Brochure: ExcelCare Plus & MediCover Plus

PROTECTION 

EXCELCARE PLUS & MEDICOVER PLUS 

About AIA Bhd. 

American International Assurance Bhd. (AIA Bhd.) began 

operations in Kuala Lumpur, Malaysia in 1948 as a branch 

of American International Assurance Company, Limited 

(AIA). With over 60 years of local market presence, AIA 

Bhd. has now become one of the country’s largest life 

insurers, with a network of 23 branches nationwide. The 

company’s focus is on designing new and innovative 

products to meet the changing needs of the market. AIA 

Bhd. is a member of the AIA Group. 

About the AIA Group 

AIA Group Limited and its subsidiaries (collectively “the AIA 

Group” or “the Group”) comprise the largest independent 

publicly listed pan-Asian life insurance group in the world, 

with a broad footprint spanning 15 markets in Asia Pacific. 

The Group traces its roots in the region back more than 90 

years and has total assets of US$107.9 billion. 

The AIA Group meets the protection, savings and 

investment needs of individuals by offering a 

comprehensive suite of products and services covering 

accident and health insurance, life insurance and 

retirement planning. It also provides employee benefits, 

credit life and pension services to corporate clients. 

The Group has operations in Hong Kong, Thailand, 

Singapore, China, Malaysia, Korea, the Philippines, 

Australia, Indonesia, Taiwan, Vietnam, New Zealand, 

Macau, Brunei and India. It is a market leader in the Asia 

Pacific region based on life insurance premiums, and holds 

number one positions in six of its geographical markets. 

AIA Group Limited is listed on the Main Board of The Stock 

Exchange of Hong Kong Limited under the stock code ‘1299’. 

Alor Setar 

Wisma AIA 

999 Jalan Telok Wanjah 

05200 Alor Setar 

Kedah Darul Aman 

Tel: 04 - 735 5372 

Fax: 04 - 731 9325 

Batu Pahat 

Wisma AIA 

54A Jalan Rahmat 

83000 Batu Pahat 

Johor Darul Takzim 

Tel: 07 - 431 1821 

Fax: 07 - 433 1488 

Bukit Mertajam 

Wisma AIA 

543 Jalan Sungai Rambai 

14000 Bukit Mertajam 

Seberang Perai 

Tel: 04 - 538 6421 

Fax: 04 - 538 9078 

Ipoh 

Wisma AIA 

118 Jalan C M Yusuff 

30250 Ipoh 

Perak Darul Ridzuan 

Tel: 05 - 255 7479 

Fax: 05 - 255 9163 

Johor Bahru 

Wisma AIA 

2 Jalan Bukit Timbalan 

80000 Johor Bahru 


Tel: 07 - 227 8440 

Fax: 07 - 223 7579 

Klang 

Ground Floor, Menara A&M 

No 3, Jalan Istana 

41000 Klang 

Selangor Darul Ehsan 

Tel: 03 - 3373 2367 

Fax: 03 - 3371 7615 

Kluang 

Wisma AIA 

230 Taman Kurnia 

Jalan Mersing 

86000 Kluang 


Tel: 07 - 774 5145 

Fax: 07 - 772 0908 

Kota Bharu 

2nd and 3rd Floor 

Lot 164, Section 8 

Jalan Pintu Pong 

15000 Kota Bharu 

Kelantan Darul Naim 

Tel: 09 - 747 3523 

Fax: 09 - 747 0761 

Kota Kinabalu 

Wisma AIA 

13 Jalan Karamunsing 

88000 Kota Kinabalu 

Sabah 

Tel: 088 - 248 545 

Fax: 088 - 221 775 

Kuala Lumpur 

Menara AIA 

99 Jalan Ampang 

50450 Kuala Lumpur 

Tel: 03 - 2056 1111 

Kuantan 

Wisma AIA 

103 Jalan Tun Ismail 

25000 Kuantan 

Pahang Darul Makmur 

Tel: 09 - 517 8795 

Fax: 09 - 515 7151 

Kuching 

Wisma AIA 

216 Jalan Song Thian Cheok 

93100 Kuching 

Sarawak 

Tel: 082 - 422 684 

Fax: 082 - 245 408 

Kulim 

67-I Jalan Raya 

09000 Kulim 


Tel: 04 - 495 9645 

Fax: 04 - 491 2858 

Melaka 

Wisma AIA 

96 Jalan Munshi Abdullah 

75100 Melaka 

Tel: 06 - 286 2364 

Fax: 06 - 281 3088 

Miri 

Wisma AIA 

Lot 663 Jalan Merbau 

98000 Miri 

Sarawak 

Tel: 085 - 426 413 

Fax: 085 - 414 355 

Petaling Jaya 

Level 3, Menara Axis 

No 2, Jalan 51A/223 

46100 Petaling Jaya 

Tel: 03 - 7680 8686 

Fax: 03 - 7680 8666 

Pulau Pinang 

Ground Floor 

Wisma Leader 

No 8, Jalan Larut 

10050 Pulau Pinang 

Tel: 04 - 222 6262 

Fax: 04 - 222 6222 

Sandakan 

Wisma AIA 

Block 30 

Jalan Dua 

90000 Sandakan 

Sabah 

Tel: 089 - 220 486 

Fax: 089 - 218 308 

Seremban 

20 Jalan Dato' Lee Fong Yee 

70000 Seremban 

Negeri Sembilan 

Darul Khusus 

Tel: 06 - 763 5768 

Fax: 06 - 764 4312 

Sibu 

17, 1st Floor 

Jalan Bindang 

(Brooke Drive 1) 

96000 Sibu 

Sarawak 

Tel: 084 - 347 740 

Fax: 084 - 343 900 

Sungai Petani 

Wisma AIA 

8 Taman Patani Baru 

Jalan Kampong Baru 

08000 Sungai Petani 


Tel: 04 - 421 2327 

Fax: 04 - 423 4257 

Taiping 

Wisma AIA 

28 Jalan Long Jaafar 

34000 Taiping 

Perak Darul Ridzuan 

Tel: 05 - 808 4845 

Fax: 05 - 806 8988 

Tawau 

Wisma AIA, 

TB 275 Block 29 

Jalan Haji Karim 

91000 Tawau 

Sabah 

Tel: 089 - 754 166 

Fax: 089 - 752 949 

We ensure long term 

protection for your 

lifetime needs 

A medical protection plan that has invaluable hospitalisation 

coverage till age 100 with an option to attach an unlimited overall 

lifetime limit plan. 

The Power of We 

PT0810209 

AIA Bhd. is licensed under the Insurance Act 1996 

& regulated by the Central Bank (Bank Negara Malaysia). 

AIA.COM.MY 

Rev 0611

ExcelCare Plus & MediCover Plus 1 

ExcelCare Plus / MediCover Plus 

Hospitalisation and Surgical Insurance 

What are ExcelCare Plus and MediCover Plus about? 

ExcelCare Plus 

Would you compromise the recovery of your loved ones by settling for less? 

Few of us actually plan for hospitalization expenses. On top of that, with the rise in medical 

inflation, this can easily bring medical expenses to ten-thousands of ringgit. The truth is, a 

completely unforeseen and unavoidable operation can sometimes dry up our savings. 

ExcelCare Plus provides for hospitalization and surgical expenses incurred and offers protection 

up to age 100. 

MediCover Plus 

Worried that your basic ExcelCare Plus medical reimbursement lifetime limit may be insufficient 

for you and your family’s long term medical needs? 

As a dedicated child, parent or spouse, you would try to seek the best possible medical attention 

available and for as long as possible. Your existing plan may be insufficient for a better and 

longer term protection. As a result, the hard-earned savings meant for your family’s future will be 

eroded. 

With MediCover Plus rider, you can rest assure that your insurance is sufficient to cover you 

and your family for life with minimal additional premium payable on top of your ExcelCare Plus 

premium. 

MediCover Plus provides for hospitalization and surgical expenses and offers higher protection 

limits to complement ExcelCare Plus. 

BENEFITS 

What are the coverage / benefits provided? 

