Medical Insurance @ Medical Card

Source : http://www.firstnstd.com/101229%20medins.html

On the subject of medical insurance, to be fair, most people realize that having medical insurance is important because medical treatment can be costly if one were to seek treatment at private hospitals. In Malaysia, we are still very fortunate because we can still relatively easily seek treatment at government or public hospitals which are heavily subsidized – unlike people in developed countries such as in the U.S., U.K., Europe, Australia, Japan, etc.  In developed countries (which we as a country aim to attain by year 2020), whilst public funded medical facilities are available, they are not so prevalent and thus are less easily accessible for those living in areas where there are none.  Most people in these countries will therefore have to rely on getting treatment at private medical facilities, but because of the high costs involved most will have no access to treatment unless they are covered by some form of medical insurance. 

Luckily for us in Malaysia, we are still able to have access to treatment at very low cost at government medical facilities.  The downside however is having to contend with the huge crowds seeking treatment at Government hospitals and the consequently long waiting time.  This is unavoidable simply because government facilities are affordable, and therefore most people, rich and poor alike, will want to seek treatment there – the rich if they didn’t mind the wait, the poor because they had no choice.

To give an example of this at our government hospitals, a few years back, there was a case of a 76 year old man who had a fall and fractured his pelvis and thigh bone (femur). Being a government pensioner, he enjoyed (almost) free medical treatment at government hospitals.  (Note that even for non-civil servants the costs of medical treatment are just nominal and still very affordable to most.)  Naturally, the man was admitted into a government hospital, a well known one with excellent facilities.  The doctor who examined him ordered surgery to repair the fractures.  In the meantime traction was administered for his fractured leg in order to prevent further injury.  An appointment for surgery was set for about two weeks or so depending on availability.  This was unavoidable simply because with the limited facilitiesavailable doctors had to ensure that those with more critical or life threatening injuries were given preference for surgery.  Now having to lie on a hospital bed (thankfully this hospital was air-conditioned) with one leg immobilized by traction and with as little movement as possible permitted for two whole weeks can be awfully agonizing!  Needless to say, if one can’t afford to seek treatment and surgery elsewhere, there will be no choice but to continue in that state and wait the two weeks or so out.

Fortunately for the man, his family could afford the additional costs of about RM20,000 to seek treatment at a private medical facility, and off he was transferred to one close by.  Surgery was carried out the day after and just about a week later, he was discharged from the private hospital.  

This is but an example of a relatively minor problem which involved about RM20,000 in treatment costs.  What if it were something more serious and the costs had been higher?  Say, RM50,000 or RM100,000 or even RM200,000?  With the double-digit rate of inflation in costs of medical treatment, it would not be surprising at all if a procedure which today costs RM50,000 may very well cost RM209,000 in 15 years’ time (just using an inflation rate of 10% - statistics for Malaysia from the World Health Organization website show the rate to be higher).  See the table on current costs of certain medical procedures – note however, these costs do not take into consideration costs of hospitalization, ICU, etc. yet.

If it costs RM200,000 for a treatment that we need, do we have the financial resources to pay for it?  If not, what are our alternatives?

Fortunately, for those who are in employment generally would enjoy some form of coverage from their employers.  However prudence dictates that we ought to find out what and how much are we covered for exactly.  In fact, not too long ago, a very senior executive of a very large public listed conglomerate discovered to his own dismay that his medical coverage entitlement had a limit of just RM30,000 per annum – after he had undergone a heart bypass operation which had cost RM65,000.  The poor chap had to pay the balance (of RM35,000) from his own pockets – what a way to learn.  

To add salt to the wound, the man was retiring the following year.  Double jeopardy for him in that he now had RM35,000 less in retirement funds as he had used part of his retirement funds for the surgery, and secondly, the prospect of him qualifying for medical insurance upon his retirement has now become pretty slim.  Even if he did qualify, the premiums would have been substantially higher because of his age and health condition, and besides that it would have been very likely that his coverage would have a permanent exclusion on treatment for heart related diseases which is now a pre-existing condition.

Suffice it to say therefore that people who are currently covered under their employer’s Group Hospitalisation and Surgical Policy will still need to consider the following:

• As mentioned above, we’d need to find out what and how much are we covered for – to make sure the coverage is adequate, and whether it is in our employment contract that the employer will pay for any medical expense above the insured amounts. 
• Getting a medical insurance policy after retirement may perhaps be one of the worst approaches simply because we might not qualify for medical insurance when we retire – there have been lots of such cases.  Secondly, even if we are of excellent health, the premiums will be very high, and surely, we will not want to incur such high expenses when we are retired.
• If I were to get a separate medical policy of my own, wouldn’t it be a waste of my money because surely I can’t claim from my employer’s as well as from my own medical policies.  While that is correct, today there are medical insurance policies which are designed to have high deductibles (that is, the first amount of the expense that we will pay for ourselves) and therefore have much lower premiums.  The large deductible will mean that the first layer of expense can be covered by our employer’s policy leaving only the amounts exceeding the limit to be claimed under our own policy.  Further, some of such medical policies even allow for the deductibles to be removed when we retire – i.e. the insurer guarantees that we will continue to be insured when we retire.
• Determining how much is adequate for a medical insurance policy can be pretty tricky.  A sum of RM100,000 might be adequate today for many types of medical treatments, but would the same be adequate in the years to come?  There are medical insurance plans today that have a benefit called “annual limit waiver” which effectively allows one to have access to the high lifetime limits, usually 10x the annual limits.  For instance, if one had a medical insurance plan that had an annual limit of RM50,000, the lifetime limit would be RM500,000. In this case, therefore, if the person had a medical treatment that costs., say RM250,000, he would still be able to claim for these expenses as they would still be below the lifetime limit.  Very useful benefit to have, but usually the premium for this benefit can be very high especially for those in the older age category.

Now, in general, whether we are covered by our employers or not, we need to ask ourselves:

• Am I in the financial position to self-insure?  To answer this question, we can ask ourselves; have I set aside a reasonable amount of money to cater for my medical expenses – say, have a sum of at least RM100,000 today not to be used for anything else?
• If I can’t even afford the insurance premium today, what will I do if I am faced with a huge medical bill tomorrow?  This is of course a tough question.  Some will just throw their hands in the air and say; well, that’s just my fate.  Only God can help….  true, but remember, God helps those who help themselves.

Anyone need a Medical Insurance @ Medical Card, please contact me at ;

Muhammad Mageswaran - 012-590289

Email : mageswaran@mzpartners.com.my

We have the Best Medical Card in Malaysia, you should own one, because you deserves the Best Medical Services and Specialist Doctor.

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Best Brands in Medical Insurance

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