Is your Shield plan keeping up with the times?

Transcription

1 AIA HEALTHSHIELD GOLD MAX AIA HEALTHSHIELD GOLD MAX ESSENTIAL PROTECTION Is your Shield plan keeping up with the times? Introducing AIA HealthShield Gold Max, a Medisave-approved medical plan that helps you cope with rising healthcare costs. aia.com.sg

2 AIA HealthShield Gold Max and Max Essential 3 72 % of Singaporeans agree that they cannot afford to get sick these days due to the high medical costs* AIA HealthShield Gold Max and AIA HealthShield Gold Max Essential represent the basic components of comprehensive health insurance planning. Medical or hospital expense plans I m concerned about paying for medical expenses if I am hospitalised. Hospital income, or hospital cash plans I m concerned about loss of income or expenses not covered by my basic medical plan. Personal accident plans I m concerned about medical bills and loss of income if I am injured in an accident. Critical illness plans I m concerned about the costs associated with a major illness, like Cancer. *Source: Singapore s Emigration Conundrum, The Business Times, 6-7 October 2012

3 AIA HealthShield Gold Max and Max Essential 4 As the common saying goes: your health is your wealth. It couldn t be more true Unexpected medical expenses could represent a significant threat to your finances. If you have no protection, or only partial protection, the impact on your savings might be substantial. Wise financial planning involves both saving for the things you want and protecting yourself against the unexpected. Isn t it time to consider a plan that helps with both? AIA HealthShield Gold Max AIA HealthShield Gold Max is a medical expense reimbursement plan that offers protection against medical bills. It reimburses your medical bills up to the amount charged and offers unlimited lifetime claims 1. You pay: You pay: Your medical bill Co-insurance Deductible AIA HealthShield Gold Max + AIA HealthShield Gold Max Essential AIA HealthShield Gold Max Essential is an optional add-on that fills the gaps of your AIA HealthShield Gold Max plan by reimbursing the deductible and co-insurance portions of your hospital bill. This means you enjoy coverage from the first dollar. AIA HealthShield Gold Max and AIA HealthShield Gold Max Essential offer affordable lifetime protection against unexpected medical bills. About AIA HealthShield Gold Max AIA HealthShield Gold Max is a Medisave-approved medical expense reimbursement plan designed to meet most of the medical expenses you are likely to incur in public or private hospitals in Singapore, to lessen your financial burden. AIA HealthShield Gold Max offers you a choice of 3 plan types to match your individual needs, allows unlimited lifetime claims 1 and most of the benefits under AIA HealthShield Gold Max A and B are offered on an as charged 2 basis. If you prefer treatment in a lower ward of class in a public hospital, AIA HealthShield Gold Max C will cover most of your hospital bill up to the stipulated benefit limits 2, therefore offering you affordable medical coverage. Enjoy more extensive coverage with these benefits: Covers inpatient stay in Community Hospital Congenital abnormalities benefit for insured (no waiting period) and female insured s biological child 3 Living donor organ transplant benefits for insured and non-insured donor Post-hospitalisation psychiatric treatment Additional claim limits and extended post-hospitalisation treatment for 30 critical illnesses Waive one year s premium upon total and permanent disability Please refer to the Benefit Table for details. Guaranteed lifetime renewal and unlimited lifetime claims 1 USE your CPF Affordable premium payments using your CPF You can simply use your CPF Medisave funds 4 to pay for AIA HealthShield Gold Max premiums for you and your family members.