ExcelCare Plus offers: 

• A choice of medical reimbursement lifetime limit ranging from RM200,000 to as high as 

RM700,000 

• 24-hour protection 

• Lifelong protection to age 100 

• Zero co-insurance for claims within a specified amount 1 

• Lower rates via the Family Plan 

• Hassle-free assistance in your admission to the hospital via AIA Health Services 2 

• Worldwide coverage 3

2 

ExcelCare Plus & MediCover Plus 

The schedule of benefits of Excelcare Plus is as follows: 

Schedule of benefits of ExcelCare Plus 

BENEFIT LIMITS 

Per Policy Year 

Hospital Daily Room & Board 

(120 days) 

Additional Hospital Room & 

Board whilst Overseas 5 (120 days) 

100 150 200 250 300 350 

100 150 200 250 300 350 

100 150 200 250 300 350 

ICU (120 days) 

Hospital Supplies and Services 

Surgical Fees Benefit 

Operating Theatre Fees Benefit 

Reasonable and Customary charges up to 

Co-insurance Free amount. 

Balance exceeding Co-insurance Free amount up to 

Annual Limit is further subject to Co-insurance. 

Anaesthetist’s Fees Benefit 

In-Hospital Physician’s Visit 

(240 days maximum per policy year) 6 

Pre-Hospitalization Benefit 7 (within 

60 days prior to Hospitalization) 

- Diagnostic Tests 

- Specialist Consultation Benefit 8 

Post-Hospitalization Treatment 

Benefit 7 

(within 60 days after hospitalization) 

- Outpatient Diagnostic X-ray & Lab 

Tests Benefit 

- Medical Expenses & Consultation 8 

Benefit including Acupuncture & 

Physiotherapy 

Day Procedure 9 

Organ/Bone Marrow Transplant 10 

(not subject to co-insurance) 

Reasonable and customary charges up to Annual Limit




Daily Cash Allowance at Government 

Hospital (120 days) 

Daily Guardian Benefit (120 days) 

Co-insurance Free Amount 

per policy year 1 

Annual Limit 

100 150 200 250 300 350 

40 45 50 55 60 65 

60 90 110 130 160 190 

15,000 22,000 25,000 28,000 33,000 36,000 

60,000 90,000 115,000 140,000 165,000 190,000 

Out Patient Benefits 

Emergency Accidental Out-patient 

Treatment & 30 days Follow-up 

Treatment at Hospital & Clinic 

1,500 2,000 2,500 3,000 3,500 4,000 

Value Added Benefit 

Emergency Evacuation Benefit 

100,000 100,000 100,000 100,000 100,000 100,000 

Per Lifetime 

Out-patient Kidney Dialysis 

Treatment Benefit 

Out-patient Cancer Treatment Benefit 

Overall Lifetime Limit 

per Insured Person 

30,000 40,000 50,000 60,000 70,000 80,000 

10,000 12,500 15,000 17,500 20,000 22,500 

200,000 300,000 400,000 500,000 600,000 700,000 

Note: All amount shown are in Ringgit Malaysia

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MediCover Plus additional benefits include: 

• No lifetime limit 4 

• High Cancer and Kidney Dialysis Treatment Limit 

• Extended coverage for Post-Hospitalization Benefit 

The schedule of benefits of MediCover Plus is as follows: 

Schedule of benefits of MediCover Plus 



Post-Hospitalization Treatment Benefit 7 

(starting on the 61st day and within 120 days 

after hospitalization) 


Co-insurance Free Amount 

per policy year 1 

Home Nursing Care (per Confinement) 

(180 days lifetime limit) 

Annual Limit 

150 200 250 300 350 


Co-insurance Free amount. Balance 

exceeding Co-insurance Free amount up to 

Annual Limit is further subject to Co-insurance. 

Share with ExcelCare Plus and 

limit remains unchanged 

3,000 4,000 5,000 6,000 7,000 

Share with ExcelCare Plus and 

limit remains unchanged 

Out-Patient Benefits 

Emergency Accidental Out-Patient Dental 

Treatment (per accident) 

3,000 4,000 5,000 6,000 7,000 



400,000 400,000 400,000 400,000 400,000 

Per Lifetime 

Out-patient Kidney Dialysis Treatment Benefit 


Overall Lifetime Limit per Insured Person 

40,000 60,000 80,000 100,000 120,000 

100,000 150,000 200,000 250,000 300,000 

NA NA NA NA NA 

Note: All amount shown are in Ringgit Malaysia


If you opt for ExcelCare Plus with MediCover Plus, please see the consolidated schedule below for 

the benefits provided: 

Schedule of combined benefits of ExcelCare Plus and MediCover Plus 



150 200 250 300 350 

Hospital Daily Room & Board 

(120 days) 

Additional Hospital Room & 

Board whilst Overseas 5 

(120 days) 

150 200 250 300 350 

150 200 250 300 350 

ICU (120 days) 

Hospital Supplies and Services 

Surgical Fees Benefit 

Operating Theatre Fees Benefit 

Anaesthetist’s Fees Benefit 

In-Hospital Physician’s Visit 

(240 days maximum per policy year) 6 

Pre-Hospitalization Benefit 7 

(within 60 days prior to Hospitalization) 

- Diagnostic Tests 

- Specialist Consultation Benefit 8 


Co-insurance Free amount. 

Balance exceeding Co-insurance Free amount 

up to Annual Limit is further subject to 

Co-insurance. 

Post-Hospitalization Treatment Benefit 7 

(within 120 days after hospitalization) 

- Outpatient Diagnostic X-ray & Lab 

Tests Benefit 

- Medical Expenses & Consultation 8 

Benefit including Acupuncture & 

Physiotherapy 


Home Nursing Care (per Confinement) 

(180 days life time limit) 

Organ/Bone Marrow Transplant 10 

(not subject to co-insurance) 

3,000 4,000 5,000 6,000 7,000 

Reasonable and customary charges 

up to Annual Limit

6 




Daily Cash Allowance at Government Hospital 

(120 days) 

Daily Guardian Benefit (120 days) 

Co-insurance Free Amount per policy year 1 

Annual Limit 

150 200 250 300 350 

45 50 55 60 65 

90 110 130 160 190 

22,000 25,000 28,000 33,000 36,000 

90,000 115,000 140,000 165,000 190,000 

Out-Patient Benefits 

Emergency Accidental Out-patient Treatment 

& 30 days Follow-up Treatment at 

Hospital & Clinic 

Emergency Accidental Out-Patient Dental 

Treatment (per accident) 

2,000 2,500 3,000 3,500 4,000 

3,000 4,000 5,000 6,000 7,000 



500,000 500,000 500,000 500,000 500,000 

Per Lifetime 

Out-patient Kidney Dialysis Treatment Benefit 


Overall Lifetime Limit per Insured Person 

80,000 110,000 140,000 170,000 200,000 

112,500 165,000 217,500 270,000 322,500 

NA NA NA NA NA 

Note: All amount shown are in Ringgit Malaysia and please refer to the policy contract for full details 

of the benefit coverage. 

ELIGIBILITY 

How ExcelCare Plus and MediCover Plus can be purchased? 

ExcelCare Plus and MediCover Plus can be purchased as a premium paying rider attachable 

to any non-participating plan. ExcelCare Plus can also be purchased as a standalone plan. Unit 

deducting ExcelCare Plus and MediCover Plus can be purchased with investment-linked plans. 

Am I eligible to apply for ExcelCare Plus and MediCover Plus? 

This policy is available to individuals from 4 weeks to 60 years of age, subject to underwriting’s 

approval. For Insured & Children and Family plans, children (dependants) between 2 weeks and 

under 23 years of age, and who are in good health, are eligible.


Can I attach MediCover Plus to my ExcelCare Plus plan 100? 

No, MediCover Plus is only available to plan 150 and above. You will need to upgrade your 

ExcelCare Plus to plan 150 & above if you wish to enjoy the extra coverage provided by 

MediCover Plus. 

How do I apply? 

Please talk to your AIA Agent. He or she will take you through the various application forms and 

offer any help you need to complete them. Alternatively, you can call the AIA Customer Service 

Hotline at 1300-88-1899 or visit any AIA branch. You will find a list of AIA branches in Malaysia on 

the back of this document. 

COVERAGE AMOUNT 

What is the coverage amount for family members in a plan? 

