AIA Med Basic FAQ

AIA Med Basic is a yearly renewable insurance plan which provides coverage for hospitalisation and surgical expenses up to age 70. 

This plan is commission-free and no intermediaries are involved in the sales or marketing of AIA Med Basic.

This plan is available to individuals aged 16 to 55, subject to underwriting.

This plan covers:

Notes:

1. This plan does not cover pre- and post-hospitalization and outpatient treatment.

2. Deductible is a fixed amount you have to pay for the medical expenses incurred as cost sharing. You have to pay the first RM300 out of the eligible expenses for any one disability, and we will pay for the rest of the eligible expenses.

3. "Any One Disability" means that if two or more Confinements are due to the same or related disability, or any complications arising from it, such confinements shall be regarded as one confinement if each of them is not separated by more than 90 days from the discharged date.

If you pass away during the policy’s term, no benefits will be payable as AIA Med Basic does not cover death.

Your coverage begins immediately after your premium payment is confirmed.

You can pay the premium for this plan with your debit card or credit card.

The premium for this plan is not guaranteed and may be increased in the future. We reserve the right to revise the premium rates by giving you 30 days written notice prior to the next policy anniversary.

Premiums are payable until the end of the policy term. Please note that the premium rate will increase depending on the attained age last birthday when the premium is due.

You can find the full premium rates in the Product Disclosure Sheet.

You can change your premium payment method or payment mode at our customer portal, My AIA. Please click on this link to login or register.

This plan is renewable every year up to the age of 70. Your policy will be renewed automatically on each policy anniversary as long as the premiums are paid.

No, you can only buy one (1) AIA Med Basic.

No, there is only one plan for AIA Med Basic.

Please note that this medical plan is cardless, hence you will not receive any medical card. For the cashless facility at admission, please refer to question 23 for more information.

Upon your successful purchase and premium payment, we will send you a confirmation email together with your e-policy contract. Please keep this email secure as proof of coverage. However, should you lose this email, you can always log on to our customer portal, My AIA, to view your policy details and download a copy of your e-policy contract. Please click on this link to login or register.

Yes, you have the option to cancel or surrender your policy. We will refund the premium based on the table below, provided that no claims have been made during the current policy year.

(Note: * not applicable to first Policy Year due to Free Look Period)

Free Look Period – You may cancel your policy by returning your policy contract and giving a written request signed by you to AIA Bhd. within fifteen (15) days after you have received your policy contract. The premiums that you have paid will be refunded.

You may reinstate your policy before the policy’s expiry date by visiting any AIA Customer Centres, subject to the following:

• (i) You are within the allowable age limits at the time of reinstatement;
• (ii) You have to produce evidence of insurability that is satisfactory to Us;
• (iii) You have to pay all overdue premiums; and
• (iv) Any other terms and conditions which we may impose at the time of reinstatement.

Please note that the reinstated policy shall only cover loss or the insured event which occurs after the reinstatement date after the applicable waiting period.

There are no fees, charges or taxes other than your premium payments. 

The eligibility for benefits under the policy will only start after a specific period from the Issue Date or Commencement Date, whichever is later, of the policy. This period is known as the “Waiting Period”.

Yes. The waiting period for AIA Med Basic will apply from the Issue Date or Commencement Date, whichever is later, and is as follows:

Deductible is a fixed amount you have to pay for the medical expenses incurred as cost sharing. You have to pay the first RM300 out of the eligible expenses for any one disability, and we will pay for the rest of the eligible expenses.

For example, if the total eligible expenses are RM5,000, the amount payable by you is RM300 and we will pay for RM4,700. 

Annual limit is the maximum amount we will pay in a year for this plan and lifetime limit is the maximum claimable amount for this plan throughout your life time.

This policy does not cover:

• (a) Pre-existing illness prior to the Issue Date or Commencement Date, whichever is later; or
• (b) Treatment or surgery for Specified Illnesses until the Insured has been continuously covered under this Policy for a period of one hundred and twenty (120) days; or
  
