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1 International Exclusive First in Malaysia Worldwide Protection.

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Presentation on theme: "1 International Exclusive First in Malaysia Worldwide Protection."— Presentation transcript:

1 1 International Exclusive First in Malaysia Worldwide Protection

2 2Date - place Main Benefits Plans 1. International Exclusive – annual limit up to RM7million (US$2.3m equiv) Cover inpatient & daycare treatment, outpatient treatment 2. International Exclusive Plus – annual limit up to RM9million (US$2.9m equiv) Cover inpatient & daycare treatment, outpatient treatment, pregnancy & delivery, routine dental, routine optical and health screening.

3 3Date - place Main Benefits Areas of Cover 1. Worldwide 2. Worldwide excluding USA (Excluding USA and US Minor Outlying Islands) 3. 32 Asia countries (Afghanistan, Bangladesh, Bhutan, Brunei, Cambodia, China, Hong Kong, India, Indonesia, Japan, Kazakhstan, Kyrgyzstan, Laos, Macau, Malaysia, Maldives, Myanmar, Mongolia, Nepal, North Korea, Pakistan, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Tajikistan, Thailand, Timor-Leste, Turkmenistan, Uzbekistan, Vietnam) Plans 1. International Exclusive Plus – annual limit up to RM9million (US$2.9m equiv) 2. International Exclusive – annual limit up to RM7million (US$2.3m equiv)

4 4 Main Benefits Benefits If you are Outside Area of Cover: - Worldwide – all areas are covered - Worldwide excluding USA – Emergency Treatment Only - Asia – Emergency Treatment Only Level of Reimbursement - Reasonable and Customary (R&C) Charges means: - Charges made by the Medical Practitioner, laboratory or other such medical services when they are at a level customarily charged by Medical Practitioners generally for the services received - We will based our challenge on the degree of deviation from our average negotiated cost of the treatment within the network applicable to your plan - If there is no network or the treatment is not available in a network hospital, we will based that calculation on the average cost of the treatment in that area or country

5 5 Benefit Schedule BenefitsInternational Exclusive PlusInternational Exclusive Please note: benefit values are per person each year unless otherwise specified and are reduced each time you claim only by the net amount (less any deductible, excess or co-insurance) we have actually paid. Area of coverWorldwideWorldwide excluding USA AsiaWorldwideWorldwide excluding USA Asia Yearly maximum up toRM9,000,000RM7,000,000 Outside area of coverAll areas covered Emergency treatment only All areas covered Emergency treatment only Level of reimbursementReasonable and customary (R&C) charges In-patient and daycare treatment (including surgery, consultations, consumables etc.) Daily accommodation chargesIncluded (lowest cost available single en-suite room) Parent accommodation up toRM500 per night Cash benefitRM700 per nightRM500 per night In-patient direct billingIncluded Applicable in-patient direct billing network International directory of hospitals Level of cover100% of reasonable and customary (R&C) charges in the international directory of hospitals Out-patient treatment (including diagnostics, prescribed drugs, dressings etc.) General Practitioner and Specialist consultation charges Included Courses of chiropractic treatment, acupuncture, homeopathy and osteopathy up to RM3,600 Traditional Chinese medicine up toRM180 per visit Up to 20 visits per year Courses of physiotherapyIncluded

6 6 Benefit Schedule - continue BenefitsInternational Exclusive PlusInternational Exclusive Please note: benefit values are per person each year unless otherwise specified and are reduced each time you claim only by the net amount (less any deductible, excess or co-insurance) we have actually paid. Area of coverWorldwideWorldwide excluding USA AsiaWorldwideWorldwide excluding USA Asia Other benefits Health screen up toRM3,000 Available only after 12 months membership No benefit Pre-existing conditions up toYears 1 & 2: RM7,000 Available only after 9 months membership Subsequent years: RM14,000 Maintenance of non pre-existing chronic conditions Included Oral and maxillofacial surgeryIncluded Ambulance transportIncluded International Emergency Medical Assistance Included Psychiatric treatment up toRM24,000RM14,000 Accidental damage to teethIncluded Pre and post-natal complicationsIncluded – available only after 12 months membership Pregnancy and delivery up toRM43,000 Available only after 12 months membership No benefit Vaccination up toRM4,800RM3,800 Routine dental care up to80% of eligible expenses incurred up to RM3,800 No benefit Routine optical care up toRM900No benefit Hospice and palliative care up toRM120,000 in a member’s lifetime Available only after 12 months membership RM95,000 in a member’s lifetime Available only after 12 months membership