All family members covered under one policy will be covered for the same amount. 

PREMIUMS 

How much premium do I need to pay? 

This will depend on your age, gender and type of plan which you choose, occupation and 

condition of health. Please refer to Appendix 1 at the end of this brochure for the table of 

premiums for a standard life. 

How can I pay the premiums? 

You should first ensure that this policy will best serve your needs and that the premium payable 

under the policy is an amount that you can afford. 

Premiums are payable in one of the following ways: 

a) In cash or cheque. For payments in cheque, please make it payable to 

“American International Assurance Bhd”. 

b) Autopay: 

i) Credit card 

ii) Auto debit (HSBC, BSN and MBB) 

c) Standing instruction 

d) AIA Maybank Corporate Collection Account (AIA MCCA) 

You may change the frequency of premium payments by submitting a written request. Subject 

to our minimum premium requirements, premiums may be paid on an annually, semi-annually, 

quarterly or monthly mode at the premium rates applicable on the Issue Date. 

Please note that for auto debit, standing instruction or AIA MCCA payment methods, the following 

additional conditions will apply: 

• For payment made annually, semi-annually and quarterly: the first payment has to be payable in 

cash or cheque. 

• For payment made once a month: a minimum of first 2 payments have to be payable in cash or 

cheque. 

What is the minimum premium for ExcelCare Plus? 

For ExcelCare Plus bought as a standalone plan, the minimum premium must be at least RM300 

for any frequency of payment. However, this amount can be reduced to a minimum of RM75 if it 

is bought together with another basic plan (term plan excluded).

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If I have both ExcelCare Plus and MediCover Plus, do I still have to pay premiums when 

my ExcelCare Plus lifetime limit has been reached? 

So long as MediCover Plus is attached to the ExcelCare Plus plan, the ExcelCare Plus plan 

will remain effective, even if the lifetime limit of ExcelCare Plus on its own has been reached. 

The premium will continue to be payable and all the benefits under the ExcelCare Plus plan will 

continue unchanged. 

When do my premium payments end? 

Premiums are payable until the expiry at age 100 or, until the cessation of premium paying 

duration of the basic plan to which this rider is attached to, whichever is earlier. Benefits of 

ExcelCare Plus and MediCover Plus will stop thereafter. 

Can my premiums increase as I age? 

Yes. The premium payable will depend on your attained age at the next birthday when the 

premium is due. 

When do I pay my renewal premiums? 

We recommend that you pay each renewal premium before it is due. The latest you can pay each 

renewal premium is 31 days from the due date. If we do not receive your renewal premium within 

31 days of the due date, your cover will stop. Cessation of premium payment before the end of 

the premium payment term will lead to an early termination of your coverage. 

Is the premium for ExcelCare Plus and MediCover Plus guaranteed? 

The premium rates are not guaranteed and the Company reserves the right to revise the rates 

upon renewal. One of the possible factors contributing to the increase in premium rates is claim 

experience. 

The possible factors contributing to premium revision and renewal above are not exhaustive 

and the premium rates may be reviewed under other justified circumstances. The Company 

will give ninety (90) days’ prior notice in writing by ordinary post to your last known address in the 

Company’s records if such revision takes place. 

Past trends on the increase in premium rates do not necessarily reflect the future trend. 

For unit deducting versions of the products, we charge insurance coverage charges that are 

deducted monthly from the value of your units. The insurance charges will increase as you grow 

older. Details of insurance charges are given in the sales illustration. 

FEES & CHARGES 

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

There are no fees and charges other than the premiums payable.


TERMS & CONDITIONS 

What are some of the key terms and conditions that I should be aware of? 

• Importance of disclosure – you must disclose all material facts such as medical condition, and 

state your age correctly. 

• Free-look period – you may cancel your policy by returning us the policy contract and giving us 

a written notice that has been signed by you. Both written notice and policy contract must be 

received by us within 15 days after you have received the policy contract. The premium that you 

have paid (less any medical fee incurred) will be refunded to you. 

• Grace period – you are given a grace period of 31 days from the due date for payment of each 

subsequent premium. If premium remains unpaid at the end of this grace period, the policy 

may lapse. Unless renewed, the coverage of this policy will cease and the insurance company 

shall strictly not be liable for any expenses that takes place after the expiry date. 

• Waiting period - you will have to wait for a specified duration (from the date your policy began 

or last reinstatement date) before your coverage takes effect: 

a) 120 days for tonsils, adenoids, hernia or a disease related to the female generative organs; 

b) 60 days for Out-patient Cancer Treatment; 

c) 30 days for Out-patient Kidney Dialysis and for all other illnesses. 

Note: 

This list is non-exhaustive. Please refer to the policy contract for the terms and conditions under 

this policy. 

EXCLUSIONS 

What are the major exclusions to this plan? 

This plan shall not cover: 

a) Pre-existing illnesses; 

b) Any medical or physical abnormalities existing at the time of birth, as well as neo-natal 

physical abnormalities; 

c) Self-inflicted injuries and illegal acts; 

d) Wars, strikes or riots; 

e) Any armed forces or military operations; 

f) Pregnancy, miscarriage or child births; 

g) Mental or nervous disorders; 

h) Alcoholism and drug abuse or its related conditions; 

i) Cosmetic, elective or plastic surgery; 

j) Dental treatment unless necessitated by accidental injury; 

k) Routine health checks and any investigations not directly related to admission; 

l) Treatment which is not medically necessary; 

m) Medical expenses which is payable by any laws, medical program or insurance policy; 

n) The following exclusions are only applicable to Out-patient Cancer Treatment benefit: 

i) All cancers which are histologically classified as pre-malignant; non-invasive; carcinoma; 

in-situ; having either borderline malignancy; or having low malignant potential; 

ii) All tumours of the prostate, thyroid and urinary bladder histologically classified as T1N0M0 

(TNM classification); 

iii) Chronic Lymphocytic Leukemia less than RAI Stage 3; 

iv) All cancers in the presence of HIV; 

v) Any skin cancer other than malignant melanoma; 

o) Overseas treatment if Insured Person resides or travels outside Malaysia for more than 90 

consecutive days;

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p) Overseas protection if Insured is a foreigner; 

q) Other additional exclusions that apply to specific benefits of MediCover Plus. 

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

this policy. For a sample of the policy contract, please talk to your AIA agent. 

COVERAGE 

When does my coverage starts? 

Your coverage starts from the date on which you completed and the signed application form is 

approved by us and when we have received the full premium due. 

Where am I covered? 

You are covered worldwide but subject to a maximum of 90 days protection if you are traveling 

overseas. If you are a foreigner, your coverage is confined to within Malaysia only. 

Does this plan pay in addition to any other insurance policy that I may have? 

No, we will only reimburse eligible medical expenses that have yet to be claimed by you. 

What expenses are covered by the Emergency Medical Evacuation Benefit? 

Expenses for the necessary transportation, medical services and medical supplies provided 

and/or arranged by American International Assistance Services (AIAS) as a result of an 

emergency medical evacuation are covered. All decisions as to the means of transportation and 

the final destination will be made by AIAS, based solely on medical necessity. 

Do I have to bear any of the expenses incurred for hospitalization? 

ExcelCare Plus and MediCover Plus have a co-insurance free amount. You may need to pay 

for certain portion of your hospitalization expenses if the cost exceeded the co-insurance free 

amount. Eligible expenses exceeding the co-insurance free amount are subject to a co-insurance 

of 90% payable by the Company and 10% payable by you. However, you will only be required to 

pay up to a maximum of RM3,000 per policy year. Please refer to the example below: 

Example: 

Mrs. Chan is a 30 year-old store manager with ExcelCare Plus and MediCover Plus riders plan 

150. During her check-up, she discovered a breast lump. One week later, she was hospitalized 

to have the lump removed. Two weeks after being discharged, Mrs. Chan went back for a 

follow-up visit. 

Prior to her hospitalization, Mrs. Chan’s diagnostic bill came up to RM750. The actual 

hospitalization bill totaled RM25,000. Her follow-up visit incurred a total bill of RM250 for 

consultation and medication. 

