e-Medical Pass Takaful

About e-Medical Pass Takaful

What is e-Medical Pass Takaful? What does it cover?
e-Medical Pass Takaful is a standalone medical Takaful plan that provides coverage for hospitalisation and surgical expenses. Please refer to the Product Disclosure Sheet or Certificate on detailed exclusions, terms and conditions of the plan.
Who is this product suitable for?
This product is suitable for adults who do not have any medical coverage or to complement any shortage of their existing medical plan.
There are 3 plans, which plan is suitable for me?
The suitability of the plan would depend on your affordability and your needs.
Will I have a medical card?
There is no medical card issued for this Certificate. However, in a more convenience way, upon hospital admission, you just present your identity card and inform the Panel hospital of your cover by Etiqa.
How can I participate? Can I go through an agent?
You may participate in this Takaful plan through our website. This is an online Takaful product and it is not offered through any of our agents. There is no commission charged on this plan.

Eligibility

Who is eligible to participate?
Malaysians between 18 and 55 years old (age next birthday) are eligible to participate, subject to the fulfillment of health questions.
Can a foreigner enroll in this plan?
This plan is only offered to Malaysians between 18 and 55 years old (age next birthday).
Can I participate a medical plan if I am above age 54 years old?
Sorry, you are not eligible for this medical plan. However, we still have other similar types of medical plans which may be suitable for you, kindly contact Etiqa Oneline by calling 1-300-13-8888.
Can I participate a medical plan if I am not eligible for this medical plan after answering the underwriting questions?
Yes, we still have other similar types of medical plans which may be suitable for you, kindly contact Etiqa Oneline by calling 1-300-13-8888.
Can I participate in more than one Certificate?
No, you are eligible for one Certificate only.
What if I misstate or do not disclose any of the required information?
Misstatement or non-disclosure of material information will result in voidance of the Certificate, or your claim not being paid. To prevent these unwanted events, you are required to disclose all relevant information, including medical condition and age, correctly.

Coverage

What is annual limit?
Annual limit is the maximum amount that you are eligible to claim for your medical expenses in every Certificate year. Annual limit will be refreshed every Certificate year.
What should I do if I don’t have sufficient annual limit to cover my medical charges?
You will have to pay the differences between your eligible annual limit and the medical charges. Annual limit will be refreshed every Certificate anniversary.
What is deductible?
Deductible is the amount of eligible hospitalisation expenses incurred that must be paid by you for each hospitalisation before any benefits are payable by Us.
Why is my contribution cheaper when I choose the plan with deductible?
It is cheaper because you will need to bear some of the eligible hospitalisation expenses for each hospitalisation.
How do I know if I need a deductible or without a deductible medical plan?
- With deductible
  If your existing medical plan or employer cover is insufficient, then this plan will complement your existing medical coverage provided additional medical protection.
- Without deductible
  If you do not have any medical coverage.
If I participate in this plan with RM1,000 deductible, how it works?
You are required to pay RM1,000 of the eligible hospital & surgical expenses incurred for each hospitalisation. We will pay the balance of the eligible expenses after deducting the first RM1,000

Example 1: Hospitalisation expenses
The eligible hospitalisation expenses = RM10,000
Deductible amount per hospital admission = RM1,000
Amount to be paid by you = RM1,000
Amount to be paid by us = RM10,000 – RM1,000 = RM9,000

Example 2: Out-patient expenses (Eligible Out-patient expenses are not subject to deductible)
The eligible Out-patient expenses = RM800
Amount to be paid by you = RM0
Amount to be paid by us (by Reimbursement basis) = RM800

