SmartCare Optimum
Hospital & Surgical Insurance

 

With the escalating and unexpected medical charges, you would prefer to stay healthy and avoid suffering from any illnesses or injuries. An illness or accident can put a real strain on your well being as well as your finances. But now you don’t have to worry about expenses. At AFFINBANK, let SmartCare Optimum concentrate on the bills whilst you concentrate on getting better.

SmartCare Optimum is a premium health plan with the widest and comprehensive coverage that gives customers a high range of benefits. From a full refund on inpatient and day surgery costs to high benefits for various outpatient treatments.

SmartCare Optimum is the only health plan that offers renewal up to age 80 provided you were already a member on your 59th birthday.

  • Wider protection and flexibility from four different plans with coverage up to RM500,000.00
  • Outpatient treatment including
    • accident and emergency treatment
    • kidney dialysis
    • cancer treatment

  • Deductible Option
    • Customer may choose to buy Deductible Option where they pay the first RM7,500, RM10,000, RM15,000 or RM20,000 of their hospitalization bills.
    • Customer will be entitled to a premium discount up to 50%

  • Cashless Admission facilities
    • Eliminates the need for an admission deposit into any of our AXA 's panel hospitals

  • 24 hours a day, 7 days a week
    • Just call AXA’s 24 hour assistance hotline to arrange cashless admission to any of their panel hospitals in Malaysia. If customer choose Plan 1, customer will also have access to 24-hour emergency medical assistance throughout the world , in addition to having customer’s medical cost reimbursed for emergency treatment oversea.
  • Income tax relief
    • You can qualify for income tax relief up to RM3,000 for medical insurance premium.

 

Table of Benefits

BENEFITS
PLAN 1
PLAN 2
PLAN 3
PLAN 4
OVERALL ANNUAL LIMIT
(benefit within Malaysia, annual maximum)
RM500,000
RM200,000
RM100,000
RM50,000
INPATIENT & DAYCARE TREATMENT (per disability)
Room & Board, daily maximum
Total number of days
RM500
RM300
RM150
RM80
150 days
120 days
120 days
120 days
Intensive care unit, daily maximum
Total number of days
Full Reimbursement
60 days
60 days
60 days
60 days
Ambulance
Full Reimbursement
RM350
RM350
Insured Child's Daily Guardian Benefits (for child below 15 years old, up to 60 days)
Full Reimbursement
Not Applicable
Prescription Drugs
Full Reimbursement
Nursing, Theatre Consumables & other Ancillary Charges
Full Reimbursement
Surgeon's Fees
Anesthetist's Fee
Diagnostic Procedures & Physiotherapy Physician Fees, one visit per day
Specialist fees, one visit per day
Full Reimbursement subject to Overall Annual
Limit provided the charges are within the
recommendations of the Malaysian Medical
Association Guidelines and Reasonable
and Customary charges
Operating Theatre
Full Reimbursement
OUTPATIENT TREATMENT (per disability)
Consultations & Diagnostic Procedures within 31 days before hospital confinement
RM5,000
RM3,000
RM2,000
RM1,000
Post Hospitalisation Care and Physiotherapy Treatment within 31 days from hospital discharge
RM5,000
RM3,000
RM2,000
RM1,000
Accident & Emergency Treatment within 14 days from the date of the accident
Full Reimbursement
SPECIAL BENEFITS
Kidney Dialysis, lifetime maximum
RM60,000
RM40,000
RM20,000
RM20,000
Cancer Treatment, lifetime maximum
RM60,000
RM40,000
RM20,000
RM20,000
International Emergency Medical Evacuation and Repatriation, per annual maximum RM500,000

Not applicable


Don't let an illness or accident stop you from enjoying life.

 

Frequently Asked Questions

Who is eligible to join?
If you are in the age group of 1 to 59 as of your next birthday, you are eligible to join. We offer renewal up to age 80 provided you were already a member on your 59th birthday. Dependent children (unmarried & unemployed) must be above 15 days and under 19 years of age, or under 23 years of age if the child is still on full-time higher education in Malaysia. Children under 2 years of age can only be included on a policy held by one or both their parents, and cannot take out a policy themselves.

Is there a surgical schedule?
No. There is no surgical schedule. Benefits are payable on a full refund basis.

What is cashless admission?
This means that you don't have to pay deposits to the hospital if you are admitted to one of the AXA panel hospitals. We will pay, provided the nature of accident or illness is covered under the policy.

What does international emergency medical assistance provide?
It provides 24 hours telephone medical consultation, telephone referral to doctors and hospitals, emergency medical evacuation and repatriation services outside Malaysia.

Are the Premiums Guaranteed?
We may charge the premiums in the future as the premium rates are not guaranteed. If we need to change, this will be based on our overall experience in underwriting this class of business and any changes in Premiums will be notified and made on your policy anniversary.

Is the Renewal Guaranteed?
There is no selective Renewal Loading or Exclusion on individual if claim is made during previous year. No restriction on lifetime limit and full annual limit is restated at Policy Renewal . However, the renewal of the Policy is conditionally guaranteed until the occurrence of any of the following:-

a) non payment of premiums or premiums not made on time
b) fraud or misrepresentation of material fact during application
c) the Policy is cancelled at the request of the policyholder
d) on the death of the policyholder or an Insured Person
e) the Insured Person ceases to qualify as a dependent based on the definitions of the Policy
f) the Insured Person attains the coverage age limit specified
g) termination of coverage for all policies in a certain market

What are the disadvantages on switching policy from one insurer to another?
One of the main disadvantages is if your current health status is less favourable to the new insurer, new terms may be imposed to exclude such illness To ensure continuous cover is provided, you are advised to check with us on the accepting terms prior to your policy expiry date.

 

Contact us at 03-2055 9931 / 03-2055 9936 or you may download, complete and fax the Proposal Form to 03-2026 4675.

 
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