4 AIA HealthShield Gold Max and Max Essential 6 Benefits of AIA HealthShield Gold Max Limits of Compensation (S$ and inclusive of GST) Plan Type A B C Hospital Ward Entitlement 1. Hospitalisation and Surgical Benefits Daily Room and Board Benefit Daily ICU Benefit Community Hospital Benefit (per day) Surgical Benefit (include Organ Transplant Benefit and Stem Cell Transplant Benefit) Surgical Procedures 5 Surgical Implants and Approved Medical Consumables Stereotactic Radiosurgery 2. Pre-Hospitalisation Benefit (within 100 days before confinement) 3. Post-Hospitalisation Benefit Post-Hospitalisation Treatment (within 100 days after confinement) Extended Post-Hospitalisation Treatment for 30 Critical Illnesses (within 100 days following the expiry of Post-Hospitalisation Treatment) 4. Accidental Inpatient Dental Treatment Benefit As Charged As Charged As Charged Subject to the respective Limits of Compensation applicable to benefits under points (1) to (3) 450 per day 900 per day 450 per day As Charged in 6 7,000 per treatment 9,600 per procedure 500 per confinement 1,000 per confinement 5. Pregnancy Complications Benefit 7 As Charged NIL 6. Congenital Abnormalities Benefits For female insured s biological child from birth 8 For insured 7. Living Donor Organ Transplant Benefits Insured donating an organ Non-insured donating an organ to the insured 8. Emergency Overseas Medical Treatment Benefit 20,000 per lifetime Limit to 5,000 per child 60,000 per transplant 16,000 per lifetime Limit to 4,000 per child Subject to the respective Limits of Compensation applicable to benefits under points (1) to (3) 40,000 per transplant NIL 20,000 per transplant Subject to the respective Limits of Compensation applicable to benefits under point (1) Limits of Compensation (S$ and inclusive of GST) Plan Type A B C Hospital Ward Entitlement 9. Psychiatric Treatment Benefits In-Hospital Psychiatric Treatment Post-Hospitalisation Psychiatric Treatment (within 200 days after confinement) 10. Outpatient Benefits 9 Radiotherapy for cancer Stereotactic Radiotherapy for cancer Chemotherapy for cancer Immunotherapy for cancer Renal Dialysis Erythropoietin Approved Immunosuppressants prescribed for organ transplant As Charged 4,000 per policy year 2,500 per policy year 3,500 per policy year 500 per policy year 280 per day 2,000 per treatment 1,240 per month 700 per month 24,000 per policy year 11. Final Expense Benefit 9 5,000 per policy 3,500 per policy 2,500 per policy 12. Waiver of Premium for 1 year Benefit (upon Total and Permanent 9, 10 Disability) Waive one year s premium 13. Extra Cover for 30 Critical Illnesses Benefit Maximum Claim Limit Maximum Limit per policy year Maximum Limit per lifetime 100,000 per policy year Unlimited per lifetime 600,000 Unlimited 7 Unlimited per lifetime 450,000 Unlimited 30,000 per policy year Unlimited per lifetime 150,000 Unlimited Pro-ration Factor 6 NIL 70% 50% Deductible (per policy year) Below age 82 next birthday 11 C class ward 1,500 B2 class ward 2,000 B1 class ward 2,500 A class ward 3,500 (All ward types, except day 3,500 surgery and short stay ward) Day surgery/short stay ward 2,000 Co-insurance 10% Last Entry Age (next birthday) 75 Maximum Coverage Period Lifetime 1,500 2,000 2,500 2,500 2,500 2,000

5 AIA HealthShield Gold Max and Max Essential 8 About AIA HealthShield Gold Max Essential AIA HealthShield Gold Max Essential is an optional add-on that complements your AIA HealthShield Gold Max plan to cover any deductible or co-insurance portions of your hospital bill. Benefits of AIA HealthShield Gold Max Essential Limits of Compensation (S$ and inclusive of GST) Plan Type A B C Additional valuable benefits include: Daily hospital incentive Immediate family member accommodation Post-hospitalisation alternative medicine (for cancer and stroke) Post-hospitalisation home nursing Emergency outpatient treatment due to an accident Are you already adequately protected? While CPF Medisave, CPF MediShield, and employer-provided health benefits offer some level of protection for most people, these measures do not add up to a comprehensive lifetime solution: Hospital Ward Entitlement Deductible and Co-insurance Daily Hospital Incentive Benefit per day B1/B2/C class ward) 150 per day A class ward) Covered 150 per day B2/C class ward) 100 per day B1 class ward) 50 per day Restructured Hospital C class ward) CPF Medisave A serious accident or illness could wipe out your entire account balance. Immediate Family Member Accommodation Benefit 13 (upon physician s or specialist s advice in writing for period of confinement) Standard charges for an additional bed Standard charges for an additional bed Up to 70 per day Standard charges for an additional bed Up to 50 per day CPF MediShield May cover a portion of the medical cost. Coverage ends when you reach 90 years old. For more information, please visit Post-Hospitalisation Alternative Medicine Benefit 13 for cancer and stroke (within 100 days after confinement) Post-Hospitalisation Home Nursing Benefit 13 (within 26 weeks after confinement) Emergency Outpatient Treatment due to Accident Benefit 3,000 per policy year 1,000 per policy year 500 per day 300 per day 3,000 per policy year 100 per day 1,000 per policy year Employee health benefits Coverage typically ends when you leave the company or retire. 2,000 per policy year 1,000 per policy year 500 per policy year