Expenses incurred for the entire treatment: 

Stages of hospitalization Type of benefit Amount incurred 

1. Pre-hospitalization: Diagnostic X-ray RM750 

2. In-hospitalization: Hospitalization bill RM25,000 

3. Post-hospitalization: Consultation and medication RM250 

Total Cost 

RM26,000


Based on the above expenses, please find the following breakdown on the amount claimable 

under ExcelCare Plus and MediCover Plus 150 and that are borne by Mrs. Chan: 

Total expenses incurred 

Co-insurance Free Amount (borne by Company) 

Total expenses subject to co-insurance 

Co-insurance expenses borne by Mrs. Chan 

Co-insurance expenses borne by Company 

RM26,000 

RM22,000 

RM4,000 

RM400 (10% of RM4,000) 

RM3,600 (90% of RM4,000) 

Hence, the total expense to be paid by Mrs. Chan is only RM400. The balance RM25,600 will be 

covered under ExcelCare Plus and MediCover Plus. 

Can I switch my ExcelCare Plus and MediCover Plus plans from a lower plan to a higher 

plan, or vice versa? 

It may not be advantageous to switch from one health plan to another, as you may be subject 

to new underwriting requirements, full waiting period and applicable period for the exclusion of 

specified illnesses of the new plans. 

CANCELLATION 

Can AIA cancel my policy based on my individual claims experience? 

No. 

Can I cancel my policy? 

You may cancel your policy by giving a written notice to us. Upon cancellation, you are entitled to 

a refund of a portion of your premium provided that you have not made a claim on the policy. 

REINSTATEMENT 

Can I reinstate my policy after it has lapsed? 

Yes, you may reinstate your policy subject to company’s terms and conditions. You may be 

required to provide health evidence to prove your insurability at the time of reinstatement. 

CLAIMS 

How do I make a claim? 

You need to complete the relevant claims forms which you can obtain from your AIA agent, by 

calling the AIA Customer Service Hotline at 1300-88-1899 or visit any AIA branch. You will find a 

list of AIA branches in Malaysia on the back of this document. 

What other documentation is required to be submitted together with the claim? 

In addition to the relevant claims forms, we require additional medical reports (as listed at the 

back of the claims form) to support the claim. 

When do I have to notify AIA of a claim? 

In the event of a claim, it is advisable that you notify us immediately + . 

+ The notification period varies in accordance with the types of claim made. Please refer to the policy contract.

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TAX RELIEF 

Can I use the premiums paid for ExcelCare Plus and MediCover Plus for tax relief purposes? 

This policy may qualify you for personal tax relief subject to the final decision of the Inland 

Revenue Board. 

INFORMATION 

What do I need to do if there are changes to my contact details? 

It is important that you inform us of any change in your contact details to ensure that all 

correspondences reach you in a timely manner. 

Where can I get further information? 

About ExcelCare Plus & MediCover Plus 

Should you require additional information on ExcelCare Plus and MediCover Plus or about any 

other AIA insurance plans or riders, you can contact your AIA agent, call our AIA Customer 

Service Hotline at 1300-88-1899 or by visiting any AIA branch nationwide. You will find a list of 

AIA branches on the back of this document. You can also contact us via email by visiting 

www.aia.com.my. 

About Medical and Health Insurance 

Should you require additional information about medical and health insurance, you may refer to 

the insuranceinfo booklet on ‘Medical & Health Insurance’ available at all our branches or you 

can obtain a copy from the insurance agent or visit www.insuranceinfo.com.my 

NOTE: 

1 10% co-insurance applies on claims in excess of the co-insurance free amount, subject to an 

overall maximum co-insurance of RM3,000 per year. 

2 All services are subject to eligibility and benefit limit of your plan. 

3 This coverage applies only if your hospitalization occurs within the first 90 days of your 

overseas stay. The treatment costs are paid according to those reasonably charged by a 

hospital in Malaysia. For a foreigner, coverage is only provided within Malaysia. 

4 Subject to annual limit continues to apply. 

5 Applicable to countries in North America, the EC (European Community) and Japan only. 

6 Subject to two consultations per day. 

7 For each confinement. 

8 Subject to one consultation per day. 

9 Covered Day Procedure Schedule: 

- Arthroscopy, Colonoscopy, Laparoscopy, Extracorporeal Shock Wave Lithotripsy, Cataract 

surgery. 

10 Limited to once per lifetime. 

11 Covered Day Procedure Schedule: 

- Adenoidectomy; Arthroscopy; Bone Marrow Aspiration and Biopsy; Cataract Surgery; 

Cholecystectomy; Colonoscopy; Coronary Artery Catheterization; Cystectomy; 

Cystourethroscopy; Diagnostic Dilatation and Curettage; Endolaser Venous Surgery; 

Endoscopic Retrograde Cholangiopancreatography; Excision of Bunions; Excision of 

Ganglion, Fibroma(s) and Breast Lump(s); Excision of Pterygium; Extracorporeal Shock 

Wave Lithotripsy; Herniotomy / Herniorapphy; Insertion of Pacemaker; Insertion or Removal 

of Ureteric J-Stent; Laparoscopic Endometrial Ablation; Laparoscopy; Marsupialisation 

and drainage of Bartholin’s Cysts; Myringotomy or Myringoplasty; Reduction of Bone 

Fracture(s); Release of Carpal Tunnel Syndrome (Carpal Tunnel Decompression); Release of 

Dupuytren’s Contracture (Release of Trigger Finger); Removal of Cervical or Vaginal Polyps; 

Removal of Nasal Polyps; Removal of Plate and Orthopedic Implants; Retinal Detachment 

Surgery; Rubber Banding of Haemorrhoids; Stapling Haemorrhoidectomy; Tonsillectomy.


IMPORTANT NOTE: 

YOU SHOULD SATISFY YOURSELF THAT THIS POLICY WILL BEST SERVE YOUR NEEDS. 

THE EXCLUSIONS AND LIMITATIONS OF BENEFITS HIGHLIGHTED ARE NOT EXHAUSTIVE. 

YOU SHOULD READ AND UNDERSTAND THE INSURANCE POLICY AND DISCUSS WITH THE 

AGENT OR CONTACT THE INSURANCE COMPANY DIRECTLY FOR MORE INFORMATION.

14 


ExcelCare Plus / MediCover Plus 

Insurans Penghospitalan dan Pembedahan 

Apakah itu ExcelCare Plus dan MediCover Plus? 

ExcelCare Plus 

Sanggupkah anda melihat yang tersayang terlantar sakit dengan memilih perlindungan yang 

kurang? 

Segelintir sahaja daripada kita yang merancang untuk perbelanjaan hospital. Tambahan pula, 

dengan kenaikan inflasi perubatan, perbelanjaan perubatan boleh mencecah puluhan ribu ringgit. 

Hakikatnya pembedahan yang langsung tidak dijangka dan tidak dapat dielakkan adakalanya 

boleh mengeringkan simpanan kita. 

ExcelCare Plus menyediakan perbelanjaan penghospitalan dan pembedahan serta menawarkan 

perlindungan sehingga umur 100 tahun. 

MediCover Plus 

Bimbang had seumur hidup pembayaran ganti perubatan asas Excelcare Plus anda tidak 

mencukupi untuk keperluan perubatan jangka panjang anda sekeluarga? 

Sebagai anak yang berdedikasi, ibu bapa atau pasangan, anda akan cuba mencari perlindungan 

perubatan yang sebaik mungkin untuk selama yang boleh. Pelan anda yang sedia ada mungkin 

tidak memadai untuk perlindungan yang lebih baik dan bagi tempoh yang lebih panjang. Justeru 

itu, wang simpanan hasil titik peluh anda untuk masa depan keluarga anda akan menyusut. 

Dengan rider MediCover Plus, anda boleh pasti bahawa insurans anda mencukupi untuk 

melindungi anda sekeluarga seumur hidup dengan premium tambahan minimum yang perlu 

dibayar di samping premium ExcelCare Plus anda. 

MediCover Plus menyediakan perbelanjaan penghospitalan dan pembedahan serta menawarkan 

had perlindungan yang lebih tinggi untuk melengkapi ExcelCare Plus. 

MANFAAT 

Apakah perlindungan / manfaat yang disediakan? 