7 7 Main Benefits In-Patient & Daycare Treatment Daily accommodation charges (Room & Board) – Lowest cost available Single En-suite Room Parent Accommodation (paid out of the child’s policy) – pays RM500 per night Cash Benefit – up to RM700 per night - Claimable only if the insured receive treatment as an in-patient and does not make a claim under this policy. (e.g. Company’s Group Policy)

8 8 Main Benefits In-Patient & Daycare Treatment (cont’d) In-Patient Direct Billing - Pre-Authorization – allows us to arrange direct settlement with the hospitals - Cashless payment Applicable In-Patient Direct Billing Network - Access to over International Directory of Hospitals all over the world Level of Cover - 100% of Reasonable and Customary (R&C) charges in the International Directory of Hospitals Note: Hospital Miscellaneous Services, Surgeon’s Fee, Surgery Fee, Anaethesis Fee, etc., are benefits under this Section.

9 9 Main Benefits Out-Patient Treatment General Practitioner and Specialist Consultation Charges Courses of Chiropractic Treatment, Acupuncture, Homeopathy and Osteopathy – up to RM3,600 per annum (Pre-Authorization prior to treatment required) Traditional Chinese Medicine – RM120 per visit up to 20 visits per year Courses of Physiotherapy (Pre-Authorization prior to treatment required)

10 10 Other Benefits Health Screening - 12 months waiting period - up to RM3,000 per annum (applicable for International Exclusive Plus only) Pre-Existing Conditions covered: - After waiting period of 270 days - Year 1 – up to RM7,000 - Year 2 – up to RM7,000 - Subsequent Years – up to RM14,000 Maintenance of non pre-existing chronic conditions: covered up to annual limit

11 11 Other Benefits Oral and Maxillofacial Surgery Ambulance Transport International Emergency Medical Assistance Psychiatric Treatment - Covers you for in-patient, daycare and out-patient treatment - Up to RM24,000 per annum - Pre-Authorization prior to treatment required

12 12 Other Benefits Accidental Damage to Teeth - Pay for treatment required immediately (within 7 days) - For initial treatment only, does not include follow-up treatment Pre and Post-Natal Complications - 12 months waiting period - Covers mother and unborn child up to the moment of delivery. Thereafter covers eligible expenses for mother only (Post-Natal Complications). E.g. Gestational Diabetes, Hypertension, Ectopic pregnancy, Threatened miscarriage, etc.

13 13 Other Benefits Pregnancy and Delivery - 12 months waiting period - Pays Up to RM43,000 - Applicable for International Exclusive Plus only Vaccinations – pays up to RM4,800 per annum - Necessary vaccinations Routine Dental Care - Pay 80% of eligible treatment - Up to RM3,800 per annum - Applicable for International Exclusive Plus only

14 14 Other Benefits Routine Optical Care - Up to RM900 per annum - Applicable for International Exclusive Plus only Hospice and Palliative Care - 12 months waiting period - Up to RM120,000 per lifetime benefit

15 15 Our Position on the following Benefits: Cancer Care - If Pre-Existing Condition, benefits will be payable under Pre- Existing Conditions - Non-Pre Ex, benefits for cancer and related treatment will be payable for 3 years in aggregate per lifetime (i.e. 1095 days) Kidney Dialysis - If Pre-Existing Condition, benefits will be payable under Pre- Existing Conditions - Non Pre-Ex, benefits up to annual limit Genetic Testing - Preventive Treatment is not payable - Genetic test is not payable

16 16 Health @ hand HEALTH AT HAND - Health at Hand is a telephone based multi clinic information service. Staffed by medical professionals, it does not diagnose a condition or prescribe treatment/medication, and is not designed to take the place of your medical practitioner. - It can provide you with valuable information to help put your mind at rest. It is a confidential service, any information you discuss is not shared with our AXA Insurance MALAYSIA.

