Introduction

This programme provides a comprehensive coverage of the medical expenses incurred due to:
1) Out-patient medical care/treatment expenses
2) In-hospital care and ambulatory care resulting from sickness, as well as diseases of accidental injury

What does IKHLAS Group Hospitalisation & Surgical Takaful cover?

This programme covers:-

1) Out-patient care/treatment

1a) Out-patient care/treatment at a legally registered General Practitioner (GP) as a result of common sickness and bodily injuries, where hospitalization is not required. This benefit is applicable within Malaysia only. This benefits comes in two plans:

Prime Plan
The Prime Plan covers medically necessary services prescribed by a panel GP (as per the list of panel clinics). Covered services are provided at no charge to the Covered person provided the covered person presents his/her Member Identification together with his/her Identity Card. Services provided by a non-panel Clinic will not be covered, except in the event of an emergency.

(i) Routine Consultation
Covers the routine consultation charges by a physician at a Panel Clinic
(ii) Medication
Covers the cost of medication, which requires a physician’s prescription at a Panel Clinic
(iii) Injection
Covers the cost of injection which requires a physician’s or physician assistant’s administration at a Panel Clinic
(iv) Diagnostic Lab/X-Ray Procedures
Covers the cost of laboratory and x-ray procedures done at a Panel Clinic
(iv) Out-Patient Surgical Procedures
Covers the cost of outpatient surgical procedures done at Panel Clinic

Choice Plan
This plan is an extension of Prime Plan where services provided by non-panel clinics are covered on re-imbursement basis.

1b) Out-patient care/treatment at a legally registered Specialist as a result of specific sickness and bodily injuries, where hospitalization is not required. The covered person must obtain a referral from panel GP, referring him/her for specialist consultation.This benefit is applicable within Malaysia only.

(i) Consultation
Covers the consultation charges by a specialist except when consultation is follow-up care after discharge from Hospital or Daycare Procedure, which is covered under the Hospital & Surgical benefit.
(ii) Medication
Cover the cost of medication, which requires a specialist’s prescription.
(iii) Injection
Covers the cost of injection, which requires a specialist’s or specialist’s assistant administration.
(iv) Diagnostic Lab/ X-Ray Procedures
Covers the cost of laboratory and x-ray procedures done by a specialist.
(v) Out-Patient Surgical Procedures
Covers the cost of outpatient surgical procedures done by a specialist

2) In-hospital care and ambulatory care resulting from sickness, as well as diseases of accidental injury

This programme or benefit provides comprehensive coverage for medical expenses due to hospitalization, upon recommendation of a Medical Practitioner, resulting from sickness, disease or accidental injury. This benefit is applicable worldwide subject to the Applicability Clause under Definitions.

This plan covers:

2a) Hospitalisation Care/Treatment
i) Hospital room and board(Private/Government) including ordinary room and intensive care unit
ii) Hospital Supplies & Services
iii) Surgical Fees
iv) Anaesthetic Fees
v) Operating Theatre Charges
vi) In-Hospital Physician Fees
vii)Malaysian Government Hospital Daily Cash Allowance
viii) Hospital Service Tax

2b) Other Medical Services & Treatment
i) Pre-Surgical/Medical Diagnostic Services
ii) Pre-Surgical/Medical Specialist Consultation
iii) Second Surgical Opinion
iv) Post-Hospitalisation & Daycare Procedure Follow-Up Treatment
v) Out-Patient Accidental Treatment
vi) In-hospital care
vii) Daycare Procedure
viii) Ambulance Fees
ix) Emergency Out-Patient Treatment
x) Medical Report Fee Treatment