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Health Insurance: What You Should Know Before Buying One

Insurance is essential in protecting our life from any potential risks that could ruin our financial wellbeing. Be it life insurance, travel insurance or health insurance, all these different types of insurance policies are there to protect you and your loved one in the event of a mishap. Among the many insurance products in the market, health insurance is a must-have policy to include in your financial plan. Health insurance will be a big help in reducing your financial burden of having to pay the hospital bills and the medicine cost that continue to rise.

Malaysian are blessed with public healthcare services which are cheaper and more affordable than private healthcare. But public hospitals are often overcrowded with patients. You may need to wait a long time for a consultation. For that reason, many Malaysians are opting to private healthcare for quicker service and more personalized care. But private healthcare doesn’t come cheap. And that’s why you need health insurance. Health insurance will cover your hospitalization bill when you need it most.

If this is your first time buying health insurance, the intimidating jargons and clauses may lead you to confusion. To help you get started, here are a few things you should know before zeroing down to a suitable medical and health insurance. 

Types of insurance plan you need

Those who work for others often get insured through their employer. But in many cases, the coverage provided by the employer may not be sufficient to protect you. Let’s face it, when your employer purchased the insurance package for the company, they did not consider your current financial health, your commitments and history. Most likely, the insurance is covering the bare minimum or slightly above the minimum. For more comprehensive coverage, you’ll need a professional advisor to look through your financial history and commitments first before prescribing you the products to take.

Therefore, don’t solely rely on the coverage provided by the employer. In the event you lose the job or if you move on to a new company, your insurance will be voided immediately. So here comes the real question: What should you look out for when choosing a health and medical insurance?

Below are the three main types of health insurance for you to choose from.

Hospitalisation and surgical insurance

This is the basic medical plan for anyone who wants medical coverage. This medical plan covers any hospitalisation cost and surgical expenses for any covered illness or injury. This includes room and board, surgeon fees, ambulance fee, diagnostic test and a long list of other benefits. You can be admitted into the hospital without pulling cash out of your pocket as the medical bills will be sent directly to your insurer.

Critical illness insurance

This insurance plan provides a lump sum upon diagnosis of any 36 dread diseases covered by the policy. Critical illness plan is suitable for someone with an inherited illness or could be diagnosed with life-threatening diseases. The insured can use the payout for anything and not restricted to medical treatment only.  

Hospital income insurance

This plan provides cash benefits on a daily, weekly or monthly basis depending on your policy during your hospitalisation. This insurance plan is suitable for people who need daily cash to support their family while staying in the hospital.

Policy exclusions

The exclusions in health insurance refer to the treatment, illness or anything that the insurer does not cover. You have to recognise the major exclusions in your policy so it won’t affect your claim process in the future. The exclusions may vary depending on which medical plan you choose. But the most common exclusions in health insurance would be:

  • Pre-existing conditions: The illness or health condition you had before applying the policy. Your insurance company will exclude these pre-existing illnesses from the coverage.
  • Medical treatment or surgery arises within the first 30 days of the plan 
  • Cosmetic surgery/dental care/corrective lenses/pregnancy treatment/mental illness

Other essential terms you need to know

  • Annual limit

The total claimable amount you can make in a year

  • Lifetime limit

The total claimable amount you can make during the policy.

  • Room and board limit

The benefit limit that covers the cost of hospital stay including the wardroom, meals provided and essential nursing care.

  • Co-insurance

Requires you to share at least 10% of the total medical cost with your insurer. Your insurer will cover the rest 90% of the cost.

  • Deductibles

A fixed amount of upfront payment that you have to make for your medical cost before your insurer begins to cover the subsequent expenses. 

  • Guaranteed renewal

Ensures the renewal of your policy despite recent diagnosis as long as the premiums are paid.

  • No guaranteed renewal

Some insurance policy doesn’t guarantee a renewal. Which means, the company has a right to reject your renewal request.

  • Panel hospital

The list of hospitals that works together with your insurer. Make sure to choose an insurance plan that works with hospitals that are easily accessible and provide cashless facilities. 

  • Waiting period

The qualifying period before you get the medical coverage. The waiting period is usually around 30 days and you are now allowed to make a claim within the period.

  • Free-look period

A period usually around 2 weeks for you to decide whether to accept or cancel your policy.

  • Outpatient treatment

The cost of pre-hospitalisation which includes follow-up treatment, kidney dialysis, cancer treatment and other medical procedures stated under the policy.

When is the best time to buy medical insurance?

Do not wait too long to get medical insurance. The perfect time for you to purchase one is when you’re still young and healthy. Why is that so? Because the older you are, the greater the likelihood that you will be diagnosed with diseases. Most insurance companies won’t cover the illness that you had before you buy their policy. You may need to fork out a hefty price and pay for a higher premium to get your existing condition covered.

Are you insured? 

If you’ve not gotten your health insurance, perhaps this is a good time to shop around for the best policy. If unsure, do more research and speak to a professional financial adviser to decide how much coverage you need. Compare and contrast for the best insurance scheme in the market.

Our needs are changing along with time. Your current state of health may not be the same as when you first bought it. That’s why you need a continuous review of your policy to ensure adequate coverage. With SyncWealth, you can regularly review your policy with just a click away. Reviewing a policy is essential in finding areas in which you might have too much coverage or areas in which you are underinsured

Whether it’s your personal health plan or employer-provided insurance, make sure you have sufficient health coverage to prevent any undesirable incident down the line.


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