• (c) Any medical or physical abnormalities existing at the time of birth, as well as neo-natal physical abnormalities developing within 6 months from the time of birth. They will include hernias of all types and epilepsy except when caused by a trauma which occurred after the date that the Insured was continuously covered under this Policy and any congenital or hereditary conditions which has manifested or was diagnosed before the Insured attains 17 years of age; or
• (d) Any Disability caused by self-destruction, intentional self-inflicted injuries, willful exposure to danger or any attempt of self-destruction while sane or insane; or
• (e) War, declared or undeclared, strikes, riots, civil war, revolution or any warlike operations; or
• (f) Service in the armed forces in time of declared or undeclared war or while under orders for warlike operations or restoration of public order; or
• (g) Any violation or attempted violation of the law or resistance to arrest; or
• (h) Pregnancy, miscarriage or child birth; or
• (i) Mental or nervous disorders, treatment of alcoholism, or drug abuse or any other complications arising from it or any drug accident not prescribed by a treating doctor; or
• (j) Elective/Plastic/Cosmetic surgery, circumcision (except circumcision due to infection), eye examination/elective surgery for visual impairments due to nearsightedness, farsightedness or astigmatism or radial keratotomy; all corrective glasses, contact lenses and intraocular lens (except monofocal intraocular lenses in cataract surgery) or the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids, and prescriptions; or
• (k) Any form of dental care or Surgery unless necessitated by injury but excluding the replacement of natural teeth, placement of denture and prosthetic services such as bridges and crowns or their replacement; or
• (l) Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered disability or any treatment which is not medically necessary and any preventive treatments, preventive medicines or examinations carried out by a physician, vitamins/food supplements and treatments specifically for weight reduction or gain; or
• (m) Any treatment or investigation which is not medically necessary, or convalescence, custodial or rest care; or
• (n) Any medical or physical conditions arising within the first 30 days of the Issue Date or Commencement Date of this policy, whichever is later except for covered injury; or
• (o) Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapon material; or
• (p) Expenses incurred for donation of any body parts or organ by the Insured and acquisition of the organ including all costs incurred by the donor during organ transplant and its complications. We will only reimburse the Reasonable and Customary Charges incurred on Major Organ/Bone Marrow Transplant Surgery for the Insured being the recipient, limited to once per lifetime; or
• (q) Medical treatment received by the Insured outside Malaysia apart from Singapore and Brunei, if the Insured resides or travels outside Malaysia for more than 90 consecutive days. Benefits in respect of the treatment shall be limited to the Reasonable and Customary and Medically Necessary Charges for such equivalent local treatment in Malaysia and shall exclude the cost of transport to the place of treatment.

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

You can download the claim form here. Please complete the form, including your bank information as we will pay the approved claim directly to your bank account via e-payment.

Below is the list of documents for your claims’ submission:

1) Individual Hospitalisation Claim Form

2) Original itemised bills (Invoice/Statement) and original official receipts including deposit receipts

3) Copy of Lab and Radiology Reports (MRI, CT Scan, Ultrasound, X-Ray, ECG, Histopathology, Biopsy & Other Medical Tests)

4) For Overseas Treatment, to include: Copy of Passport Indicating Biodata, Dates of Departure from Malaysia and Arrival Overseas or copy of Flight Ticket/Boarding Pass,

Original Detailed Admission Bill showing breakdown of each charges and translation of foreign language.

Any non-original documents must be certified as true copy by AIA’s authorised staff at any AIA Customer Centres.

You can submit the completed claim form together with the necessary documents at any AIA Customer Centres.

The cashless facility is only applicable for our panel and platinum hospitals.

For prompt processing of your admission, please present your Identity Card and referral letter, where applicable, to the hospital admission officer. Note that no medical card is required for the admission process. If you are eligible for the Letter of Guarantee, you are required to sign a claim form upon admission to the hospital and an approved claims statement at the time of discharge. Please also note that you will need to pay the deductible amount of RM300, and any other ineligible expenses upon discharge.

Any non-eligibility or invalidity of the cashless facility will be communicated to you through the hospital. Guarantee letter is a value-added service and is subject to the policy terms & conditions and information available during the request of Guarantee Letter. In the event you are hospitalised and not eligible for the Guarantee Letter, you will have to pay the charges in full and submit your claim with all the necessary documentation. Please refer to question 22 for more information on the necessary documentation for claims.

Letter of Guarantee is an assurance of payment offered by us confirming that the cost of treatment is eligible under the plan and will be covered by us. This letter is only applicable for our panel and platinum hospitals.

There are some specialists within the appointed panel hospitals that do not have any working arrangement with AIA Bhd. Policyholders who seek treatment from non-panel doctors will have to pay the charges in full and submit your claim with all the documents. Please refer to question 22 for more information on the documents for claims.

In the event you seek treatment from a non-panel hospital, you will have to pay the charges in full. Once this is done, you may submit your claim with all the documents. Please refer to question 22 for more information on the documents for claims.

To locate a panel and platinum hospital near you, please click here.

You can check your claims’ status by registering as a user of our customer portal My AIA. Please click on this link to register. You can also visit any of our Customer Centres or contact our Care Line at 1300 88 1899.

Please leave us your contact details by clicking on this link. You can also call our Care Line at 1300-88-1899.

If you send us an email, you will receive an immediate automated acknowledgement. Our customer service representatives will respond to your email within 3 working days.