6 AIA HealthShield Gold Max and Max Essential 10 Annual Premiums (S$ and inclusive of GST) Example Age Next Birthday Age Next Birthday AIA HealthShield Gold Max A B C , , ,667 1, ,250 1, ,831 2,339 1,219 3,162 2,570 1,414 AIA HealthShield Gold Max Essential A B C Mr Khor, a 32-year-old sales engineer is covered under the AIA HealthShield Gold Max A with AIA HealthShield Gold Max Essential A plan. After experiencing an unexplained weight loss and blood in his stool, he visited a specialist for a colonoscopy examination, which revealed a stage 3 colon cancer. He was hospitalised in a Government Hospital A class ward for 30 days and underwent surgery. After being discharged from the hospital, Mr Khor went for chemotherapy treatments for a year. His condition has now stabilised. The following table illustrates the list of benefits and claims payable by AIA: Medical Expenses Amount Payable (S$) Pre-Hospitalisation Benefit (specialist consultation and colonoscopy) 549 Hospitalisation and Surgical Benefits Daily Room and Board (30 days in Government Hospital A ward) Surgery Outpatient Benefit Chemotherapy for cancer Total medical expenses subject to Deductible and Co-insurance Less Deductible (not applicable to Outpatient Benefit) 27,243 10,590 31,458 69,840 (X) 3,500 (Y) Balance less Deductible 66, Less 10% Co-insurance (10% x S$66,340) AIA HealthShield Gold Max A pays 6,634 (Z) 59,706 (X Y Z) , , AIA HealthShield Gold Max Essential A pays: Deductible and Co-insurance Daily hospital incentive (S$150 x 30 days) 10,134 (Y+Z) 4, ,730 2,220 1,660 2,170 1,125 1,345 Mr Khor pays ,260 2,205 1,565 Premium rates do not remain level throughout the life of the policy and will increase with age. The premiums quoted are not guaranteed and are expected to be adjusted from time to time in line with our claim experience, medical inflation cost and general cost of treatment, supplies or medical services in Singapore.

