Medical Plan Version 1.0

Dakten

ALL YOU NEED TO KNOW
ABOUT AIA MEDICAL PLAN

Biograpgy

Hi!! I'm Dakten @
aten and I'm founder

of Hello Dakten,
which you can find
me at Tiktok as well

as instagram.



Joined AIA Public
Takaful in 2019, and
handling numbers of
experience in claims

and hospital
admission.



Hope this flipbook
help my clients know

more about
Medical Plan and
the tips and tricks

of Medical Card.



Enjoy!

Contents

1 MEDICAL COST

2 COVID-19 COVERAGE
GL AVAILABLE FOR OUTPATIENT
(CHEMOTHERAPY & RADIOTHERAPY)
POST-HOSPITALISATION VISIT ARE
NOW CASHLESS

3 MEDICAL CARD
4 HIGHLIGHT

(WHAT YOU SHOULD KNOW)

5 WAITING PERIOD
(COVERED & NOT COVERED)

6 TYPE OF CLAIM
GUARANTEE LETTER

7 TYPE OF CLAIM
PAY & CLAIM

8 EXCLUSIONS

1
Medical Cost

HAVE YOU PREPARE
FOR THIS POSSIBILITY ?



2

Covid-19 Coverage,
GL Available for Outpatient

[CHEMOTHERAPY, RADIOTHERAPY,
POST-HOSPITALISATION VISIT]

GET THE TREATMENT THAT YOU
NEED, AND LET US ASSIST YOU
FINANCIALLY…

More info on
Covid-19

Now, AIA cover side effects of
Covid-19 Vaccination & Stage 3
and above for Hospital admission



WAiT,siHgOWnTO up

Please declare all your
medical history

Terms :
Loading - Get full coverage but the premium
increase, due to several factors.
Exclude - Only that exclude, others still cover.
Decline - Sorry, your application Rejected!

3
Medical Card

ONLY WITH MYAIA

CHOOSE THE RIGHT MEDICAL CARD
& FEEL THE PRIVILEGE

AIA PRIORITY LANE

Locate AIA Submit up to 5
Panel Clinics receipts, with
& Hospitals additional number of
documents upload
Request for GL and bigger file size
only available for
120 days from the DID YOU KNOW?
date of issuance. The turnaround
Referral Letter time for e-claims is
are only available 5 working days
for 180 days from
the date of Misplaced your
issuance. Medical Card?

EVERYTHING No Problem!
AT YOUR

FINGERTIPS

AIA MEDICAL PLAN

Click for more
details

Basic Medical Plan

A LIFE MEDIK FAMILI

Premium Medical Plan

A PLUS TOTAL HEALTH

TYPES OF AIA MEDICAL CARD

No Medical Benefits.

Medical Benefits.
Red Card - Corporate Solution
Gold Card - Individual Policy

4
Highlight

WHAT YOU SHOULD KNOW

HIGHLIGHT ON MEDICAL PLAN!

CONCEPT OF TAKAFUL

Participate in Tabaru’ Pool of Fund with
medical underwriting, assessment of risk

(age, occupation, smoking status,
medical history, lifestyle)

PRODUCT MEDICAL PLAN

A Life Medik Famili ,
A Plus Total Health



Previously: A Life Link-i

A Life Joy-i
A Life Med Regular-i

A Plus Health

COVERAGE TERM

A Life Medik Famili - Up to 100 years old
A Plus Total Health - 70 or 80 years old

WAITING PERIOD

No waiting period for accident,
30 days normal illness.

120 days for specific illness.

TYPE OF CLAIM

Guarantee Letter (GL) & Pay & Claim
Basis.

5
Waiting Period

COVERED & NOT COVERED

WAITING PERIOD
CLAIM MEDICAL CARD

IN MALAY VERSION

APA ITU
CONTESTABLE
PERIOD??

WHAT IS CONTESTABLE PERIOD??

INI ADALAH SUATU TEMPOH YANG DI
TETAPKAN OLEH BANK NEGARA KEPADA
SEMUA PENGENDALI INSURANS/TAKAFUL,

UNTUK TUNTUTAN DI BAWAH 2 TAHUN,
(SELEPAS TEMPOH MENUNGGU), PIHAK
INSURANS BERHAK UNTUK MELAKUKAN
SIASATAN SEBELUM MEMBAYAR TUNTUTAN.



JIKA KES TIADA YANG MENCURIGAKAN,
PIHAK INSURANS AKAN MEMBAYAR SEMULA

KOS PERUBATAN YANG TELAH DI
KELUARKAN.

