Complete Medical Coverage for Employees with MediGap Care

The benefit(s) payable under eligible product are protected by PIDM up to limits. Please refer to PIDM’s TIPS Brochure or contact MCIS Life or PIDM (visit www.pidm.gov.my).
MediGap Care

Complete Medical Coverage for Employees with MediGap Care

The benefit(s) payable under eligible product are protected by PIDM up to limits. Please refer to PIDM’s TIPS Brochure or contact MCIS Life or PIDM (visit www.pidm.gov.my).

Feel empowered knowing you have added medical coverage whenever you need it.

MediGap Care revolutionizes medical coverage with its Group Yearly Renewable Hospitalisation and Surgical plan, offering essential top-up protection against illness or accidental injury.

Tailored for employees, organization members, associations, or groups and their dependents, this plan ensures comprehensive coverage for all.

Even if one resigns from their company or ceases to be a member of the organization, the coverage for the Life Assured remains intact, offering peace of mind for the long haul.

The MediGap Care advantage

Multiple choice of plan

5 plan to choose from with 3 deductible options.

Affordable premium

Lower premium with the deductible option

Continuous coverage

Continue the medical coverage even after you resigned from the company or no longer a member with the organization/association.

Peace of Mind upon age 60

Conversion to zero deductible plan upon attaining age 60

Extra coverage

On top of your existing medical coverage

MediGap Care Medical Plan Benefits

Enhanced Medical Coverage

MediGap Care is an employee top-up medical plan designed to provide supplementary coverage for hospitalisation and surgical expenses arising from accidents or illnesses. This ensures that employees and members of organizations, associations, or groups receive the additional financial support they need during medical emergencies.

Comprehensive Protection

The plan caters to the medical needs of corporate employees and members of various organizations, offering a range of plans and deductible options. This flexibility allows individuals to choose the coverage that best suits their needs.

Seamless Continuity

One of the standout features of MediGap Care is its commitment to providing continuous medical coverage. Upon reaching the age of sixty (60), the plan transitions from a chosen deductible plan to a zero deductible plan, ensuring uninterrupted protection.

Post-Retirement Security

MediGap Care extends its benefits beyond active employment. Coverage for the Life Assured continues even after retirement or career transitions, maintaining protection regardless of changes in employment or organizational membership.

Dependents Coverage

The plan is designed not only for individuals but also for their dependents*, offering peace of mind that family members are also protected under the same comprehensive medical plan.

Learn More

MediGap Care is a group annual renewable hospitalization and surgical plan providing medical coverage for illness or accidental injury, beyond the deductible (if applicable), in accordance with the terms and conditions of the chosen plan.

The deductible is the amount you must pay first, based on your selected deductible*, before MCIS Life will cover the total eligible expenses, subject to the overall annual limit.

Note: *Deductible is not applicable to Outpatient Treatment Benefits

An employee, or member of an organization, association or group of persons, and their dependent(s) (spouse/child) at the minimum and maximum entry age as per the table below:

Life Assured   Employee/Spouse Child
Minimum Entry Age 16 Age Next Birthday
(ANB)
30 days
Maximum Entry Age 59 ANB 19 ANB
(25 ANB if full time student)
Maximum Renewal Age 84 ANB
Maximum Maturity/Expiry Age 85 ANB

This is a yearly renewable plan that covers you up to age 85 (ANB).

The premium you need to pay may vary based on the chosen plan, deductible option, the Life Assured’s age next birthday, and other underwriting requirements of MCIS Insurance Berhad. This premium is not guaranteed. MCIS Life reserves the right to adjust the premium rate if actual claim experience is worse than expected, with at least thirty (30) days prior written notice.