ExcelCare Plus memberikan: 

• Pilihan had seumur hidup pembayaran ganti perubatan daripada RM200,000 hingga setinggi 

RM700,000 

• Perlindungan 24 jam 

• Perlindungan sepanjang hayat sehingga umur 100 tahun 

• Ko-insurans sifar bagi tuntutan dalam amaun yang ditetapkan 1 

• Kadar yang lebih rendah melalui Pelan Keluarga 

• Bantuan bebas kerenah semasa kemasukan anda ke hospital melalui AIA Health Services 2 

• Perlindungan di seluruh dunia 3


Jadual manfaat ExcelCare Plus adalah seperti berikut: 

Jadual manfaat ExcelCare Plus 

HAD MANFAAT 

Setiap Tahun Polisi 

Bilik Penginapan Harian Hospital 

(120 hari) 

Bilik & Penginapan Tambahan 

Hospital Semasa Di Luar Negara 5 

(120 hari) 

100 150 200 250 300 350 

100 150 200 250 300 350 

100 150 200 250 300 350 

Unit Rawatan Rapi (120 hari) 

Bekalan dan Perkhidmatan Hospital 

Manfaat Yuran Pembedahan 

Manfaat Yuran Bilik Pembedahan 

Manfaat Yuran Pakar Bius 

Caj Munasabah dan Biasa Diamalkan sehingga 

amaun Bebas Ko-insurans. Baki yang melebihi 

amaun Bebas Ko-insurans sehingga Had 

Tahunan akan tertakluk kepada Ko-insurans. 

Lawatan Pakar Perubatan Dalam Hospital 

(maksimum 240 hari setiap tahun polisi) 6 

Manfaat Sebelum Penghospitalan 7 

(dalam tempoh 60 hari sebelum) 

- Ujian Diagnostik 

- Manfaat Rundingan Doktor Pakar 8 

Manfaat Rawatan Selepas Penghospitalan 7 

(dalam tempoh 60 hari selepas 

penghospitalan) 

- Manfaat X-ray Diagnostik & Ujian 

Makmal Pesakit Luar 

- Manfaat Perbelanjaan Perubatan & 

Rundingan 8 termaksuk Akupunktur & 

Fisioterapi 

Prosedur Harian 9 

Pemindahan Organ/Sumsum Tulang 10 

(tidak tertakluk kepada ko-insurans) 

Caj Munasabah dan Biasa Diamalkan 

sehingga Had Tahunan

16 


HAD MANFAAT 


Elaun Tunai Harian di Hospital 

kerajaan (120 hari) 

Manfaat Penjaga Harian (120 hari) 

Amuan Bebas Ko-insurans bagi 

setiap tahun polisi 1 

Had Tahunan 

100 150 200 250 300 350 

40 45 50 55 60 65 

60 90 110 130 160 190 

15,000 22,000 25,000 28,000 33,000 36,000 

60,000 90,000 115,000 140,000 165,000 190,000 

Manfaat Pesakit Luar 

Rawatan Kecemasan Pesakit Luar 

Akibat Kemalangan & Rawatan 

susulan 30 hari di Hospital & Klinik 

1,500 2,000 2,500 3,000 3,500 4,000 

Manfaat Nilai Tambahan 

Manfaat Pemindahan Perubatan 

Kecemasan 

100,000 100,000 100,000 100,000 100,000 100,000 

Had Seumur Hidup 

Manfaat Rawatan Dialisis Buah 

Pinggang Pesakit Luar 

Manfaat Rawatan Kanser 

Pesakit Luar 

Had Seumur Hidup Keseluruhan 

setiap Orang Yang Diinsuranskan 

30,000 40,000 50,000 60,000 70,000 80,000 

10,000 12,500 15,000 17,500 20,000 22,500 

200,000 300,000 400,000 500,000 600,000 700,000 

Nota: Semua amaun ditunjukkan dalam Ringgit Malaysia


Manfaat tambahan MediCover Plus ialah: 

• Tiada had seumur hidup 4 

• Had yang Tinggi bagi Rawatan Kanser dan Dialisis Buah Pinggang 

• Perlindungan diperluas untuk Manfaat Selepas Penghospitalan 

Jadual Manfaat MediCover Plus adalah seperti di bawah: 

Jadual Manfaat MediCover Plus 

HAD MANFAAT 

Per 



(bermula pada hari yang ke-61 dan dalam 

tempoh 120 hari selepas penghospitalan) 

Prosedur harian 11 

Amaun Bebas Ko-insurans setiap tahun polisi 1 

Rawatan Di Rumah (setiap Pengasingan) 

(had seumur hidup 180 hari) 

Had Tahunan 

150 200 250 300 350 

Caj Munasabah dan Biasa Diamalkan sehingga 

amaun Bebas Ko-insurans. 

Baki melebihi amaun Bebas Ko-insurans 

sehingga Had Tahunan akan tertakluk 

kepada ko-insurans. 

Berkongsi dengan ExcelCare Plus 

dan had kekal tidak berubah 

3,000 4,000 5,000 6,000 7,000 

Berkongsi dengan ExcelCare Plus 

dan had kekal tidak berubah 


Rawatan Pergigian Kecemasan Pesakit Luar 

Akibat Kemalangan (setiap kemalangan) 

3,000 4,000 5,000 6,000 7,000 


Manfaat Pemindahan Kecemasan 

400,000 400,000 400,000 400,000 400,000 


Manfaat Rawatan Dialisis Buah Pinggang 

Pesakit Luar 

Manfaat Rawatan Kanser Pesakit Luar 

Had Seumur Hidup Keseluruhan 

setiap Orang Yang Diinsuranskan 

40,000 60,000 80,000 100,000 120,000 

100,000 150,000 200,000 250,000 300,000 

Tiada Tiada Tiada Tiada Tiada 

Nota: Semua amaun ditunjukkan dalam Ringgit Malaysia

18 


Jika anda memilih ExcelCare Plus dengan MediCover Plus, sila rujuk kepada jadual gabungan di 

bawah untuk manfaat yang diberikan: 

Jadual manfaat gabungan ExcelCare Plus dan MediCover Plus 

HAD MANFAAT 


P e r 

150 200 250 300 350 

Bilik & Penginapan Harian Hospital 

(120 hari) 

Bilik & Penginapan Tambahan Hospital 

Semasa di Luar Negara 5 

(120 hari) 

150 200 250 300 350 

150 200 250 300 350 

Unit Rawatan (120 hari) 

Bekalan dan Perkhidmatan Hospital 

Manfaat Yuran Pembedahan 

Manfaat Yuran Bilik Pembedahan 

Manfaat Yuran Pakar Bius 

Lawatan Pakar Perubatan Dalam Hospital 

(maksimum 240 hari setiap tahun polisi) 6 

Manfaat Sebelum Penghospitalan 7 

(dalam tempoh 60 hari sebelum 

Penghospitalan) 

- Ujian Diagnostik 

- Manfaat Rundingan Doktor Pakar 8 


sehingga amaun Bebas ko-insurans. 

Baki yang melebihi amaun Bebas 

ko-insurans sehingga Had Tahunan 

akan tertakluk kepada Ko-insurans. 


(dalam tempoh 120 hari selepas 

penghospitalan) 

- Manfaat X-ray Diagnostik Pesakit Luar & 

Ujian Makmal 

- Manfaat Perbelanjaan Perubatan & 

Rundingan 8 termasuk Akupunktur & 

Fisioterapi 

Prosedur Harian 11 

Rawatan Di Rumah (setiap Pengasingan) 

(had seumur hidup 180 hari) 

Pemindahan Organ/Sumsum Tulang 10 (tidak 

tertakluk kepada ko-insurans) 

3,000 4,000 5,000 6,000 7,000 


sehingga Had Tahunan


HAD MANFAAT 


Elaun tunai harian di Hospital Kerajaan 

(120 hari) 

Manfaat Penjaga Harian (120 hari) 

Amaun Bebas Ko-insurans setiap tahun polisi 1 

Had Tahunan 

150 200 250 300 350 

45 50 55 60 65 

90 110 130 160 190 

22,000 25,000 28,000 33,000 36,000 

90,000 115,000 140,000 165,000 190,000 


Rawatan Kecemasan Pesakit Luar Akibat 

Kemalangan & Rawatan Susulan 30 hari di 

Hospital & Klinik 

Rawatan Pergigian Kecemasan Pesakit Luar 

Akibat Kemalangan (setiap kemalangan) 

2,000 2,500 3,000 3,500 4,000 

3,000 4,000 5,000 6,000 7,000 


Manfaat Pemindahan Kecemasan 

500,000 500,000 500,000 500,000 500,000 


Manfaat Rawatan Dialisis Buah Pinggan 

Pesakit Luar 

Manfaat Rawatan Kanser Pesakit luar 

Had Seumur Hidup Keseluruhan setiap orang 

Yang Diinsuranskan 

80,000 110,000 140,000 170,000 200,000 

112,500 165,000 217,500 270,000 322,500 

Tiada Tiada Tiada Tiada Tiada 

Nota: Semua amaun ditunjukkan dalam Ringgit Malaysia. Untuk maklumat penuh berkenaan 

perlindungan manfaat, sila rujuk kepada kontrak polisi . 

