See how much of a hospital bill your medical card pays and how much you pay, from your policy's limit, deductible and co-payment.
You pay
RM 1,975.00
Your insurer pays RM 28,025.00 of RM 30,000.00
You pay: RM 1,975.00
Read these from your policy schedule. Many newer medical plans include a co-payment share; the annual limit is what is left for the year after earlier claims.
RM30,000 bill, RM500 deductible, 5% co-pay capped at RM3,000
Your insurer pays RM28,025.
You pay RM1,975
RM200,000 bill on a RM150,000 limit, no deductible
Everything above the annual limit is yours.
You pay RM50,000
How the figures above are worked out — the rules, rates and reasoning behind every line.
Your deductible comes off first. Then you pay your co-payment share of the rest, up to any cap. The insurer pays the remainder, up to the annual limit you have left. Anything above that limit is yours too.
All four numbers are on your policy schedule. If you have claimed earlier in the year, use the limit that remains.
Annual limit: the most the policy pays in a policy year.
Deductible: a fixed amount you pay per claim or per year before the policy pays. A higher deductible usually means a lower premium.
Co-payment (co-takaful): a percentage of the bill you share. Many newer plans include one, often with a cap per claim.
No. Premiums depend on the insurer, your age, health and plan, so only an insurer's quote is reliable. This shows what a plan pays out once you have one.
Usually not, and most plans have waiting periods for certain illnesses. Check the exclusions in your policy.
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