KUALA LUMPUR, 18 Nov 2021:
One of the perks with being employed is usually free outpatient medical coverage offered by the employer. But with more people seeking to be self-employed in the fallout of Covid-19 restrictions, visits to the clinic comes out of your own pocket.
To address this need, AXA Affin General Insurance Bhd is offering standalone medical insurance coverage for outpatient visits – available to self-employed people until they turn 46. Due to an extensive list of exclusions, this insurance is basically for clinic visits involving accidental injuries or mild illnesses.
This AXA SmartMedi Outpatient covers outpatient medical expenses (including medication) at any private general or specialist clinic plus diagnostic tests like X-rays and more, extending to clinical procedures after consultations.
As this policy covers medical costs without hospitalisation, it acts as a complementary plan to the usual Hospitalisation and Surgical Medical plans offered to individuals. A medical card is provided for cashless payment at designated clinics and reimbursements provided for those not already on AXA’s panel list.
This plan is provided on an annual basis – similar to personal accident – with two-tier packages. For claims up to RM8,000 per year, the premium is RM634 (360 for children aged 3-18). The higher claim package of RM15,000 yearly is charged RM1,006 premium (RM590 for children). The policies are specific to individuals – not shared.
While the number of visits to general clinics are unlimited, only the first visit on any day is covered. Further, the first RM30 (co-payment) has to be paid by the policyholder under the first package.
The co-payment also applies for specialist clinic consultations and diagnostic tests or clinical procedures – set at 25% for the first package and 10% for the second. These category of claims are also capped at six annually under the first package and doubled with the second.
This policy doesn’t cover pre-existing illness of carcinoma, cancer, leukaemia, systemic lupus erythematosus (SLE), disorder of immune system or blood, diabetes, epilepsy, Parkinson disease or kidney failure/dialysis.
Also not covered are plastic/cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of near-sightedness and the use or acquisition of external prosthetic appliances or devices.
Other exclusions are investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy or expenses incurred for sex changes.
Further excluded are pregnancy or erectile dysfunction related conditions, psychotic, mental, nervous disorders and behavioural conditions and treatment related to dental conditions.