BAGI PEMEGANG SIJIL PERUBATAN
AIA PUBLIC TAKAFUL, SEPANJANG
SIASATAN, SEGALA KOS LAPORAN
PERUBATAN AKAN DI TANGGUNG

SEPENUHNYA OLEH AIA PUBLIC TAKAFUL.
(PAY & CLAIM)

FLOWCHART BEFORE ADMISSION

EMERGENCY?

no yes

GP ED

(Referral Letter) (Emergency
Department)

Bawa Referral Letter ke ED Registration, Request GL
> divert ke Specialist GL Approval / Declined
*Selagi tak approve, segala
Standby
cash pembayaran adalah
tanggungjawab pencarum
Specialist Fill up Admission Form
& Treatment Plan to request GL

GL Approval / Declined
*Selagi tak approve, segala

pembayaran adalah
tanggungjawab pencarum

6
Type of Claim

GUARANTEE LETTER

TYPES OF CLAIMS
1) Guarantee Letter

Only available after 90 days
policy set inforce

(For accident & normal illness)
Only available after 1 years
for policy set inforce.
(For specific illness)
Procedure & Treatment that
require Admission or Day
Care Procedure
Document needed: Letter from AIA
Panel Clinic to ease & expedite
hospital admission matters.
This can ensure smooth
issuance of GL.

Important : Bring your Referral
Letter from GP!

Referral Letter -
Klinik Kesihatan

Memo Letter - Referral Letter - Panel Clinic AIA
Non Panel AIA

TYPES OF GUARANTEE LETTER

GL ADMISSION REQUEST

Once GL approved, patient get sms
notification and please take note on

GL coverage note
For children, AIA have Daily Guardian

Benefits

GL DISCHARGE REQUEST

Once GL approved, patient get sms
notification and give a choice to stay

until final bill approved or put a
deposit and going back home early.

GL FINAL BILL SUBMISSION

All non-payable items will be listed here.
Eligibility for Cashless Post Discharge
Follow up

GL FOLLOW UP REQUEST

GUARANTEE LETTER COVERAGE NOTES

NOT COVERED

A POST-HOSPITALISATION GL

WAwhiaTt is
DAILY GUARDIAN
BENEFITS
Free Lodging & Meals.
Kerusi Malas also FREE when you
accompanying the Life Assured.
(For both junior & senior)

Client will receive GL notification via SMS

SIMPLE FLOWCHART

60 days 150 days
Pre-hospitalisation Post-hospitalisation

Pay & Claim Request GL

IN Hospital OUT

Get treatment Request GL Follow-up after
at clinic GP *take note on Discharge
Request waiting period

Referral Letter *Deposit -
depends on hospital

*Deductible -
depends on plan

DAKTEN 016-3915224
AIA GL 1300-88-8860

7
Type of Claim

PAY & CLAIM

TYPES OF CLAIMS
2) Pay & Claim

Pay & Claim (Investigation) : sometimes apply to
admission for policy that in-force below 2 years
(contestable period).
1. Specific illness occurs within 1st 1 year
policy inforce.
2. Critical illness occurs within 1st 2 years
policy inforce.
Pay & Claim for Pre-admission cost
(clinic bill) & Post-admission cost
(follow-up check up)
Pay & Claim Basis (outpatient
benefit) : emergency accidental
treatment, dialysis/cancer out-
patient benefit, home nursing.
Document needed:
Original Receipt , hospital bills,
AIA Claim Form, Doctor’s Report
(if needed) & Medical Report (if
needed)

Claims Process
& Guides

FLOWCHART AIA E-CLAIM

The AIA Malaysia eClaim process is very
straight forward. See the process flow below :

1. Claims Documents List of
Prepare the document required. Documents

2. Upload the Photos
Upload the photos of the documents to AIA
via MyAIA or through AIA web portal.

3. AIA Assesses the Claim
AIA will go through the usual validation and
assessment process for the claim. The
turnaround time for e-claims is 5 working days

4. Claims Approval
Once approved, AIA will credit the payment
into your bank acocunt in 3 working days.

TESTIMONY AIA E-CLAIM

Pre & Post Pre & Post
Hospitalisation Claim Hospitalisation Claim

My Clients
Feedback

Pay & Claim Pay & Claim
due to Hypertension (below 2 years, due to Kidney Stone (below 2 years,
policy inforce more than 120 days) policy inforce more than 120 days)

8

Exclusions

MEDICAL CARD AIA

EXCLUSIONS

Click for more
details

PLEASE TAKE NOTE!

You are Dont ask agent
responsible for to reminds
your contribution
everyday about
every month, your monthly
every year. payment.




Always up to Please take note
date with your on pre-lapsed
policy and Dont
current Lapse!
coverage. Eitherwise,
waiting period

will start over
Always liase again.


with your Do not follow
Insurance agent
oblique advice.
everytime you
need helps

BABY PLAN

016-3915224 [email protected]