• Etiqa Health Insurance

    You can take care of your healthcare-related expenses with the health insurance/takaful products offered by Etiqa. The list of health insurance/takaful products available is listed below.

    Etiqa Health Insurance Plans

    Health Insurance Plan Coverage Provided For Events Covered Annual Limit Lifetime Limit Room and Board Rate
    Elite Medical Plus Yourself, spouse, and children Surgical fee, in-hospital physician visit charges, pre-hospitalisation diagnostic tests, post-hospitalisation treatment, outpatient physiotherapy, and more. Up to RM1.5 million Unlimited Up to RM500 per day
    Elite Takaful Medical Plus
    Medical Plus Cashless hospital admission, surgery, ICU, medical report fee, pre-hospitalisation diagnostic test, post-hospitalisation treatment, outpatient kidney dialysis treatment, cancer treatment, and more
    Takaful Medical Plus

    Etiqa Health Insurance Highlights

    Lifetime Limit Unlimited
    Annual Limit Up to RM1.5 million
    Daily Cash Limit (per annum) Unlimited (government hospital)
    Alternate Medical Practitioner Charges RM200 per annum (applicable until 90 days after discharge)

    Features and Benefits of Etiqa Health Insurance

    • Get the deductible cover option with Etiqa health insurance plans.
    • No limit on the number of days per annum for the hospital room and board cover.
    • Get a daily cash allowance of up to RM200 per day if admitted to a government hospital.
    • Get cashless hospitalisation benefit at a panel hospital.
    • The Etiqa Healthcare app shows the nearest panel hospital and increases medical care entitlement.

    How to Claim?

    Online Claim Form
    • Notify the insurer as early as possible of the incident causing a claim request.
    • Visit the official website of Etiqa and open the Online Claims Form.
    • Enter accurate details in the form, such as policy information; incident date, venue, damage details, and more; supporting documents to back your statement; and other people/vehicles involved in the incident.
    General Claim Form
    • Download the General Claim Form from the official website of Etiqa.
    • Fill up the form with relevant details.
    • Send the form and supporting documents via email to [email protected]
    • You can also drop the claim application at the nearest branch office or at Claims Care, Level 12, Tower B, Dataran Maybank, 1, Jalan Maarof, 59000 Kuala Lumpur.

    Eligibility

    Health Insurance Plan Age Criterion
    Elite Medical Plus Adults—18 to 65 years Children—14 days onwards
    Elite Takaful Medical Plus
    Medical Plus
    Takaful Medical Plus

    Documents Required for Claim

    Outpatient Claims
    • Police report in the case of a motor accident.
    • Medical report.
    • Original medical receipts.
    Medical Expenses and Ambulance Fee Reimbursement
    • Claim form filled up by you and the attending doctor.
    • Original medical bills and receipts.
    • Police report in the case of a motor accident.
    • Original receipt for ambulance fee.
    Hospitalisation
    • Claim form filled up by you and the attending doctor.
    • Original medical bills and receipts.
    • Admission/Discharge note.
    • Police report in the case of a motor accident.

    Contact Information

    Etiqa Online 1300 13 8888
    Etiqa Healthcare Personnel 1800 88 9998 [email protected]
    Claims Enquiry [email protected]
    Telephone +603 2297 3888
    Fax + 603 2297 3800

    Etiqa Malaysia provides a host of in-hospital, pre-hospitalisation, and post-hospitalisation benefits across its health insurance plans. You can also get cashless hospitalisation benefit with Medical Plus, and Takaful Medical Plus policies. Get in touch with the staff of the insurance company to get more details on the cost of purchasing one of the policies.

    FAQs

    Q. Is organ transplant charges covered by Etiqa health insurance plans?

    A. Yes. All 4 of Etiqa health insurance plans cover organ transplant charges. However, it is limited to 1 organ transplant per policy.

    Q. What riders can I attach to these insurance plans?

    A. Etiqa specifies the riders you can attach to each of the health insurance plans available and they are specified in the table below:

    Health Insurance Plan Riders Available
    Elite Medical Plus Elitelink
    Elite Takaful Medical Plus Elite Takafulink
    Medical Plus Enrich Life Plan Triple Lifestyle Protector
    Takaful Medical Plus Harmoni Mabrur Karisma Intelek Prisma Prisma+

    Q.How is my claim application processed?

    A. Once you submit a claim application, the following steps will take place to process it:

    1. A claims expert will be assigned to each claim application. For complex claims, a team of claims experts will be assigned.
    2. The claims expert will contact you will talk to you to collect/provide details about the claims processing. They may also make an in-person appointment to discuss.
    3. The claims expert will make an inspection, interview witnesses (if required), and evaluate the situation.
    4. You will receive the claim settlement or you will be explained on why the application did not hold well.

    Q.Which are the panel hospitals of Etiqa?

    A. Etiqa has partnered with a host of hospitals across the nation to provide its policyholders with a hassle-free medical treatment. Currently, there are more than 130 panel hospitals in different parts of Malaysia, such as Salam Specialist Hospital in Kuala Terengganu; Mahkota Medical Centre, Pantai Hospital Ayer Keroh, and Oriental Melaka Straits Medical Centre in Melaka; Amanjaya Specialist Centre, and Putra Medical Centre in Kedah; Cardiac Vascular Sentral Kuala Lumpur, Institut Jantung Negara, and KPJ Tawakkal Specialist Hospital in Kuala Lumpur and more.

    Q.What are the outpatient benefits available with these plans

    A. You can get the following outpatient benefits with Etiqa health insurance plans:

    • Pre-hospitalisation diagnostic tests or specialist consultation.
    • Post-hospitalisation treatment charges up to 90 days after discharge.
    • Physiotherapy expenses up to RM1,000 up to 90 days after discharge/surgery.
    • Emergency accidental treatment charges.
    • Ambulance fees.
    • Home nursing charges of up to RM100 per day for a maximum of 60 days per annum.
    • Day surgery fees.
    • Emergency sickness treatment fees of up to RM100 per medical condition.
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