KELAYAKAN 

Bagaimana ExcelCare Plus dan MediCover Plus boleh dibeli? 

ExcelCare Plus dan MediCover Plus boleh dibeli sebagai rider pembayaran premium yang boleh 

dilampirkan pada mana-mana pelan tanpa penyertaan. ExcelCare Plus juga boleh dibeli sebagai 

pelan bersendirian. ExcelCare Plus dan MediCover Plus potongan unit boleh dibeli dengan pelan 

berkaitan pelaburan. 

Adakah saya layak memohon ExcelCare Plus and MediCover Plus? 

Polisi ini boleh disertai oleh individu yang berumur daripada 4 minggu hingga 60 tahun, 

tertakluk kepada kelulusan penajajaminan. Bagi pelan Insured & Anak dan pelan Keluarga, anak 

(tanggungan) berumur di antara 2 minggu hingga di bawah 23 tahun dan sihat tubuh badan, 

layak memohon.

20 


Bolehkah saya melampirkan MediCover Plus pada ExcelCare Plus pelan 100? 

Tidak, MediCover Plus hanya boleh dilampikan pada pelan 150 dan ke atas. Anda perlu menaik 

taraf ExcelCare Plus anda kepada pelan 150 & ke atas jika anda ingin menikmati perlindungan 

tambahan yang disediakan oleh MediCover Plus. 

Bagaimana saya hendak memohon? 

Sila hubungi ejen AIA anda. Beliau akan menjelaskan kepada anda butir-butir dalam 

borang permohonan dan menawarkan bantuan yang anda perlukan untuk melengkapkannya, 

ataupun anda boleh menghubungi Hotline Khidmat pelanggan AIA di talian 1300-88-1899 atau 

mengunjungi mana-mana cawangan AIA. Senarai cawangan AIA di Malaysia boleh didapati di 

belakang dokumen ini. 

AMAUN PERLINDUNGAN 

Apakah amaun perlindungan untuk ahli keluarga dalam sesuatu pelan? 

Semua ahli keluarga yang dilindungi di bawah satu polisi akan dilindungi untuk amaun yang 

sama. 

PREMIUM 

Berapakah premium yang perlu saya bayar? 

Ini akan bergantung pada umur anda, jantina dan jenis pelan yang anda pilih, pekerjaan 

dan keadaan kesihatan anda. Sila rujuk kepada Lampiran 1 pada penghujung Lembaran 

Pendedahan Produk ini untuk jadual premium bagi hayat standard. 

Bagaimana boleh saya membayar premium? 

Anda hendaklah memastikan bahawa pelan ini menepati keperluan anda dan anda mampu 

membayar amaun premium yang perlu dibayar di bawah polisi ini. 

Premium boleh dibayar dengan salah satu cara berikut: 

a) Secara tunai atau dengan cek. Bagi bayaran dengan cek, sila bayar atas nama “American 

International Assurance Bhd.”. 

b) Bayaran automatik: 

i) Kad kredit 

ii) Autodebit (HSBC, BSN dan MBB) 

c) Arahan tetap 

d) Akaun Kutipan Korporat AIA Maybank (AIA MCCA) 

Bayaran premium anda boleh dibuat sekali setahun, dua kali setahun, empat kali setahun atau 

sekali sebulan. 

Sila ambil perhatian bahawa untuk autodebit, arahan tetap atau kaedah bayaran AIA MCCA, 

syarat-syarat tambahan berikut akan dikenakan: 

• Bagi bayaran yang dibuat sekali setahun, dua kali setahun dan empat kali setahun: bayaran 

pertama hendaklah dibuat secara tunai atau dengan cek. 

• Bagi bayaran yang dibuat sekali sebulan, minimum 2 bayaran pertama hendaklah dibuat 

secara tunai atau dengan cek. 

Berapakah premium minimum bagi ExcelCare Plus? 

Bagi ExcelCare Plus yang dibeli sebagai pelan bersendirian, premium minimum mestilah 

sekurang-kurangnya RM300 bagi mana-mana kekerapan bayaran. Walau bagaimanapun, 

amaun ini boleh dikurangkan kepada minimum RM75 jika ia dibeli bersama dengan pelan asas 

lain (tidak termaksuk pelan bertempoh).


Jika saya mempunyai ExcelCare Plus dan juga MediCover Plus, adakah saya masih perlu 

membayar premium apabila had seumur hidup Excelcare Plus saya telah dicapai? 

Selagi MediCover Plus dilampirkan pada pelan ExcelCare Plus, pelan ExcelCare Plus akan terus 

berkuat kuasa meskipun had umur hidup ExcelCare Plus itu sendiri telah dicapai. Premium akan 

terus perlu dibayar dan semua manfaat di bawah pelan ExcelCare Plus akan terus tidak berubah. 

Bila bayaran premium saya berakhir? 

Premium perlu dibayar sehingga tamat tempoh pada umur 100 tahun atau sehingga berakhirnya 

tempoh bayaran premium pelan asas yang rider ini dilampirkan padanya, mana-mana yang 

dahulu. Manfaat ExcelCare Plus dan MediCover Plus akan berhenti selepas itu. 

Bolehkan premium saya meningkat mengikut umur saya? 

Ya. Premium yang perlu dibayar akan bergantung pada umur tercapai anda pada hari jadi yang 

berikutnya apabila premium genap tempoh. 

Bilakah saya membayar premium pembaharuan saya? 

Kami menasihatkan anda supaya membayar setiap premium pembaharuan sebelum ia 

genap tempoh. Paling lewat anda boleh membayar setiap premium pembaharuan ialah 

31 hari dari tarikh genap tempoh. Jika kami tidak menerima premium pembaharuan anda dalam 

masa 31 hari dari tarikh genap tempoh itu, perlindungan anda akan terhenti. Pemberhentian 

bayaran premium sebelum akhir tempoh bayaran premium akan menyebabkan penamatan awal 

perlindungan anda. 

Adakah premium bagi ExcelCare Plus dan MediCover Plus dijamin? 

Kadar premium tidak dijamin dan Syarikat berhak menyemak kadar semasa pembaharuan. 

Salah satu faktor yang boleh menyumbang kepada kenaikan kadar premium ialah pengalaman 

tuntutan. 

Faktor yang boleh menyumbang kepada semakan premium dan pembaharuan di atas adalah 

tidak terperinci dan kadar premium boleh disemak dalam keadaan-keadaan lain yang wajar. 

Syarikat akan memberi notis terdahulu dalam tempoh sembilan puluh (90) hari secara bertulis 

melalui pos biasa ke alamat terakhir anda yang diketahui di dalam rekod Syarikat jika semakan 

tersebut dibuat. 

Trend kenaikan kadar premium pada masa yang lepas tidak semestinya menggambarkan trend 

pada masa akan datang. 

Bagi versi produk potongan unit, kami mengenakan caj perlindungan insurans yang dipotong 

setiap bulan daripada nilai unit anda. Semakin usia anda meningkat caj insurans juga akan turut 

meningkat. Butir-butir caj insurans diberikan dalam ilustrasi jualan. 

YURAN DAN CAJ 

Apakah yuran dan caj yang perlu saya bayar? 

Tiada yuran dan caj lain selain jumlah premium yang dibayar.