17 17 24/7 Customer Service 24 Hour Customer Service - Enquiry on Policy Benefits - Claims Enquiry - Request for Pre-Authorization

18 18 Eligibility Last entry aged 80 years or less Yearly renewable up to members’ lifetime Portfolio Underwriting Covers: - Malaysia Citizens residing in Malaysia - Malaysia Citizens residing overseas - Expatriate Residing in Malaysia - Expatriate Residing outside of their Resident Country Note: 1. We can’t cover if you are a national of your resident country (other than Malaysia) – e.g. Indonesian residing in Indonesia. In addition, country specific regulations may impact your eligibility. 2. Principle Country of Residence is where you live or intend to live for more than 185 days or more.

19 19 Premiums Premium Table Premium Payable is based on the Insured’s attained age Premium in Ringgit Malaysia 3 Simple Steps to find the Right Premium Step 1 - Locate your applicable zone from the Country of Residence table Step 2 - Flip to the corresponding page of the Annual Premium Table according to your zone Step 3 - Locate the premium according to your choice of plan, area of cover, currency and age. Repeat the same for each of your family members to be included in your plan.

20 20 International Exclusive - Premium Snapshot (country of residence: Malaysia) International ExclusiveInternational Exclusive Plus Area of CoverAsiaWorldwide excluding USA WorldwideAsiaWorldwide excluding USA Worldwide Age 10RM4,0404,4908,0847,0457,82514,088 Age 20RM5,0355,59610,07410,14011,26720,280 Age 30RM7,8198,69215,64316,20017,99932,395 Age 40RM12,14813,49624,29220,44322,71440,886 Age 50RM17,80519,78335,61126,48029,42552,963 Age 60RM27,90731,00655,81239,26443,62878,525 Age 70RM49,03354,48098,06866,19673,555132,396 Age 80RM72,58180,646145,16296,435107,149192,866

21 What does a customer get for RM 12,000 pa (aged 40,IE, Asia area) BenefitAmount (RM) Pre-existing conditions (after 9 months) 7,000 Vaccinations (available day 1) 3,800 5 TCM, 2 acupuncture visits 900 6 GP visits 360 TOTAL 12,060

22 What does a customer get for RM 16,200 pa (age 30, IE plus, Asia area) BenefitAmount (RM) Pre-existing conditions (after 9 months) 7,000 Vaccinations (available day 1) 4,800 5 TCM, 2 acupuncture visits 900 6 GP visits 360 Maternity (after 12 months) 43,000 Routine dental (80% contribution) 3,800 Routine optical (available day 1) 900 Health screen (after 12 months) 3,000 TOTAL 63,760

23 23 New Biz Submission Application form and any medical check up report, blood test done in the past Proof of Identity Copy of Passport; or Government issued ID (NRIC/ FIN) Proof of Residential address Utility, rates or council tax bill ; or A letter headed paper from a bank with which the policy owner has an account, which confirms the policy owner’s current residential address Photo of each member Premium by cheque or credit card, 60 days credit for keyman or group

24 24 Keyman Meet Mr Samy The CEO Name: Samy Krishnan Age: 46 years old Occupation: CEO of a public listed company Fav pastime: Sailing Mr. Krishnan travels extensively in his role as a CEO of a public listed company with interest all over the world. To ensure that medical access is available to him anywhere in the world, Mr. Krishnan’s company paid RM40,886 per year / RM3,407.16 per month to enjoy up to RM9,000,000 medical access.

