board when hospitalised, it makes sense to find out the average cost for the Room and Board of your choice in your preferred private hospitals. Currently private hospital rooms cost anywhere between RM60 (for a four-bedded room) up to RM700 (for a single deluxe).

In the end, participating in the right medical takaful plan depends heavily on your budget so even if you want a higher coverage, you should not jeopardise your budget and cash flow for something that is out of your affordability since it is a long term commitment.

3. What about Annual and Lifetime Limits?

These limits dictate how much you can claim in a year and in a lifetime. So if your takaful plan has an annual limit of say RM60,000, that is the maximum total amount of coverage you can claim for your medical treatments in a year. The lifetime limit is the maximum total amount of coverage offered by your takaful plan until you exhausted the lifetime limit amount.

You may think that your chances of hitting your annual or lifetime limit is slim. However, in case that you are unfortunate enough to get a serious illness and required to be admitted to ICU and other intensive treatments for more than a week, your annual limit of RM60,000 may not be enough.

In the example of breast cancer, your annual treatment can easily go up to RM65,000 a year and that can easily wipe out your annual limit too.

If you’re uncertain of the amount of coverage you should get, use the Great Eastern Takaful calculator to estimate that. You can also look into takaful plans that have no limits in their lifetime coverage.

For long-term illnesses like kidney failure, the best protection would be to have a takaful plan that has a high annual and lifetime limit. There are also certain plans that offer unlimited lifetime limit, giving you the peace of mind to face any unfortunate medical scenarios.

Note: Terms and Conditions Apply

4. Co-takaful vs full coverage

A co-takaful is an agreement that is set between the takaful operator and you, where a certain percentage of the cost charged for any medical treatments will be shared between two parties. Normally this means that you will have to pay a certain percentage, usually 10%-20% of the medical treatments you received and the takaful operator will pay for the rest. On the other hand, full coverage means the takaful operator will fully pay the medical bill on selected charges such as Room and Board, ICU, surgery as well as inpatient and outpatient treatments.

Similar with choosing an annual or lifetime coverage, opting for a co-takaful and how it will impact you highly depends on how much you claim for treatments.

If your claims are minimal, the co-takaful will not be a high figure and will have minimal impact on your finances. The co-takaful only becomes an issue if the cost of treatment is high or you need treatment on an almost monthly basis.

We already know a monthly basis treatment would build up in time, but how about a one-time procedure? Here’s the breakdown on the cost if you were to get an appendectomy at a private hospital:

Estimated Cost
With co-takaful
RM7,000 – RM10,000
You need to pay RM700 to RM1,000 (10% co-takaful)

These costs may be lower or higher, but it will give you a rough idea on how much you will still have to fork out with a co-takaful. This can get pretty straining on your finances if you require major treatments or regular monthly treatments.

A plan with co-takaful is a good option to help you lower your takaful plan contribution, making it more affordable. However, if you want a total peace of mind, it’s good to look into a takaful plan that offers no co-takaful (full coverage) to keep you from having further financial burdens.

5. Does the takaful plan cover outpatient treatments post-hospitalisation?

Post-hospitalisation covers doctor’s visits, check-ups and any other treatments you may need after you have been warded at the hospital.

A doctor’s visit post-hospitalisation from dengue fever could cost up to RM200 if you require another blood test or more medication. On the other hand, post check-up for acute ischaemic stroke costs around RM103 in 2012. And you may need more than one follow-up visits, which is why it’s important to ensure your medical takaful plan covers these follow-up visits as well.

Typically, a takaful plan covers up to 90 days after discharge for follow-up check-ups.

6. What is the maximum age of coverage?

Some takaful coverage ends at the age of 65 or 70. This exposes the Person Covered to a myriad of risks in their most vulnerable stage of life.

With the average life expectancy of Malaysians on the rise, reaching 74.7 years in 2016 compared to 72.2 years in 2000, having a medical plan that ends early would mean having the latter years of a person’s life completely unprotected.  The chances of getting illnesses in your old age is also higher.

The risk is further exacerbated as most retirees would have no income and has minimal retirement fund to fall back on. Being more susceptibility to illnesses that take a longer time to recover, treatments can be quite costly for senior citizens.

This is why it is important to look for a takaful plan that gives you the longest coverage to at least 99 years of age.

7. Rider vs standalone medical

What is the difference between a medical rider attached to investment-linked plan or other takaful plan and a standalone medical plan?

Both types of protection cover similar risks – the risk of high medical costs due to illnesses. However, the difference lies in the contribution structure.

An investment-linked plan with a unit deducting medical rider charges the same contribution every year, whereas a standalone medical plan or contribution paying rider increases its contribution rate as the Person Covered ages. However, the investment-linked plan may require top up contribution in case of the participant’s account value is less than or equal to zero at any point of time.

This is how it works:

great eastern takaful

Note: Terms and Conditions Apply

The standalone takaful plan is more affordable in the early years but the cost can go up significantly as you age. However, riders allow you to manage your cash flow better as the contribution rate is set at the same amount as you age.

8. Waiting periods for claims

All takaful plans that you’re applying for will have a panel of hospitals and clinics that they recommend. Why? Because these hospitals and clinics are already linked with the takaful operator, making the admission, payment and even claim process easier.In fact, admitting to a panel hospital gives you the option of cashless transaction, where the payment will be handled by the takaful operator. However, in some cases, the Person Covered will need to pay some amount of deposit, which is refundable.

However, most takaful operators will still give you coverage outside of their list of panel hospitals. But you may be required to make the payment upfront, and then file for claims later on.

To make your claim, you will need to fill up a form and the necessary documents including:

  • All original tax invoices, receipts and itemised billing from the medical center and/or clinic.
  • Duly completed claim form and attending physician statement at Person Covered’s own expense.
  • Other supporting documents such as laboratory reports, radiology reports, ECG etc.
  • A photocopy of employee and claimant’s NRIC. For non-Malaysian, please provide photocopy of passport.

You may also need to check the requirement checklist in the claim form for more details. Claims must be filed within 30 days after you have been discharged from the hospital.

Most takaful plans come with a waiting period before you can make a claim. This waiting period is typically between 30 to 120 days from the date your medical takaful plan is active.

Normally, a medical plan has a waiting period of 30 days from the effective date of the medical plan for normal illnesses. For specified illnesses such as hypertension, diabetes mellitus and cardiovascular disease, the waiting period is 120 days from the effective date, and for certain illnesses such as cancer, the waiting period is 60 days.

It’s now time to choose the right takaful plan

The best time to participate in a takaful plan is when you’re young and healthy as the chances of you getting approved for the plan is higher. As you get older, your risks of falling ill is much higher, hence your contribution would be higher or worse, you can’t get a takaful plan at all due to a previous illness!

Finally, you can always upgrade your medical plan when you are ready financially, so you can fulfil your healthcare needs in the future.

Note: Terms and Conditions Apply

Great Eastern Takaful offers both medical standalone and rider plan for you to consider, offering you the best protection while also taking note of how much you can afford. Once you have decided what you need in terms of medical coverage, you can browse through what they have to offer and see which one suits you.

Not sure what you really need?

Speak to a takaful advisor to find the most suitable plan for your needs or find out more about i-Great MediMax and i-Medik Rider Suite.

Don’t procrastinate in getting covered, and take the steps that you need to secure your healthcare.

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