22 


TERMA DAN SYARAT 

Apakah antara terma-terma dan syarat-syarat penting yang perlu saya ketahui? 

• Kepentingan pendedahan – anda mesti mendedahkan semua fakta-fakta penting seperti 

keadaan kesihatan dan menyatakan umur anda dengan betul. 

• Tempoh percubaan – anda boleh membatalkan polisi anda dengan memulangkan kontrak 

polisi anda berserta dengan notis bertulis yang anda tandatangani kepada pihak syarikat. 

Notis bertulis serta kontrak polisi tersebut perlu diterima terus oleh kami dalam masa 15 hari 

selepas anda menerima kontrak anda. Premium yang anda telah bayar (ditolak sebarang yuran 

perubatan yang ditanggung) akan dipulangkan kepada anda. 

• Tempoh ihsan – anda diberi tempoh ihsan selama 31 hari dari tarikh genap tempoh bagi 

pembayaran setiap premium berikutnya. Jika premium tetap tidak dibayar pada akhir ihsan 

polisi ini, polisi ini mungkin luput. Melainkan di perbaharui, perlindungan polisi ini akan terhenti 

dan syarikat insurans tidak akan bertanggungjawab terhadap sebarang perbelanjaan yang 

dibuat selepas tarikh tamat tempoh. 

• Tempoh tangguh – anda perlu menunggu tempoh tertentu (dari tarikh polisi anda bermula atau 

tarikh pemgembalian semula yang terakhir) sebelum perlindungan anda berkuat kuasa: 

a) 120 hari bagi tonsil, adenoid, hernia atau penyakit berkaitan dengan organ pembiakan wanita; 

b) 60 hari bagi Rawatan Kanser Pesakit Luar; 

c) 30 hari bagi Dialisis Buah Pinggang Pesakit Luar dan bagi semua penyakit lain. 

Nota: Senarai ini adalah tidak terperinci. Sila rujuk kepada kontrak polisi untuk terma-terma dan 

syarat-syarat polisi ini. 

PENGECUALIAN 

Apakah pengecualian utama untuk pelan ini? 

Pelan ini tidak melindungi: 

a) Penyakit sedia ada; 

b) Sebarang keabnormalan perubatan atau fizikal yang wujud semasa lahir, serta 

keabnormalan fizikal neo-natal; 

c) Kecederaan diri yang disengajakan dan tindakan yang menyalahi undang-undang; 

d) Peperangan, mogok atau rusuhan; 

e) Sebarang operasi angkatan bersenjata atau tentera; 

f) Kehamilan, keguguran atau melahirkan anak; 

g) Kecelaruan mental atau penyakit saraf; 

h) Ketagihan alkohol dan penyalahgunaan dadah atau keadaan yang berkaitan dengannya; 

i) Pembedahan kosmetik, elektif atau plastik; 

j) Rawatan pergigian melainkan diperlukan kerana kecederaan akibat kemalangan; 

k) Pemeriksaan kesihatan rutin dan sebarang penyiasatan yang tidak berkaitan secara 

langsung dengan kemasukan ke hospital; 

l) Rawatan yang tidak perlu dari segi perubatan; 

m) Perbelanjaan perubatan yang untuknya pampasan atau pembayaran ganti peril dibayar di 

bawah mana-mana undang-undang, program perubatan atau polisi insurans; 

n) Keadaan berikut adalah dikecualikan daripada Manfaat Rawatan Kanser Pesakit Luar: 

i) Semua kanser yang secara histologinya diklasifikasikan sebagai pramalignan, tidak 

menyerang; karsinoma in situ; sama ada mempunyai risiko hampir malignan atau 

mempunyai potensi malignan yang rendah; 

ii) Semua tumor prostat, tiroid dan pundi kencing yang secara histologinya diklasifikasikan 

sebagai T1N0M0 (klasifikasi TNM); 

iii) Leukemia Limfositik Kronik yang kurang daripada RAI Tahap 3; 

iv) Semua kanser akibat daripada HIV; 

v) Sebarang kanser kulit selain daripada melanoma malignan;


o) Rawatan di luar negara jika orang yang diinsuranskan tinggal atau mengembara di luar 

Malaysia selama lebih daripada 90 hari berturut-turut; 

p) Perlindungan luar negara jika orang yang diinsuranskan adalah warga negara asing; 

q) Pengecualian tambahan lain yang dikenakan kepada manfaat tertentu MediCover Plus. 

Senarai ini adalah tidak terperinci. Sila rujuk kepada kontrak polisi untuk senarai penuh 

pengecualian-pengecualian di bawah polisi ini. Untuk contoh kontrak polisi, sila hubungi ejen AIA anda. 

PERLINDUNGAN 

Bilakah perlindungan insurans hayat saya bermula? 

Perlindungan anda bermula dari tarikh permohonan anda yang telah lengkap diisi dan 

ditandatangani itu diluluskan oleh kami dan apabila kami menerima premium yang sewajarnya. 

Di manakah saya dilindungi? 

Anda dilindungi di seluruh dunia tetapi tertakluk kepada perlindungan maksimum 90 hari jika 

anda mengembara ke luar negara. Jika anda adalah seorang warga negara asing, perlindungan 

anda terhad dalam Malaysia sahaja. 

Adakah pelan ini membayar di samping mana-mana polisi insurans lain yang saya 

mungkin ada? 

Tidak, kami hanya akan membayar ganti perbelanjaan perubatan layak sahaja yang belum 

dituntut oleh anda. 

Apakah perbelanjaan yang dilindungi oleh Manfaat Pemindahan Perubatan Kecemasan? 

Perbelanjaan bagi pengangkutan, khidmat perubatan dan bekalan perubatan perlu yang 

disediakan dan/atau diuruskan oleh American International Assistance Services (AIAS) akibat 

pemindahan perubatan Kemalangan adalah dilindungi. Semua keputusan mengenai cara 

pengangkutan dan destinasi akhir akan dibuat oleh AIAS, semata-mata berdasarkan 

keperluan perubatan. 

Adakah saya perlu menanggung sebarang perbelanjaan untuk penghospitalan? 

ExcelCare Plus dan MediCover Plus mempunyai amaun bebas ko-insurans. Anda mungkin perlu 

membayar bahagian tertentu daripada perbelanjaan penghospitalan anda jika kos ini melebihi 

amaun bebas ko-insurans. Perbelanjaan layak yang melebihi amaun bebas ko-insurans adalah 

tertakluk kepada ko-insurans 90% yang dibayar oleh Syarikat dan 10% dibayar oleh anda. 

Walaubagaimanapun, anda akan hanya dikehendaki membayar sehingga maksimum RM3,000 

setiap tahun polisi. Sila rujuk contoh berikut: 

Contoh: 

Puan Chan adalah seorang pengurus stor berumur 30 tahun yang menyertai ExcelCare Plus dan 

rider MediCover Plus pelan 150. Semasa menjalani pemeriksaan kesihatan, beliau mendapati 

terdapat ketulan pada payu daranya. Seminggu kemudian, beliau dimasukkan ke hospital untuk 

menjalani pembedahan membuang ketulan itu. Dua minggu selepas keluar hospital, Puan Chan 

kembali ke hospital untuk lawatan susulan. 

Sebelum penghospitalan, bil diagnostik Puan Chan berjumlah RM750. Bil penghospitalan 

sebenar berjumlah RM25,000. Lawatan susulannya menelan kos sebanyak RM250 untuk 

rundingan dan ubat.

24 


Perbelanjaan yang terlibat bagi seluruh rawatan: 

Peringkat penghospitalan Jenis manfaat Amaun terlibat 

1. Sebelum Penghospitalan: X-ray diagnostik RM750 

2. Semasa Penghospitalan: Bil hospital RM25,000 

3. Selepas Penghospitalan: Rundingan dan ubat RM250 

Jumlah kos 

RM26,000 

Berdasarkan perbelanjaan di atas, berikut ialah pecahan bagi amaun yang boleh dituntut di 

bawah ExcelCare Plus dan MediCover Plus 150 dan amaun yang ditanggung oleh Puan Chan: 

Jumlah perbelanjaan yang terlibat 

Amaun Bebas Ko-insurans (ditanggung oleh Syarikat) 

Jumlah perbelanjaan yang tertakluk kepada ko-insurans 

Perbelanjaan ko-insurans ditanggung oleh Puan Chan 

Perbelanjaan ko-insurans ditanggung oleh Syarikat 

RM26,000 

RM22,000 

RM4,000 

RM400 (10% daripada RM4,000) 

RM3,600 (90% daripada RM4,000) 

Jadi, jumlah perbelanjaan yang perlu dibayar oleh Puan Chan cuma RM400. Baki RM25,600 itu 

akan dilindungi di bawah ExcelCare Plus dan MediCover Plus. 