25 25 Frequent Traveler Name: Fiona Wong Age: 28 years old Occupation: Lady of Leisure (Tai-Tai) Fav pastime: Mahjong and high tea Mrs. Wong divides her time between Australia and Malaysia. To ensure her medical needs are covered, Mr Wong paid RM11,267 per year / RM938.92 per month to provide his wife up to RM9,000,000 medical access anywhere in the world. Now that Mrs. Wong is pregnant with her first child, the cover also pays Maternity benefits up to RM43,000 Meet Mrs. Wong @ Tai Tai

26 26 High Net Worth Name: Nathan Yong Age: 10 years old Fav hobby: Swimming Name: Judy Chong Age: 36 years old Occupation: Homemaker (loves to bake) Name: Ian Yong Age: 38 years old Occupation: Senior Regional Oil and Gas Consultant Name: Illona Yong Age: 13 years old Fav hobby: Facebooking Meet the YONG family Mr. Yong greatest pride is his family. As a regional consultant, relocation to different part of the world comes with the job. To ensure that his family’s medical needs is taken care of, he made sure that adequate medical insurance is made available to him and his family members anywhere in the world. To enjoy a total of RM36 million worth of medical access anywhere in the world for him and his family, he paid only RM92,966 per year / RM7,747.16 per month. And when his wife carries no 3 or 4 or 5, she’ll receive up to RM43,000 maternity benefits per pregnancy.

27 27 Incentive For Individual and Keyman policy Premium as per Premium Table Commission 15% For Group (more than 3 employees) Discounted Premium Waiting period for Pre-Ex is waived Commission 10%

28 28 IDOH

29 29 Hospitals in the network Singapore – Gleneagles Hospital, Mount Elizabeth Hospital, John Hopkins Singapore Int’l Medical Centre Malaysia – Prince Court Medical Centre, Gleneagles, Pantai Group, KPJ group Hong Kong – Adventist Hospital, Matilda Int’l Hospital Thailand – Bumrungrad Hospital, Samitivej Hospital Vietnam – HCM City Family Medical Practice, Hanoi Family Medical Practice China – Beijing United Family Hospital, Shanghai United Family Hospital UK – Wellington Hospital/King Edward VII Hospital/London Bridge Hospital/London Clinic/Harley Street Clinic USA - Cleveland Clinic / Mayo Clinic /Johns Hopkins Hospital /University of Texas M.D. Anderson Cancer Center

30 30 IDOH Where you can receive treatment in the following parts of the world  Caribbean  Central America  South America  North America  Africa  Asia  Australasia  Europe  Middle East

31 31 Important Phone Number

32 32 Photo Membership Card 1.During renewal, member will receive new card 2.If member wish to cancel the policy midterm, this card must be returned

33 33 Pre-authorisation is Required Before receiving any planned treatment or services, member must contact Health Services Team to obtain authorization: All in-patient and daycare admissions within or outside network, All non-emergency tests, diagnostic, treatment, surgery and other medical services All in-patient maternity services, dental services, special nursing or outside area of cover;

34 34 Pre-authorisation is Required Outpatient Chiropractic Treatment, Acupuncture, Homeopathy, Physiotherapy, Osteopathy, Psychiatric Treatment, or 2 nd Opinion; CT scans, MRI, endoscopy, colonscopy, gastroscopy etc; Any medicines purchased for 30 days or more;

35 35 Pre-authorization Process We may ask member a few questions on his condition, type of treatment, name of doctor/hospital, treatment plan (if any); This is to determine member’s benefit and coverage; We will advise type of claim form to be completed; Claim form to be signed by treating doctor (note that report fee is not payable under the policy); Submit claim form to HST and we will give the member a written Pre-authorization Letter (outside Network), or Guarantee Letter (within Network)

36 36 Comparison to conventional H&S products InternationalExclusive X 30 days waiting period for all illnesses X 120 days waiting period for Specified Illnesses X Co-payment on upgraded Room & Board X 90 days Residence Overseas clause X Overseas Treatment constraint X Entry Age 59

