A-Plus MedCare-i

Q: What is Takaful?

Takaful is a mutual assistance scheme based on the principles of solidarity, brotherhood, and cooperation. Each participant agrees to contribute based on Tabarru‘ (donation) into a fund, namely the Participants’ Risk Fund (PRF), which will be used to assist each other in times of need. AIA PUBLIC Takaful Bhd. (AIA PUBLIC) as a Takaful Operator is entrusted to invest and manage this fund in accordance with Shariah-compliant investment strategy.

Q: What is A-Plus MedCare-i?

A-Plus MedCare-i is an optional unit deducting rider that provides Personal Medical Case Management (PMCM) benefit, focusing on ensuring that you receive the best possible treatments and personalised ongoing support throughout your medical journey when you face serious medical conditions.

In the event that overseas medical treatment is recommended (i.e. outside of Malaysia), and you decide to proceed with the recommended treatment, we shall reimburse the flight ticket for you and one companion, to and/or from the location of such treatment up to a combined limit of RM10,000 per lifetime.

Q: Who is eligible to participate A-Plus MedCare-i?

A-Plus MedCare-i is available to A-Life Link-i, A-Life Joy-i and A-Life Fleksi customers entry age between 14 days to 70 years old.

Q: What is the expiry age or coverage term of A-Plus MedCare-i?

A-Plus MedCare-i is renewable yearly up to the expiry of the basic plan that it is attached to. A-Plus MedCare-i will be renewed automatically on each rider anniversary. 

Q: How much Tabarru’ do I have to contribute?

Tabarru’ is RM10 per month. Please note that the Tabarru’ is not guaranteed and we reserve the right to revise the Tabarru’ rate by giving you 30 days’ prior written notice.

Q: What are the fees and charges that I have to pay?

There are no fees and charges other than Tabarru’ deducted.

Q: How does A-Plus MedCare-i differ from a second opinion?

Most second opinion services review medical reports and information to provide an independent diagnosis and recommended treatment plan. Following the second opinion, a patient is often left with questions, as well as the need to find the best doctor and hospital to administer the treatment.

With A-Plus MedCare-i, the customer is never alone. This 24/7 service accompanies the customer at all times, throughout the journey of diagnosis, treatment, monitoring the treatment progress until recovery.

Q: How will my medical information and reports be obtained?

When you are eligible and decide to use the PMCM benefit, you will be required to sign the service acceptance form and confidentiality waiver form. With the form, our service provider is authorised to require from you to provide all of the relevant information and medical documents relating to your medical case.

We recognise the importance and sensitivity of such personal data and will only share information that is required to accurately analyse the customer’s condition, and enable appropriate recommendations to be made.

Q: Will I be referred for treatment abroad?

The assessment of treatment is based on medical necessity. Generally, you will be referred to available treatment locally, but you may be recommended for consultation or treatment abroad in the rare instances where there is a lack of local expertise in relevant fields.

Please note that if you decide to proceed with the treatment plan as recommended by our service provider, the cost of medical treatment may or may not be covered under your Certicate or medical card with us. You are advised to confirm your Certificate coverage with us before performing the treatment. 

Q: What if the treating doctor disagrees with the treatment recommendation?

In such a situation, with the patient’s permission, the service provider will discuss the case with the treating doctor and collectively agree upon the best course of action for the patient. At the end of the day, the patient will make a final decision on how to proceed with the suggested treatment plan.

Q: What happens in the case of a wrong medical recommendation?

The decision of treatment is always taken jointly with the patient’s treating doctor, together with the patient’s consent. It is important to note that our service provider do not treat patients directly, nor prescribe medications, nor execute treatments or procedures, and therefore would not be able to take on the responsibility of the treating doctor. However, our service provider does have Professional Medical Liability Insurance and takes full responsibility for its medical recommendations.

AIA PUBLIC is not involved in the recommendations that is provided. The intent is for our service provider to provide independent medical advice.

Q: What are the major exclusions for A-Plus MedCare-i?

The following conditions are excluded for coverage under the PMCM benefit:

1. Emergency care and or any medical conditions of urgent invasive and/or urgent surgical procedures;
2. Diabetes;
3. Short stature as an isolated condition;
4. Endocrine conditions that affect only fertility;
5. Isolated snoring (without sleep apnea);
6. Cosmetic/Aesthetic surgery;
7. Excluded medical conditions in the pediatric medical field:
   1.  Pediatric gastroenterological diseases of the following types:
      1. Failure to thrive; and
      2. Eating disorders (e.g., anorexia, bulimia);
   2. Attention Deficit/Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD); and
   3. Any Medical Condition pertaining to premature babies during initial hospitalisation after birth or during the first six (6) months of life.
8. Excluded disorders:
   1. ADHD and ADD; and
   2. Anorexia/Bulimia and other related eating disorders
9. Fertility-related conditions or procedures, with the exception of cases of three (3) or more consecutive miscarriages;
10. Obstetrics;
11. Child, youth, and adult psychiatric and/or mental diseases;
12. Conditions related directly or indirectly to issues of looks and aesthetics, including obesity, with the exception of reconstructive breast surgery following a mastectomy;
13. Medical conditions in the fields of dentistry;
14. Fibromyalgia disease;
15. Chronic fatigue syndrome;
16. Complete and irreversible blindness;
17. Acute Cerebrovascular Accident (CVA);
18. Severe burns if patient is hospitalised;
19. Allergies;
20. Sexually Transmitted Diseases (STD);
21. Human Immunodeficiency Virus (HIV);
22. Obesity;
23. Any condition that necessitates urgent medical attention; and
24. Any condition resulting from substance, drug or alcohol addiction.

Note: The list is non-exhaustive. Please refer to the Takaful certificate for the full details of the exclusions.

• Please note that if you decide to proceed with the treatment plan as recommended by our service provider, the cost of medical treatment may or may not be covered under your Takaful Certificate or medical card with us. You are advised to confirm your Takaful coverage with us before performing the treatment.
• AIA PUBLIC is not involved in the recommendations that the PMCM team provides as the intent is for the service provider to provide independent medical advice.
• A waiting period of 30 days is applicable starting from the commencement date or reinstatement date of this rider, whichever is later. During this waiting period, you shall not be eligible for the benefits stated above.
• If the basic certificate of the Investment-Linked Takaful to which this rider is attached, is cancelled within the 15-day free look period, the Wakalah Fee, value of units (if any), Tabarru’ and any other charges that have been deducted less medical expenses (if any) will be refunded. 
• The Tabarru' for this plan is not guaranteed and We reserve the right to revise the Tabarru' by giving you 30 days’ prior written notice. 
• We reserve the right to cancel the portfolio as a whole if it decides to discontinue this rider by giving 30 days’ prior written notice to You.
• You are advised to refer to the Product Brochure, Product Illustration and Product Disclosure Sheet for further information.