The table below explains:

  Benefits Plan Type
Plan 100
(RM)
Plan 100
(RM)
Plan 150
(RM)
Plan 150
(RM)
Plan 200
(RM)
Hospitalisation and Surgical Benefits
1. Hospital Room and Board
(Limit per day and up to 120 days per disability)
100 100 150 150 200
2. Intensive Care Unit
(Limit per day and up to 90 days per disability)
500
3. Hospital Supplies and Services As Charged, subject to Reasonable and Customary Charges
4. Surgical Fees
(Post-surgical care is within 90 days following discharge)
5. Operating Theatre Fees
6. Anaesthetist Fees
7. Ambulance Fees
8. Daycare Surgery
9. In-Hospital Physician Visit
(2 visits per day and up to 120 days per disability)
10. Goods and Services Tax
11. Medical Report
(Limit per Disability)
100
Pre-Hospitalisation Benefits
12. Pre-Hospitalisation Diagnostic Test Benefit
(within 90 days before hospitalisation)
As Charged, subject to Reasonable and Customary Charges
13. Pre-Hospitalisation Specialist Consultation
(within 90 days before hospitalisation)
As Charged, subject to Reasonable and Customary Charges
Post-Hospitalisation Benefits
14. Post Hospitalisation and Daycare Surgery Follow-up Treatment
(within 90 days after discharge)
As Charged, subject to Reasonable and Customary Charges
Outpatient Treatment Benefits
15. Outpatient Kidney Dialysis Treatment As Charged, subject to Reasonable and Customary Charges
16. Outpatient Cancer Treatment
17. Emergency Accidental Outpatient Treatment
(Limit per Accident, maximum 90 days from date of Accident for follow-up treatment)
1,000 1,000 1,500 1,500 2,000
18. Emergency Accidental Outpatient Dental Treatment
(Limit per Accident, maximum 30 days from date of Accident for follow-up treatment)
1,000 1,000 1,500 1,500 2,000
Other Benefits
19. Home Nursing Care
(Limit per Disability)
500
20. Second Medical Opinion
(within 90 days before hospitalisation)
As Charged, subject to Reasonable and Customary Charges
Limits
21. Overall Annual Limit 75,000 100,000 150,000 200,000 500,000
22. Overall Lifetime Limit No limit
Deductible Option
23. Deductible
(per certificate year)
5,000; or
10,000; or
30,000; or
 

Yes, the premiums paid for this plan may qualify you for a personal tax relief for medical insurance, subject to the final decision of the Inland Revenue Board of Malaysia.

No, reinstatement is not allowed.

This plan does not cover:
  1. Pre-Existing Conditions
  2. Disability signs/symptoms within 30 days from Certificate Effective Date
  3. Specified Illness within 120 days from Certificate Effective Date
  4. Cosmetic/plastic surgery, circumcision (unless medically necessary), vision correction surgeries (e.g., Lasik), prosthetics, and non-medical devices
  5. Dental conditions and treatments, except for acute traumatic injury to natural teeth
  6. Private nursing, illegal drugs, alcohol intoxication, sterilization, venereal diseases, AIDS, HIV, and quarantinable communicable diseases
  7. Congenital abnormalities, hereditary conditions, developmental issues, and complications thereof
  8. Pregnancy, childbirth, miscarriage, abortion, and related care; birth control and infertility treatments
  9. Erectile dysfunction treatments
  10. Hospitalization for investigatory purposes, general exams, non-medically necessary treatments, and preventive care
  11. Drug abuse, substance misuse, and alcohol-related injuries or hospitalizations.
  12. Suicide, self-inflicted injuries.
  13. War, terrorism, active military duty, strikes, riots, nuclear, biological, and chemical warfare.
  14. Ionizing radiation or radioactive contamination
  15. Organ donation costs, including donor expenses.
  16. Sleep and snoring disorders, hormone replacement, stem cell therapy, PET scans, and alternative therapies.
  17. Care covered by other insurance or Workman’s Compensation
  18. Mental or nervous disorders
  19. Non-medical expenses (e.g., TV, phone, internet, admission kits)
  20. Hazardous sports and racing (except foot racing)
  21. Unlawful acts, assaults, felonies
  22. Private flying, except as a fare-paying passenger on commercial flights
  23. Sex change expenses
  24. Neonatal conditions within the first 30 days from Certificate Effective Date or birth

Note: This list is non-exhaustive. Please refer to the policy contract for the full list of exclusions under the policy.

 

Note

  • The above list is not exhaustive. Please refer to the Policy Contract for full details.
  • The product information provided on this website is for general information only and does not tantamount to a contract of insurance. You are advised to refer to the Product Brochure, Sales Illustration (if applicable), Product Disclosure Sheet and Policy Contract for complete details of the product.
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