A Life-long Medical Coverage with MaxHealth Plan

The benefit(s) payable under eligible product are protected by PIDM up to limits. Please refer to PIDM’s TIPS Brochure or contact MCIS Life or PIDM (visit www.pidm.gov.my).
MaxHealth Plan

A Life-long Medical Coverage with MaxHealth Plan

The benefit(s) payable under eligible product are protected by PIDM up to limits. Please refer to PIDM’s TIPS Brochure or contact MCIS Life or PIDM (visit www.pidm.gov.my).

Enjoy peace of mind with a medical coverage plan that you can fully entrust your health.

According to the 2022 Global Medical Trend Rates Report by Aon, Malaysia’s medical inflation rises at an average rate of 10% to 15% annually. This staggering number shows that health insurance in Malaysia is more important than ever now.

Enter MaxHealth Plan, a comprehensive medical coverage plan made for modern times. Enrolling in this plan can potentially help you lighten the financial burden from increasing medical costs.

How Comprehensive is the MaxHealth Plan?

No Overall Lifetime Limit
High Annual Limit
Outpatient Dengue Fever Treatment
Alternative Medicine
(e.g. Chiropractic, Homoeopathy)
Extensive Network of Panel Hospitals
Flexible & Tailored To Your Needs
Hassle-free Hospital Admissions
Get Rewarded With Room & Board Benefit Increase
Lifelong Coverage Up To Age 100

Covered for Life

Better yet, you can feel secure knowing that MaxHealth has a high annual limit of up to RM1,500,000 and without a limit on coverage for your whole life. This means it can protect you and your family up to age 100 (age next birthday). And if you already have an existing plan by us? No worries, this medical coverage can also be added as a rider to our other plans.

What are the benefits of this medical insurance?

Flexible & Tailored To Your Needs

We aspire to provide a range of options so that you can obtain medical coverage that is affordable and one that best suits your needs. There are 5 different levels of coverage to select from with 0 or RM3,000 deductible*. The RM3,000 deductible option allows you to enjoy savings with lower premium rates, making medical protection more affordable.

*Deductibe refers to the amount out of the eligible amount payable by us for the benefits that you must first pay.

Get Rewarded With Room & Board Benefit Increase

As a reward for staying healthy, your Room and Board benefit will be increased by 20% of the initial amount at the end of every 2 years provided that no claim has been made in the previous 2 years, subject to the total increment amount not being more than 100% of the initial Room and Board benefit.

Hassle-free Hospital Admissions

A medical card will be provided to ease any hospital admission and discharge.

Lifelong Coverage Up To Age 100

It is crucial to have medical protection, especially during the golden years of your life. With MaxHealth Plan, you are protected up to age 100 (age next birthday).

No Overall Lifetime Limit

MaxHealth Plan gives you total peace of mind with no overall lifetime limit.

High Annual Limit

MaxHealth Plan provides extensive coverage with an annual limit of up to RM1,500,000 depending on the plan selected.

Outpatient Dengue Fever Treatment

What better way to recover from an illness than in the comfort of your home. MaxHealth Plan provides coverage for outpatient dengue fever treatment, allowing you to recuperate comfortably.

Alternative Medicine

Reimburses charges incurred for alternative treatments such as Chiropractic, Chiropody, Homoeopathy, and Osteopathy.

Extensive Network of Panel Hospitals

Our medical card is accepted by our panel hospitals throughout Malaysia.

Note:
The product features above are not exhaustive. Please refer to the policy contract for more details.