Bolehkah saya menukar pelan ExcelCare Plus dan MediCover Plus saya daripada pelan 

yang lebih rendah kepada pelan yang lebih tinggi, atau sebaliknya? 

Adalah tidak menguntungkan untuk bertukar daripada satu pelan kesihatan kepada pelan lain 

kerana anda mungkin tertakluk kepada keperluan penajajaminan baru, tempoh tangguh penuh 

dan tempoh yang dikenakan bagi pengecualian penyakit tertentu pelan baru itu. 

PEMBATALAN 

Bolehkah AIA membatalkan polisi saya? 

Tidak. 

Bolehkah saya membatalkan polisi saya? 

Anda boleh membatalkan polisi anda dengan memberi notis bertulis kepada kami. Setelah 

dibatalkan, anda berhak mendapat bayaran balik sebahagian daripada premium anda dengan 

syarat anda tidak membuat tuntutan ke atas polisi. 

PENGEMBALIAN SEMULA 

Bolehkah saya mengembalikan polisi saya jika ia telah luput? 

Ya, anda boleh mengembalikan semula polisi anda tertakluk pada terma-terma dan syarat-syarat 

Syarikat. Anda mungkin diminta untuk mengemukakan bukti untuk membuktikan kebolehinsuransan 

kesihatan anda pada saat penerimaan kembali. 

TUNTUTAN 

Bagaimana saya hendak membuat tuntutan? 

Anda perlu melengkapkan borang tuntutan yang berkaitan yang boleh didapati daripada ejen 

AIA anda, dengan menelefon Hotline Perkhidmatan Pelanggan AIA di 1 300-88-1899 atau 

mengunjungi sebarang cawangan AIA di Malaysia dinyatakan di belakang dokumen ini.


Apakah dokumen lain yang perlu diserahkan bersama tuntutan? 

Di samping borang tuntutan yang diberikan, kami juga memerlukan laporan perubatan tambahan 

(seperti yang dinyatakan di belakang borang tuntutan) untuk menyokong tuntutan. 

Bilakah saya perlu memberitahu AIA mengenai tuntutan? 

Sekiranya berlaku tuntutan, anda hendaklah memberitahu kami dengan segera + . 

+ Tempoh pemberitahuan berbeza mengikut jenis tuntutan yang dibuat. Sila rujuk pada kontrak polisi. 

PELEPASAN CUKAI 

Bolehkah saya menggunakan premium yang telah dibayar untuk ExcelCare Plus and 

MediCover Plus untuk tujuan pelepasan cukai? 

Polisi ini boleh melayakkan anda mendapat pelepasan cukai perseorangan tertakluk kepada 

keputusan muktamad Lembaga Hasil Dalam Negeri. 

MAKLUMAT 

Apa yang perlu saya lakukan jika butir-butir hubungan saya bertukar? 

Adalah penting bagi anda memberitahu kami mengenai sebarang pertukaran butir-butir hubungan 

anda bagi memastikan semua surat-menyurat sampai kepada anda tepat pada masanya. 

Di mana saya boleh mendapatkan maklumat lanjut? 

Mengenai ExcelCare Plus dan MediCover Plus 

Sekiranya anda memerlukan maklumat tambahan mengenai ExcelCare Plus dan MediCover 

Plus atau mengenai mana-mana pelan insurans atau rider AIA yang lain, anda boleh menelefon 

Hotline Perkhidmatan Pelanggan AIA kami di 1300-88-1899 atau mengunjungi mana-mana 

cawangan AIA di seluruh negara. Senarai cawangan AIA dinyatakan di belakang dokumen ini. 

Anda juga boleh menghubungi kami melalui emel dengan melayari www.aia.com.my. 

Mengenai Insurans Perubatan Dan Kesihatan 

Sekiranya anda memerlukan maklumat tambahan mengenai insurans perubatan dan kesihatan, 

anda juga boleh merujuk buku kecil insuranceinfo mengenai ‘Insurans Perubatan Dan Kesihatan’ 

yang boleh didapati di semua cawangan kami atau anda boleh mendapatkan satu naskah 

daripada ejen insurans atau kunjungi www.insuranceinfo.com.my. 

NOTA: 

1 10% ko-insurans dikenakan bagi tuntutan yang melebihi amaun percuma ko-insurans, tertakluk 

kepada ko-insurans maksimum keseluruhan RM3,000 setahun. 

2 Semua perkhidmatan adalah tertakluk kepada kelayakan dan had manfaat pelan anda. 

3 Perlindungan ini terpakai hanya sekiranya penghospitalan anda berlaku dalam tempoh 

90 hari pertama anda berada di luar negara. Kos rawatan dibayar mengikut caj berpatutan 

yang dikenakan oleh hospital di Malaysia. Bagi warga asing, perlindungan hanya disediakan 

di Malaysia. 

4 Sentiasa tertakluk kepada had tahunan. 

5 Untuk negara-negara di Amerika Utara, EC (Komuniti Eropah) dan Jepun sahaja. 

6 Tertakluk kepada dua perundingan sehari. 

7 Untuk setiap kemasukan ke hospital. 

8 Tertakluk kepada satu perundingan sehari. 

9 Jadual Prosedur Harian Yang Dilindungi: 

- Artroskopi, Kolonoskopi, Laparoskopi, Litotripsi Gelombang Kejutan Ekstrakorporeum, 

pembedahan Katarak. 

10 Terhad kepada sekali seumur hidup.

26 


11 Jadual Prosedur Harian Yang Dilindungi: 

- Adenoidektomi; Artroskopi; Aspirasi dan Biopsi Sumsum Tulang; Pembedahan 

Katarak; Kolesistektomi; Kolonoskopi; Pengkateteran Arteri Koronari; Sistektomi; 

Sistouretroskopi; Pendilatan dan Pengkuretan Diagnostik; Pembedahan 

Vena Endolaser; Kolangiopankreatografi Retrogred Endoskopi; Eksisi Bunion; Eksisi 

Ganglion, Fibroma dan Gumpalan Payu Dara; Eksisi Pterigium; Litotripsi Gelombang 

Kejutan Ekstrakorporeum; Herniotomi / Herniorafi; Insisi Perentak; Insisi atau Pembuangan 

J-Sten Ureterik; Ablasi Endometrium Laparoskopi; Laparoskopi; Marsupialisasi dan Penyaliran 

Sista Bartholin; Miringotomi atau Miringoplasti; Pengurangan Fraktur Tulang; Pelepasan 

Sindrom Terowong Karpus (Penyahmampatan Terowong Karpus); Pelepasan Kontraktur 

Dupuytren (Pelepasan Jari Membengkok); Pembuangan Polip Servikal atau Vagina; 

Pembuangan Polip Hidung; Pembuangan Plat dan Implan Ortopedik; Pembedahan Pemisalah 

Retina; Pengikatan Hemoroid dengan Gelung Getah; Hemoroidektomi Mengokot; Tonsilektomi. 

NOTA PENTING: 

ANDA HENDAKLAH MEMASTIKAN BAHAWA POLISI INI MENEPATI KEPERLUAN ANDA. 

PENGECUALIAN DAN HAD-HAD MANFAAT YANG DITERANGKAN ADALAH TIDAK LENGKAP. 

ANDA HENDAKLAH MEMBACA DAN MEMAHAMI POLISI INSURANS ITU DAN BERBINCANG 

DENGAN EJEN ATAU MENGHUBUNGI TERUS SYARIKAT INSURANS UNTUK MAKLUMAT 

LANJUT.

ExcelCare Plus & MediCover Plus 27

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ExcelCare Plus & MediCover Plus


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