Sum Insured & Coverage Period

How does the contribution amount determined?
You are charged a certain amount of contribution based on the plan type, deductible option, occupation and attained age at the commencement date. The contribution may increase in accordance to your attained age. You will need to pay the contribution up to age 80. Contribution rates are non-guaranteed and we reserve the right to revise the contribution rate by giving 30-day prior notice.
How to pay and what is the frequency to pay the contribution for the Certificate?
You may pay the contribution via credit card/debit card. You may opt to pay the contribution monthly, or annually. You may continue using the credit card/debit card or switch to your bank saving account to pay for the renewal contribution.
How do I change my credit/debit card used for contribution deduction?
You may walk in to any of our branches and fill up a Request For Change form, and a Contribution Payment through Visa/Master Card form.
What happens if I stop paying the contribution?
There is a grace period of 31 days from the contribution due date given to you to pay the contribution. You are still covered within the grace period. If the contribution due is not paid within the grace period, your Certificate may lapse thereafter and you will not be entitled for the benefits shall the covered event (In-patient & Day Care Surgery Benefits and Out-patient Benefits) occurs.
Can I access the medical plan if I miss a contribution payment?
If you missed any contribution payment and provided that your Certificate has not lapsed, you may be able to access the medical plan, however, you may face some interruption during the discharge process from the hospital and You will need to pay back the contribution due.
Do I enjoy a tax relief on the contribution paid?
You may use the Family Takaful contribution paid for tax relief, as per current Malaysian tax regulation and subject to the Inland Revenue Board’s approval.

Surplus Sharing

Do I get to enjoy the underwriting surplus?
We will determine the underwriting surplus or deficit on a yearly basis. 50% of the surplus will be paid to us for managing and operating the Participant’s Risk Fund (PRF) and the other 50% will be shared among participants whose certificates are in force and do not make any claim to takaful benefits within the financial year.

The distributed surplus shared to participants is accumulated within a segregated fund. 85% of any investment profits on the segregated fund will be shared amongst the participants with in force certificates, and the remaining 15% to be paid to us, based on the contract of Mudarabah. The accumulation within the segregated fund is paid together with the benefits, on expiry of the certificate, or should the participant requests at any time prior to expiry of the certificate, provided that the amount requested is at least RM500.

Certificate Administration & Cancellation

Can I upgrade my plan?
You may upgrade to a higher room and board plan, subject to our underwriting decision.

Can I cancel the Certificate?
You may cancel your Certificate with a written instruction to us within 15 days after the Certificate has been received by you. We will then refund the contribution received to you. However, no refund can be made when a claim has been admitted.

However, if you cancel the certificate after the 15 days, you are entitled to the accumulated distributed surplus, if any, plus a refund of the partial contribution as follows:

Period Not Exceeding	Refund of Annual Contribution
15 days (renewal only)	90%
1 month	80%
2 months	70%
3 months	60%
4 months	50%
5 months	40%
6 months	30%
7 months	25%
8 months	20%
9 months	15%
10 months	10%
11 months	5%
Period exceed 11 months	No refund

Note: There is no Contribution refund for monthly cases.

What if I lose or do not receive my Certificate documents? Or if I need to update my personal information or contact details?
You may email us at info@etiqa.com.my or call Etiqa Oneline at 1-300-13-8888.

Claims

How to file a claim in case of covered events happen (In-patient & Day Care Surgery Benefits)?
- If you choose to visit a panel hospital:
  For hospital admission, no medical card is required, just present your identity card and inform the hospital you are covered with Etiqa. We will pay the eligible hospitalisation expenses that you incurred subject to the annual limit of the plan you participate in. For plan with deductible, you will need to pay for eligible expenses up to the deductible amount per hospital admission before we cover the remaining eligible expenses.
- If you choose to visit a non-panel hospital:
  You are required to pay for the hospitalisation expenses upon discharged. Submit the list of documents required to Etiqa for reimbursement of the eligible hospitalisation expenses within 30 days from discharge date.
  
  For further information, download the claim guide. List of Panel Hospitals are available in the claim guide. We can be contacted via email at info@etiqa.com.my or call Etiqa Oneline at 1-300-13-8888.
How to file a claim in case of covered events happen (Out-patient Benefits)?
You are required to pay for the Out-patient expenses. Submit the list of documents required to Etiqa for reimbursement of the eligible Out-patient expenses within 30 days from discharge date.

For further information, download the claim guide. List of Panel Hospitals are available in the claim guide. We can be contacted via email at info@etiqa.com.my or call Etiqa Oneline at 1-300-13-8888.

Medical Examination

Will there be any medical examination for this plan?
No medical examination is required. Your application will either be accepted or rejected based on our pre-determined requirements.

Other Information

How will I receive confirmation on my application? When does the cover start?
The confirmation of your application is immediate through the website. The cover will start on the day your application is accepted with payment made, with a Certificate document and payment receipt emailed to you.
Who can I contact for further information?
You may email us at info@etiqa.com.my or call Etiqa Oneline at 1-300-13-8888 for further information. A 24-hour Live Chat is also available on our website for enquiry.