Learn More

DESCRIPTION OF BENEFITS Ringgit Malaysia (RM)
Plan150 Plan200 Plan300 Plan400 Plan500
Limits
Overall Annual Limit 850,000 1,000,000 1,200,000 1,400,000 1,500,000
Overall Lifetime Limit Unlimited
Deductible Option 0 or 3,000
Hospital and Surgical Benefits  
Hospital Room and Board
(Limit per day, up to 150 days per Policy Year)
150* 200* 300** 400** 500**
Intensive Care Unit
(Limit up to 150 days per Policy Year)
As Charged, subject to Reasonable and Customary Charges
Hospital Supplies and Services
Surgical Fees
Operating Theatre
Anaesthetist Fees
In-Hospital Physician Visit
(2 visits per day)
Pre-Hospitalisation Treatment
(within 45 days before Hospitalisation)
Post-Hospitalisation Treatment
(within 90 days after Hospitalisation) - including Physiotherapy and Acupuncture
Organ Transplant
Day Care Surgery
Ambulance Fees
Goods and Services Tax
(On taxable supplies and services)
Hospital Admission Fee and Medical Report Fee
(Limit per Hospitalisation)
100
Daily Guardian Benefit
(Limit per day, up to 120 days per Policy Year)
75 100 150 200 250
Outpatient Treatment Benefits
Emergency Accidental Outpatient Treatment
(Limit per Accident, maximum 30 days from date of Accident for follow up treatment)
1,500 2,000 3,000 4,000 5,000
Outpatient Dengue Fever Treatment
(Limit per Policy Year)
2,000 2,500 3,000 4,000 5,000
Outpatient Cancer Treatment As Charged, subject to Reasonable and Customary Charges
Outpatient Kidney Dialysis Treatment
Other Benefits
Daily Cash Allowance at Government Hospital
(Limit per day, up to 150 days per Policy Year)
75 100 150 200 250
Home Nursing Care
(180 days lifetime limit)
Limit per Hospitalisation
3,000 4,000 6,000 8,000 10,000
Alternative Medicine - Chiropractic, Chiropody, Homeopathy and Osteopathy
(Limit per Policy Year, within 90 days after Hospitalisation)
Not applicable 200 300 400 500
No Claim Reward Room and Board benefit to be increased by 20% of the initial amount at the end of every 2 years provided that no claim has been made in the previous 2 years, subject to the increment amount not being more than 100% of the initial Room and Board benefit.
Notes:
Hospital and Surgical Benefits, Outpatient Treatment Benefits and Other Benefits are subject to Reasonable and Customary Charges.
* If Life Assured is hospitalised at the Room and Board rate which is higher than the entitled benefit, the Life Assured has to pay:
  • The exceeded amount of the Hospital Room and Board charges; and
  • Co-payment of 20% of other eligible Hospital and Surgical benefits described in the Schedule of Benefits, subject to a maximum of RM1,000 for any one (1) disability.
** If Life Assured is hospitalised at the Room and Board rate which is higher than the entitled benefit, the Life Assured has to pay the exceeded amount of the Hospital Room and Board charges.

This plan is available for anyone between the ages of 30 days and 65 years (age next birthday), subject to underwriting.

MaxHealth Plan provides coverage up to 100 years old (age next birthday) and the premium is payable until the end of the coverage term.

The premium amount payable will vary depending on the plan and deductible option you choose, your age, gender, occupation class and is subject to underwriting. You can choose to pay your premiums yearly, half-yearly, quarterly or monthly. Payments can be made via Private Deduction, Debit/Credit Card, Angkasa Deduction, Auto-Debit or Direct Payment methods.

Yes, the premiums paid for MaxHealth Plan may qualify you for a personal tax relief of up to RM3,000 for medical and education insurance. However, tax benefits are subject to the Malaysian Income Tax Act, 1967, and the final decision of the Inland Revenue Board of Malaysia.

If the Life Assured is hospitalised at the Room and Board rate which is higher than the entitled benefit, the Life Assured has to pay the exceeded amount of the Hospital Room and Board charges and a co-payment equivalent to 20% of the other eligible Hospital and Surgical benefits described in the Schedule of Benefits, subject to a maximum of RM1,000 for any one (1) disability. However, if you select Plan300, Plan400 and Plan500, the co-payment will be waived and you only need to pay the exceeded amount of the Hospital Room and Board charges.

For MaxHealth Plan, if you select the RM3,000 deductible option, you must first pay a fixed amount of RM3,000 out of the eligible amount payable upon claims, for any one (1) disability. However, the benefits under Outpatient Treatment Benefits and Other Benefits are not subjected to this deductible.

By selecting the RM3,000 deductible option, you will enjoy savings through lower premium rates. Below is an example of the amount of premium that you can potentially save:

Mr. X is currently 30 years old (age next birthday) and intends to purchase Plan200. By selecting the RM3,000 deductible option, he could potentially save a total of RM 156,736 in premiums throughout his policy term of 70 years. Please refer to the table below for the amount you can potentially save by selecting the RM3,000 deductible option instead of the zero deductible option.

Age of Entry
(next birthday)
Policy Term
(years)
Amount of savings in premium (RM)
Plan150 Plan200 Plan300 Plan400 Plan500
1 99 155,688 166,363 191,758 212,392 248,512
10 90 152,206 163,271 188,745 209,355 245,106
20 80 149,026 160,461 186,013 206,594 242,020
30 70 144,816 156,736 182,394 202,956 237,942
40 60 140,784 153,165 178,951 199,495 234,068
50 50 135,534 148,009 173,363 193,472 227,114

Note: The table above is based on the total difference in premiums throughout the policy term between the deductible of RM0 and RM3,000 for occupational class 1 & 2, male, with standard risk, and assuming that the birthday of the Life Assured falls on the same day as the policy inception date.

Example:
Mr. A purchased Plan150 and opted for the deductible option of RM3,000. Six years later, he has to undergo a surgery which requires 2 days of hospitalisation. He is entitled for the RM150 Room and Board rate, but decides to upgrade to a room that cost RM200 per day.

