Product information - Allianz SME Choice Plus
Option 1 - Basic Plan: Group Basic Medical (GBM)
- Below RM500 Range: Allianz SME Choice Plus - RB 90
- Below RM500 Range: Allianz SME Choice Plus - RB 140
- Between RM501 to RM1,000 Range: Allianz SME Choice Plus - RB 180
- Between RM501 to RM1,000 Range: Allianz SME Choice Plus - RB 250
- Above RM1,000 Range: Allianz SME Choice Plus - RB 400
- Above RM1,000 Range: Allianz SME Choice Plus - RB 600
- Reasonable and Customary Charges based on Private Health Care Facilities and Services (Private Hospitals and Other Private Healthcare Facilities) Regulation 2006 in Malaysia.
- We shall reimburse the Goods and Services Tax (GST) on taxable supplies and services provided to the Insured Member, incurred in connection with the Eligible Expenses if any, subject to the limits as stated in the Table of Benefits.
Allianz SME Choice Plus GBM schedule of benefits :-
What are the covers/benefits provided?
Option 1 - Basic Plan: Allianz SME Choice Plus Group Basic Medical (GBM)
Cover medical expenses incurred as a result of hospitalisation or surgery due to an illness or an accident
- Benefits, give your employees peace of mind when they need to be hospitalised.
- Medical Coverage with High Overall Annual Limit (up to RM300,000).
- Fully covered Hospital Admissions (No Co-Payment required).
- Cashless medical card for quick, hassle-free convenience at panel clinics.
- Unlimited outpatient general practitioner care.
- Outpatient specialist care for up to RM1,800.
1. Please refer to the full feature and benefits and scale of benefits in the policy contract.
2. Duration of cover is for one (1) year. You need to renew your insurance coverage annually.
How much premium do I have to pay?
- The total premium that you have to pay may vary depending on the choice of the plan required and underwriting requirements:
1) Annual Premium Rates (In MYR)
- Allianz SME Choice Plus Group Basic Medical (GBM)
- Allianz SME Choice Group Outpatient Medical (GOM)
- Allianz SME Choice Extra Fees / Charge
The premium rate and Management Care Outpatient (MCO) fees shown above are inclusive of Sales and Services Tax (SST), at the prevailing rate.
- Companies wishing to purchase GOM must opt for the cashless basis GBM plan, i.e. the company will need to take up the RM42.00 MCO fee option for the combined GBM and GOM.
1. Premium rates are not guaranteed. Factors contributing to the increase in premiums rates are plan specific, medical inflation, age band, occupation and underwriting requirement
2. New hires: We will charge the additional premium by the number of days starting from the effective date of coverage to the end of the policy period
3. Leavers: We will refund the excess premium by the number of days beginning from the effective date of termination to the end of the policy period
What are the key terms and conditions that I should be aware of?
Duration of coverage is for 12 months, renewable annually
The coverage for twenty-four (24) hours a day. If the insured person elects to or is referred to be treated outside Malaysia by the Attending Physician, benefits payable shall be limited to the Reasonable and Customary and Medically Necessary Charges for such equivalent local treatment in Malaysia which excludes the cost of transport to the place of treatment
No benefit shall be payable for any medical treatment received by the Insured if he/she resides or travels outside Malaysia for more than ninety (90) consecutive days
- All full-time, permanent and actively at-work employee, directors partners and proprietors aged 16 to 66 years old are eligible for medical coverage, renewable up to age 70 (next birthday)
- Dependants of employees are also eligible for coverage:
- employee’s a legally married spouse, the eligible entry age is below 66 years old.
- Coverage is extended to unmarried children over fifteen (15) days old and the coverage is up to twenty-four (24) years of age (next birthday)
- Dependant Plan shall be the same as the Employee Plan. If dependant's coverage is taken, it will apply to all eligible employees in the company within the same basis of coverage
All benefits are available to Occupational Class 1 to 4
- The premium rate is based on the individual's attained age (age next birthday)
- Mode of payment is Annual
- Prevailing GST applies to all plans if any
All pre-existing conditions are excluded for first 12 months of coverage, except for Outpatient Cancer & Kidney Treatment, for which pre-existing conditions will be permanently excluded
Please refer to the relevant policy contract for full list and details of exclusions
General FAQ - Allianz SME Choice
What should you know after purchase the insurance plan?
|Type of Claim||Waiting Period|
No Waiting Period
No Waiting Period
What are Specific Illnesses?
- Common Specific Illnesses :
• Hypertension, Diabetes Mellitus, Cardiovascular Disease
• All tumours, cancers, cysts, nodules, polyps, stones of urinary/ biliary system
• All ears, nose (including sinuses) and throat conditions
• Hernias, haemorrhoids, fistulae, hydrocele, varicocele
• Endometriosis, including diseases of the reproductive system
• Vertebral-spinal disorders (including disc) and knee conditions
- What are Pre-existing Illnesses
If the Insured Member elects or is referred by the attending Physician to receive treatment outside Malaysia, the benefits payable in respect of such treatment shall be limited to the Reasonable and Customary Charges that are Medically Necessary for such equivalent local treatment in Malaysia and shall exclude the cost of transport to the place of treatment.
General Policy Exclusions
- Group Hospitalisation & Surgical
- Air travel except as a fare-paying passenger
- War, declared or undeclared, riots, Civil Commotion etc.
- Active duty in military, naval, arm force, police or any uniformed unit
- Ionising radiation or contamination by radiotherapy
- Any intentionally self-inflicted injury, while sane or insane
- Dental treatment and cosmetic surgery except due to an accident
- Functional disorder of psychic or mental
- AIDS or Aids Related Complex
- Routine medical checkup or any treatment purely for investigation purposes Any circumcision unless it is medically required, Sex changes, etc.
- Sleep and Snoring disorder
- Abuse of Alcohol and /or Drugs
- Congenital Abnormalities
- Non-medical items
- Tissues, Toilet rolls
- Telephone/ Fax Charges
- Vitamins (unless medically necessary)
- Denture Pot/ Mouth Piece
- Dietician Fee
- Valuable Envelope/ Mineral Water
- CDs/DVDs (patient’s copy)
- Electricity charges
- Rental of Television / Radio
- Sanitary pads/towels (unless utilized for a related medical condition)
- Shaving blades (unless utilised for surgery purposes)
- Sarongs (unless utilised in Operating Theater)
- Discharge Pack
- Purchase of appliances such as crutches, wheelchairs and etc.
- Lodging Fees/Lodger
- Extra meals
1. Hospitals might collect deposit upon admission for charges not covered by insurance (commonly RM100 to RM1,000)