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“Kelebihan skim ini ialah kekuatan NUTP dan Great Eastern yang memberikan perkhidmatan cemerlang, tepat dan teratur kepada ahli.”
- Puan Lok Yim Pheng
Setiausaha Agung NUTP
Semenanjung Malaysia |
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It is never too early to take precautions where your well-being and that of your loved ones are concerned. Leave no room for future regret... because life gives NO advance of what it holds in store. |
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 Why choose NUTP Health Care? |
- One standard rate for individual and family members who is between 18 and 55 years old.
- Children are free insured with same benefits obtain by member
- Co-insurance is not needed.
- No age limit
- Yearly limit is RM 100,000
- RM 50,000 claim for every diablement of each individual
- This card can be renewed until you reach 65 years old
For any question about claim, please contact 03-4813 3906 or TOLL FREE: 1-300-880-125
For any question about hospital admission, please contact 03-20893888
or TOLL FREE:1-800-882-762 |
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| Features |
- covers eligible members between 6 months and 60 years of age
- Renew as long as the premium is paid until age 65
- Cashless facility (which may be reviewed from time to time) hospital admission to more than 30 approved panel hospitals throughout Malaysia
- Reimbursement of every diasblement can achieve Overall Maximum Limit (subject to your option as long as 14 separatement days [for worker] & 90 separatement days conditions [for non-worker] are met)
- 24 hours worldwide coverage and when travelling overseas you can continue to enjoy worlwide cover up to 90 days
- Treatment in other than panel hospital is allowed to claim medical fees, but it is subject to the stated Maximum Benefits Limit
- Payment fees include:
- surgical fees
- Hopsitalisation treatment fees
- intensive care unit
- pre-hospitalisation and post-hospitalisation treatment
- organ transplant
- kidney dialysis
- Tax free benefits (subject to Malaysian Income Tax Act 1967)
** Note: subject to validation checks, accidental and emergency cases shall enjoy automatic admission. For elective admission, there will be a pre-admission screening at the panel hospital. Certain exclusions on pre-existing conditions may not enjoy the cashless facility and a deposit may be required. Such admission shall still be eligible to submit the claims for reimbursement by Great Eastern Life Assurance (M) Berhad.
Importance Notice:
The policy is effective if :-
1) Great Eastern's Letter Acceptance is accepted AND
2) First premium has been accepted by Great Eastern or salary cut for first premium has been carried out
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 Premium Bulanan Pelan A |
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| During the first Policy Year |
No cover is provided for the following however caused, irrespective whether the Life Assured is aware of it or not :- endometriosis, hernias of any kind, stones in urinary or billiary systems, gastric and duodenal ulcers, cataracts, hypertension and/or cardio-vascular diseases, thyroidectomy, hysterectomy, cyst, benign neoplasm and malignant neoplasm. |
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| Pre-existing Condition shall mean any illness or injury |
- Which existed or was diagnosed; and/or
- For which signs and symptoms existed that would cause an ordinary prudent person to seek diagnosis, care or treatment, within five (5) years prior to the Risk Commencement Date
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EXCLUSIONS |
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- No benefits shall be payable with respect to any illness or injury unless the entire treatment and all services and supplies so rendered and performed had been recommended and approved by a Physician, and in accordance with the diagnosis and treatment of the condition for which the Hospital was required.
- No benefits shall be paid for the following :-
a) AIDS (Acquired Immuno Deficiency Syndrome), ARC (AIDS Related Complex), & all illness or disease in the presence of the Human Immuno-deficiency Virus (HIV).
b) any dental work or treatment (including any surgery), except as necessiatated by an Accidental injury occuring during the Period of Insurance of this Policy.
c) charges for routine physical examinations, test not incidental to treatment or diagnosis of a covered illness/injury or any treatment which is not medically necessary including preventive treatment, preventive medicines, sexual dsyfunction, weight reduction or weight improvement.
d) charges for seeing a general practitioner, acupunture and inoculation, and charges for telephone, television, newspapers and other ineligible non-medical items.
e) claims with respect to any injury or illness or condition, other than the condition as hereinbefore defined in "During the first Policy Year" above, for which:
- any injury, illness or condition which existed or was diagnosed
i. during the Waiting Period of thirty (30) days; or
ii. after the expiry of the Waiting Period of thirty (30) days but which is related to an injury illness or condition which exited or was diagnosed during the Waiting Period.
- a claim with respect to any injury, illness or condition as described at item 2(e)(i) and / or item 2(e)(ii) above, shall not be payable merely because the said claim was notified to the Company after the expiry of the Waiting Period.
f) charges for services received in convalescent and nursing homes, nature cure clinics and similar establishments, and for rest care.
g) eye test, refractive errors of the eyes, photo refractive keratectomy, cosmetic or plastic surgery and the provision of appliances, inclusing spectacles, lenses, hearing aids, wheelchairs and prosthesis.
h) out-patient treatment not related to in-patient treatment except as provided under the Policy.
i) Pre-exisitng Conditions, unless declared and stated in the proposal form and specifically accepted by the Company and endorsed thereon.
j) treatment and/or cost incurred in a country other than Malaysia in respect of an illness or injury which has been diagnosed in Malaysia.
k) treatment arising from geriatric, phsyco-geriatric or psychiatric conditions inclusing neourosis and psychosis, self-inflicted injury or attempted suicide, consequences of alcohol abuse and drug addiction.
l) treatment for congeital abnormalities, including physical defects present from birth.
m) treatment arising from pregnancy which shall include childbirth, miscarriage, infertility, abortion or sterilisation, or contraception, including any complications realting thereto.
n) treatment arising from racing of any kind (except on foot), skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports and criminal activities.
o) treatment directly or indirectly arising from or consequent upon war or civil war (whether war be declared or not), invasion acts of foreign enemies, hostilities, rebelion, revolution, insurrection or military or usurped power, particpating or servicing in any of the military or armed forces, nuclear action.
p) charges incurred for Hospitalisation, pre-hospitalisation and/or post-hospitalisation on the expiry of the last day of the Period of Insurance/Policy Year.