Item Incurred Bill Amount Covered Amount Payable by Mr. A
Room and Board RM200 x 2 days = RM400 RM150 x 2 days = RM300 RM400 - RM300 = RM100
Other Eligible Hospital and Surgical Benefits (e.g. surgical fees, hospital supplies, etc.) RM20,000 RM20,000 - co-payment of RM1,000 = RM19,000 Co-payment: Lower of (RM20,000 x 20%) or RM1,000 = RM1,000
Total RM20,400 RM19,300 RM1,100
Total (After deductible of RM3,000) RM20,400 RM19,300 - RM3,000 = RM16,300 RM1,100 + RM3,000 = RM4,100

What are the restrictions, conditions and exclusions for MaxHealth Plan? This plan does not cover any hospitalisation, surgery or charges caused directly or indirectly, wholly or partially, by any one (1) of the following occurrences:-

  1. Pre-existing Illness;
  2. Any medical or physical conditions arising within the waiting period of thirty (30) days except for Accidental Injuries;
  3. Specified Illnesses occurring within the first one hundred and twenty (120) days from the Effective Date of Insurance;
  4. Plastic/cosmetic surgery, circumcision, eye examination, glasses, lens and refraction or surgical correction of nearsightedness and farsightedness (Radial Keratotomy or Lasik) and the use or acquisition of external prosthetic appliances or devices such as artificial limbs, hearing aids and prescriptions thereof;
  5. Dental conditions including dental treatment or oral surgery; except as necessitated due to Accidental Injuries to sound natural teeth occurring in any Policy Year and performed by Dentist. In addition, expenses arising from placement of denture and prosthetic services such as bridges, implants and crowns or their replacement will not be payable;
  6. Private nursing, rest cures or sanitaria care, illegal drugs, intoxication (including but not limited to alcohol and drugs), sterilisation, venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related diseases, and any communicable diseases required quarantine by law;
  7. Any treatment or surgical operation for Congenital Conditions or deformities including hereditary conditions;
  8. Pregnancy, childbirth (including surgical delivery and any surgical or non-surgical procedures on the female reproductive system during surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilization;
  9. 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, and treatments specifically for weight reduction or gain;
  10. Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane;
  11. War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any armed forces, direct participation in strikes, riots and civil commotion or insurrection;
  12. Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material;
  13. Expenses incurred for donation of any body organ by a Life Assured and cost of acquisition of the organ including all costs incurred by the donor during organ transplant and its complications;
  14. Investigations and treatment of sleep and snoring disorders, hyperhidrosis treatment, hormone replacement therapy, stem cell therapy, positron emission tomography (PET) scan and alternative therapy such as treatment, medical service or supplies, including but not limited to reflexology, bone setting, herbalist treatment, massage, hyperbaric oxygen therapy or aromatherapy or other alternative treatment, except as provided for Post-Hospitalisation Treatment and Alternative Medicine – Chiropractic, Chiropody, Homeopathy and Osteopathy;
  15. Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Life Assured and Disabilities arising out of duties of employment or profession that is covered under a Workman’s Compensation Insurance Contract or from either sources in respect of Injury or Illness or Disease for which the claim is made;
  16. Psychotic, mental or nervous disorders, (including any neuroses and their physiological or psychosomatic manifestations);
  17. Costs/expenses of services of a non-medical nature, such as television, telephones, telex services, broadband services, electricity bills for handphone charging, radios or similar facilities, admission kit/pack and other ineligible non-medical items;
  18. Sickness or Injury arising from racing of any kind (except foot racing), hazardous sports such as but not limited to parachuting, sky-diving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities;
  19. Engaging in aerial flights other than as a crew member or as a fare-paying passenger of an international Airline operating on a regular scheduled route; Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes;
  20. Expenses incurred for sex change;
  21. Any Outpatient treatment not related to Inpatient treatment, except as provided under this plan;
  22. Any Accident caused by mosquito bites, worm infestations such as “Hookworms” and allergic reaction to insect bites during the first thirty (30) days from the Effective Date of Insurance; or
  23. Charges which are not Reasonable and Customary Charges, or any surgery or treatment which is not Medically Necessary, or charges in excess of Reasonable and Customary Charges, or charges which are incurred for Hospitalisation, Pre-Hospitalisation and/or Post-Hospitalisation after the Expiry Date.

Room and Board Benefit
Coverage of daily room charges as billed by a hospital for the cost of accommodation, meals, and general nursing care.

Lifetime Limit
The maximum aggregate amount claimable from the time the policy is bought until the policy coverage expires.

Annual Limit
The maximum amount of money you can claim for a policy year.

Panel Hospital
A Hospital approved and identified by the insurer to provide treatment to the Life Assured.

Guardian Benefit
Reimbursement for expenses incurred for meals and lodging when a guardian accompanies a hospitalised Life Assured who has not attained aged fifteen (15) years.

Note

  • The product information provided on this website is for general information only and shall not be construed as a policy of insurance. You are advised to refer to the Product Brochure, Sales Illustration (if applicable), Product Disclosure Sheet and Policy Contract for complete details of the product.
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