EMPLOYEE BENEFITS

Great Eastern Life Assurance (M) Berhad

Company Name : IFCA MSC Berhad

Policy Period : 01/03/2021 – 28/02/2022

ELIGIBILITY OF BENEFITS

Benefits Entry Age Expiry Age

GHP

Employee/ Spouse 17 – 64 70

Child15 days

(if full time student)

19

(can be extended to 23 if still

studying)

Remark :

GHP - Group Health Plan

Insured Benefits Plan 001 Plan 002 Plan 003

A.Hospital Room and Board(maximum per day, up to 180 days maximum per disability)

250 200 150

B.Intensive Care Unit (maximum per day, up to 30 days maximum per disability)

C. Hospital Supplies and Services

D. Surgical Fees

SCHEDULE OF BENEFIT – INPATIENTGROUP HOSPITAL & SURGICAL

As Charged

E. Operating Theatre

F. Anesthetists Fees

G. In Hospital Physician Visit (maximum 2 visits per day)

H. Day Surgery

I.Pre-Hospital Specialist Consultation (within 60 days prior to hospitalisation)

J.Pre-Hospital Diagnostic Test (within 60 days before hospitalisation)

K.Second Surgical Opinion (within 60 days prior to hospitalisation)

L.Post Hospitalisation Treatment (within 60 days following discharge from Hospital)

Insured Benefits Plan 001 Plan 002 Plan 003

M.Emergency Accidental Outpatient Treatment (within 24 hours/ max. 60 days follow-up treatment)

As ChargedN.Emergency Accidental Dental Treatment (within 24 hours/ max.14 days follow up treatment)

O. Ambulance fees

Daily Cash Allowance at Malaysian Government Hospital

SCHEDULE OF BENEFIT – INPATIENTGROUP HOSPITAL & SURGICAL

P.Hospital (max daily benefit, up to 180 days maximum per disability)

125 60 50

Q. Medical Report Fee Reimbursement 100 100 100

R.Emergency Sickness Treatment (10pm – 8am) (max. per disability)

100 100 100

S. Outpatient Cancer Treatment

As ChargedT. Outpatient Kidney Dialysis

U. Outpatient Physiotherapy

Overall Annum Limit (item A – U) 70,000 50,000 20,000

WHAT’S NOT COVERED UNDER THE INSURED PROGRAMME?

Cosmetic surgery or treatment

Experimental procedures

Substance abuse

Private nursing care

Sexual dysfunction or infertility

Psychotic, mental or nervous disorders

Pregnancy

Congenital or hereditary illnesses

Routine physical examination

Refractive errors

Vitamins/ Supplements

Alternative therapies

Sex Changes

Hospital Deposit

� Most hospitals would require a deposit prior to

admission.

� Deposits* are normally in the range of RM300 –

RM500.

� This deposit will be refunded upon discharge from

hospital if members do not incur any additional non-

payable charges.

� Deposits are determined by the hospitals and may

change from time to time in accordance to the

IMPORTANT NOTE

Overseas Hospitalisation

� Member would need to pay first and eek

reimbursement.

� Reimbursement would be based on reasonable &

customary charges for the similar disability in

Malaysia.

� Medical Report(in English) must be furnished for

reimbursement.

� A copy of Passport is required indicating dates

travelledchange from time to time in accordance to the

internal policies/practices of the hospitals.

e-Medical Card

� This is a identity card to be used for admission intoapproximately 140 panels hospitals in Malaysia.

� This scheme does not apply to non panel hospital

� If admitted to non-panel hospital, member must pay upondischarge and seek reimbursement from Great Eastern.

travelled.

� All bills and receipts must be originals.

Letter of Guarantee (LoG) issuance

Medical professionals team

CALL CENTRE MICARE

Enquiries of medical benefits & coverage

Dedicated team on-call

1300 88 1132 (Toll Free) / 7839 7835

callcenter@micaresvc.com

• Member to presente-Medical card &NRIC to hospitaladmission counter

AD

MIS

SIO

N

• Hospital to contact MiCare formembership verification

• Doctor to fill in PAF and fax/uploadrelevant documents to MiCare

HOSPITAL ADMISSION & DISCHARGE – MICARE (GL)

• MiCare to issue GL within 60minutes to Hospital if themedical condition andtreatment coverage withinthe policy terms &conditions

• Member can contact Micareto follow-up on GL statusadmission counter relevant documents to MiCare

DIS

CH

AR

GE

• Doctor advise patient can bedischarged

• Doctor complete dischargedocuments for patient and passto billing department

• Billing officer compiles allmedical expenses incurred fromdifferent departments(consultations/OT/ pharmacy/lab/radiology etc.)

• Hospital fax final bill withsupporting documents toMiCARE.

to follow-up on GL status(Hotline: 1-300-88-1132 (tollfree) / 03-7839 7835

• MiCare will proceed with

assessment of bills and if no

further Q&A is required, final

LoG will be issued within 2

hours

• Final GL upon discharge will

be extended with 60 days of

post hospitalization visits

subject to policy terms &

conditions

• Final GL includes Post

Hospitalisation coverage

U p t o 4 H O U R S U p t o 2 H O U R S

Some hospitals may require deposit although LoG is issued. This is to cover excluded items under the insurance policy

HOW TO DOWNLOAD

MICARE MYMED APP

Locate and open

Google Play

on the phone

Locate and open App

Store on iPhone

Top Features :

� e-medical card

� Locate Panel Providers

� Request Outpatient Guarantee

Letter

� View Guarantee Letter Status

� Claims Submission

� View Claims History

MICARE MYMED MOBILE APP

� View Claims Utilization

� View Benefits

Policyholder holder are required to provide

member’s email address to register for

mobile app

Dear Valued Member,

Thank you for insuring with MiCare Sdn Bhd.

We are pleased to advise that we have created an access for you through the Micare Mobile Apps for the below

policy:-

Company : XXX

Please refer below for steps to register in the MiCare MobileApps

(a) For iOS device, search for “MiCare Mymed” (without the quotes) at AppStore.

(b) For Android devices, search for “MiCare Mymed” (without the quotes) at GooglePlay.

(c) Use your undersigned UserID below to register as a new user.

Your User ID: XXX

SAMPLE “WELCOME EMAIL”

Your User ID: XXX

(d)Key in your temporary password as shown below to log in to MobileApps (If you have logged in to the web portal,

please use your new password)

Your temporary password: XXXX

What I can view from mobile app?(a) My Info – To view your details such as full name and company name

(b) My Dependents – To view your family details as per the registration (if applicable)

(c)View Panel Clinics – To view panel clinics by address or find a panel nearest you by location. You will be able to

locate the location via Google Map facility

(d) View Utilisation history, reimbursement status & details

Questions?For further queries, email callcenter@micaresvc.com

Alternatively, contact MiCare Call Center (24/7) at 1-800-88-2678

This is an automatically generated email. Please do not reply to this emailaddress.

ACCESS VIA YOUR MOBILE PHONE

My Info Dependents

Panel Provider

Please login with User ID and password that

hasbeen provided in "Welcome Email "from

MiCare.

E-Medical

Card

Utilization

More Logout

Panel Provider

MiCare MyMed user interface will show few

categories outline for member to choose and

view

MICARE MY MED APP:

EMPLOYEE/ DEPENDENT INFO

MICARE MYMED APP:

e-MEDICAL CARD

MICARE MYMED APP:VIEW UTILIZATION

15

MICARE MYMED APP:

FORGOT ID/ PASSWORD

Click Here

THANK YOUTHANK YOU