37 37 Case Study Claim : Left leg abscess due to infection Treated in a US hospital How will it be payable under SmartCare Optimum Plan 1 (RM500K)? SC Optimum will pay RM151,640 IE will pay RM413,035 (whereby RM3415 is not payable as it is external prosthesis)

38 38 Competitor Comparison BenefitsAXA InternationalExclusiveBUPA Worldwide Health Options Plan optionsTwo plans available 1.Plan IE - Inpatient & Outpatient 2.Plan IE plus - Inpatient, Outpatient, Maternity, Dental, Optical, Health Screen Single Plan with Inpatient (include inpatient maternity) Optional riders: 1.Medical Plus (Outpatient, pre & post) 2.Medicine and Equipment 3.Wellbeing (Dental, Optical and Health Screen) 4.Emergency Medical Evacuation and Repatriation Yearly maximum up to1.Plan IE - RM7 mil (USD2.3 mil) 2.Plan IE plus – RM9 mil (USD2.9mil) - USD2.55m for inpatient - USD42,500 for Medical Plus - USD8,500 for Wellbeing Pre-existing conditions  9 months waiting period  Sub-limit: RM7,000 per year for policy year 1 and 2, RM14,000 for subsequent years Not available Maintenance of non pre- existing Chronic Conditions  No waiting period  Sub-limit: none. Not mentioned

39 Competitor Comparison Scenarios CompanyAXABUPA Scenario 1 Male aged 51 Female aged 51 Region Plan type RM37,032 Asia Inpatient and outpatient RM43,296 Asia Inpatient and outpatient Scenario 2 Male aged 40 Region Plan type RM12,148 Asia Inpatient and outpatient RM13,542 W/wide (ex USA) Inpatient and outpatient Scenario 3 Male aged35 Female aged 35 Region Plan type RM27,760 Asia Full cover for female RM49,896 Asia Full cover Scenario 4 Male aged 40 Female aged 40 Kids – aged12 & 8 Region Plan type RM32,376 Asia Inpatient and outpatient RM38,112 Asia Inpatient and outpatient

40 40 BUPA 1. No legal recourse in Malaysia the event of claim disputes 2. Product is not approved by BNM 3. Product available & purchased through internet 4. The distribution of this product is not legalized in Malaysia

41 41 ING I.ExpatCare 1. Only cover inbound and outbound expatriate and family 2. Area of cover: 3. Area of Cover Worldwide, Worldwide excl USA & Canada, Worldwide excl US, Canada, Switzerland, European Union, Japan, HK & SG 4. No routine Optical care 5. No routine Dental care 6. No cover for elective caesarean delivery 7. Max entry age 59, renewal up to 70.

42 42 ING I.ExpatCare 8. No psychiatric treatment 9. No periodic preventive health test/screening 10. To be eligible to cover outside area of cover, the treatment must be sought within 90 days 11. Only cover for those emergency illness that is not existed before travelling 12. Investigation tx/procedure is not cover 13. Maternity waiting period is 10 months 14. Cover for hearing aids and orthopedic appliances

43 43 ING I.ExpatCare Worldwide, IE vs ING (orbit, OAL RM7mil), Malaysian AgeAXAING 189,22512,536 3116,34615,604 4125,38719,264 5137,03626,900 6159,16245,436

44 44 ING I.ExpatCare IE - WW exclude USA ING (orbit, OAL RM7mil), worldwide exclude US, Canada Residing in Malaysia AgeAXAING 185,1235,584 319,0836,956 4114,1038,600 5120,57512,040 6132,86820,472

45 45 ING I.ExpatCare IE - Asia ING (orbit, OAL RM7mil), worldwide exclude US, Canada, Switzerland, European Union, Japan, HK, SG Residing in Malaysia AgeAXA (cover Japan HK & SG) ING 184,6124,748 318,1735,916 4112,6947,312 5118,51610,236 6129,58017,400

46 46 Thank You


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