Monday, September 10, 2012

What to do should you need hospitalization?

This is useful for those whom have never been admitted to the hospital before as it can be a daunting experience to some.

Most insurance company have standby staffs even on weekends or public holidays, hence getting a Guarantee Letter during those days is not really an issue. Hence getting yourself admitted during weekends/public holidays is just like getting admitted on weekdays.

The first thing to remember should you need to get hospitalized is call your servicing agent. Have him /her on speed dial and on your spouse hand phone number. 

Contrary to popular belief, even without the servicing agent's help you're still able to get yourself admitted. Yes its true. All you need to know is your I/C or passport number and at least know you're going to claim from which insurance company (if you have multiple medical card). Should you are being covered by your company medical insurance, do use that first. Should the hospital bill is RM 10K, and your company only covers RM 8K, the balance of RM2k can be claimed from your personal medical card. However, if you were to opt to use your personal medical card, definitely it is still possible.

You don't even need to remember your policy number nor do you need to bring along your medical card (though it helps to remember to fasten the process of getting admitted). The reason is that PRIVATE hospitals are mostly linked to the insurance company. 

This is also the reason why insurance company can easily check your hospitalization records, should they want to, in the event of non-disclosure.

The second thing you need to remember is hospital deposits. The hospital deposits are being introduced with the introduction of co-insurance concept, meaning based on the hospital bill the insurance company will only pay 90% (or lesser) of the bill. In western countries, this is known as deductible.

Even if your card covers 100% of the bill, you may still be required to pay for a minimal hospital deposits, ranging from RM300~RM600, depending on the hospital. Should you are admitted without a medical card, the minimum deposits could range from RM2,500 or higher, depending on the severity of the case. Anything that involves surgical may need a deposits of RM 5K or more if you're without a health insurance.

Thirdly, do remember when is your cover date. This is important as most health insurance have waiting periods for certain ailments. The waiting period range from 30days to 4 months. For a lists of waiting period, do check out the Exclusion clause.

Once the hospital staffs gets confirmation from the insurance company, the insurance company will issue a Guarantee Letter (GL) to the hospital.

Other things to remember:

1. Prior to the event of hospitalization, you may have seek treatment at a local clinic, eg for flu and later was admitted as the flu did not subside. Keep those bills as it is claimable under Pre hospitalization. Bills up to 30days could be claimed. However the admission and the previous bill must tally in terms of the sickness. Should the sickness of flu was treated at the clinic, but admission was due to an accident, the bill for the flu is not claimable.

2. Upon discharged, most of the time the doctor will ask you to come back for a few follow ups. This is known as Post hospitalization and is a pay and claim process. Hence please bring your "plastic" to the hospital if needed.

Upon the last follow up, do check with the hospital insurance counter whether there are still balance for the hospital deposits. The hospital will reimburse to you should there be left over for the hospital deposit.

As usual, keep the bills for the post hospitalization and pass it to your agent to help with the claim process once you're done with the last followup.