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| Jadual Manfaat Hospital Insurans Dan Faedah Insurans Bedah Kumpulan |
Pelan A |
| Group Hospitalisation And Surgical Insurance Schedule of Benefits |
RM |
| (A) Room And Board Benefit / Bilik Hospital & Penginapan |
| (i) Ordinary Ward (Maximum Per day) / Bilik Biasa (Maksimum Sehari) |
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- Private Hospital Admission (maximum 150 days) / Kemasukan Hospital Swasta (Maksimum 150 hari)
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30, 000 |
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(ii) Intensive Care Unit (Maximum per day) / Unit Rawatan Rapi (Maximum Sehari) |
400 |
- Maximum Per Any One Disability (Maximum 75 days) / Had Maksimum Keseluruhan Setiap Hilangupaya (Maksimum 75 hari)
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30,000 |
| (B) Surgical Benefit / Manfaat Pembedahan |
- Maximum Per Any One Disability Not Subject To The Schedule of Surgical Operations and Benefits
Had Maks. Keseluruhan Setiap Hilang-upaya Tidak Tertakluk Dalam Jadual
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37,500 |
- Anaesthetist's Fees / Bayaran Anestetis
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11,250 |
| (C) Miscellaneous Hospital Benefit / Lain-lain Manfaat Hospital |
As charged /
Kos Sebenar Yang Dikenakan |
- Maximum Per Any One Disability / Maksimum Bagi Setiap Hilang-upaya
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| (D) Consultation Benefit / Manfaat Perundingan |
- Maximum Per Day / Maksimum Sehari
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- Max. Per Any One Disability (Max. 60days) / Had Maks. Keseluruhan Setiap Hilang Upaya (Maks 60 hari)
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| (E) Emergency Accident Outpatient Treatment / Rawatan Kemalangan Kecemasan Untuk Pesakit Luar |
| (F) Pre-Hospitalisation Specialist Consultation Benefit / Rawatan Sebelum Kemasukan Hospital |
| (G) Pre-Hospitalisation Diagnostic X-Ray And Lab /
Perbelanjaan X-Ray Dan Makmal Sebelum Kemasukan Hospital |
| (H) Post-Hospitalisation Benefit (within 31 days) / Rawatan Selepas Kemasukan Hospital (dalam 31 hari) |
| (I) Outpatient Physiotherapy Treatment / Rawatan Fisioterapi Untuk Pesakit Luar |
| (J) Ambulance Service / Bayaran Ambulans |
200 |
| (K) Government Hospital Daily Cash Allowance (Maximum 150 days) / Wang Tunai Harian Hospital Kerajaan ( Maksimum 150 hari) |
100 |
| (L) Medical Report Reimbursement / Bayaran Laporan Perubatan |
80 |
| (M) Monthly Outpatient Kidney Dialysis & Cancer Treatment / Rawatan Dialisis Buah Pinggang & Kanser Untuk Pesakit Luar |
4,000 |
| (N) Organ Transplant |
35,000 |
| (O) Maximum Overall Limit / Had Maksima Menyeluruh |
- Per Member (Malaysia) / Seorang Ahli (Malaysia)
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50,000 |
- Per Member (Outside Malaysia) / Seorang Ahli (Di Luar Malaysia)
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80,000 |
- Per Family (Malaysia) / Sekeluarga (Malaysia)
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100,000 |
- Per Family (Outside Malaysia) / Sekeluarga (Di Luar Malaysia)
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200,000 |
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NOTE :
The above premiums are applicable to persons in standard health. Extra premiums and / or reduced cover may be imposed if there is special health risk.
* Every member of the family will be given a NUTP Health Care Card. |
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Important Notice:
“Pre-existing Disease ” means the assured has already known the disabilities. The insured is to be said that he/she has known the pre-existing condition for one of the below circumstances:-
• insured has received or still having treatments;
• medical consultation, diagnose, suggested care or treatment;
• clear or obvious symptons; or
• the pre-existing condition is obvious to a normal people.
“Certain Disease” means the below disbilities and the realted complication, which happens within first 120 days pertama from the date of Authorization Certificate for the insured:
• Hypertension, diabetes and cardiovascular disease
• All tumor, canser, nodule, polyp, stone in
excreta and biliary
system
• All ears, nose (including sinus) and gullet disease
• Hernia, hemorrhoid, fistula, hiydrocele, varicocele
• Endometriosis including breeding system disease
• Spinal vertebro disturb (including disc) and kneel disease
“Waiting Period” means first 30 days between the start of diabilities of the insured and Date of Authorization Certificate / date of Reauthorization and is used when only he/she is insured at the first time. It will not be used after the first year of protection. However, if insurance period is terminated, Waiting Period will be applied again.
24 hours wordlwide protection and during visit to overseas, you will continue to enjoy the worldwide protection until 90 days.
Reimbursement of all the cost of each disability can reach maksimum of the sum (sunbject to your option as long as 14 days separate period (for workers) & 90 days separate period (for responsibility) is met.
Children's participation is refered to those who are not yet married, below age of 19 and at least 15 days or not more than age of 23 if they are full time student and not yet working. Renewal for spouse and member are up to age of 65.
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