7 AIA HealthShield Gold Max and Max Essential 12 Frequently Asked Questions It is always our intention to write in plain English, and to be as transparent as possible when describing our products. The questions and answers below reflect the most common concerns raised by our customers. If you have any other questions not addressed here, please ask your AIA Financial Services Consultant for more information. Alternatively, you may visit our website at aia.com.sg or contact our AIA Customer Care Hotline at Q1. Am I eligible to apply for AIA HealthShield Gold Max for myself and my family members? You can apply for AIA HealthShield Gold Max for yourself and your family members (grandparents, parents, spouse or children) if you and your family members are Singaporeans or Singapore Permanent Residents aged 75 years or below on your/their next birthday. Q2. How can I pay premiums for myself and my family members? AIA HealthShield Gold Max premiums can be paid from your CPF Medisave account, subject to the CPF Medisave withdrawal limit 4. If you have insufficient funds in your CPF Medisave account, or if your premium exceeds the CPF Medisave withdrawal limit 4, the balance of the premium payment must be made by cash. AIA HealthShield Gold Max Essential premiums can only be paid by cash. Q3. Will my premium change when I renew my policy? Your premium will change as you move into the next age group. Q4. Are these plans guaranteed renewable? Yes, they are guaranteed yearly renewable on your policy anniversary date by payment of the annual premium in advance before the end of the grace period. Q5. Do I have to take a medical examination? Subject to underwriting, you may be required to take a medical examination. Q6. What are deductible and co-insurance? The deductible is a fixed amount of up to a stipulated amount on a policy year basis that you have to pay first before the benefits are paid. The co-insurance is a fixed percentage of the medical bill that you have to pay after deducting the deductible amount. Q7. What conditions are excluded under these plans? Exclusions common to many medical expense reimbursement plans apply to AIA HealthShield Gold Max and AIA HealthShield Gold Max Essential, including: Pre-existing conditions, which means any illness or condition that occurred before the date your policy began or the date your policy was last reinstated, whichever is later (unless a declaration has been made by the Insured at the time of application or reinstatement of the policy and we have specifically accepted the application). Treatment for infertility, sub-fertility, assisted conception or any contraceptive operation and sex change operations. Treatment arising from injuries sustained during wars (whether war be declared or not), civil commotion, riots, revolutions, strikes, nuclear reaction or any war-like operations. There are other conditions whereby the benefits under these plans will not be payable. You are advised to read the policy contracts for the full list of exclusions. Q8. Is there a waiting period before I am eligible for certain benefits? There are waiting periods applicable to some benefits under these plans. Such benefits shall not be payable if the condition relating to or covered by the benefits is diagnosed during the waiting period. These waiting periods start from the date your respective plan began, the last reinstatement date of your respective plan (if any) or effective date of plan upgrade (if any), whichever is latest. (i) For pregnancy complications benefit, a waiting period of 10 months applies. (ii) For congenital abnormalities of insured s biological child from birth, a waiting period of 10 months applies. (iii) For insured (as living donor) donating an organ, a waiting period of 24 months applies. The date the recipient of the organ is first diagnosed with organ failure must be after the 24 months waiting period. Q9. Can I buy AIA HealthShield Gold Max Essential after my AIA HealthShield Gold Max plan is incepted? Yes you can. However, the waiting periods applicable to benefits under AIA HealthShield Gold Max Essential will start from the inception date or the last reinstatement date of the rider, whichever is later. Please refer to the policy contract for more information. Q10. How will I receive my claim payout? Most benefits payable under the plans are paid on a reimbursement basis (except for Waiver of Premium Benefit (upon Total and Permanent Disability) under AIA HealthShield Gold Max and Daily Hospital Incentive Benefit under AIA HealthShield Gold Max Essential), which means that any claim needs to be supported by original hospital or medical bills. Q11. Can I change my mind and cancel the policy after I ve purchased? Yes you can. You may cancel AIA HealthShield Gold Max by writing to us within 2 calendar months from the date you receive your AIA HealthShield Gold Max policy document (free-look period). You may cancel AIA HealthShield Gold Max Essential by writing to us within 14 days from the date you receive your AIA HealthShield Gold Max Essential policy document (free-look period) or within the free-look period of your AIA HealthShield Gold Max (whichever is later).

8 AIA HealthShield Gold Max and Max Essential 14 1 Subject to policy year limit and any overall benefit limits. 2 We shall pay the Eligible Expenses incurred, subject to any applicable Pro-ration Factor, Deductible and/or Co-insurance and any other benefit limits as stated in the Benefit Table and subject to the terms and conditions of the policy contract. 3 This benefit is not applicable to AIA HealthShield Gold Max C plan. 4 The current Medisave withdrawal limit per Insured per policy year is: S$800 for age 75 next birthday S$1,000 for age 76 to 80 next birthday S$1,200 for age 81 and above next birthday 5 Surgical Procedures refer to the types of surgical operations listed in the Table of Surgical Procedures under the Medisave Scheme operated by the Ministry of Health excluding all surgical operations stated in the General Exclusions and any other surgical operations that are not specified in the Table of Surgical Procedures. The costs of any surgical implants, Approved Medical Consumables and/or Stereotactic Radiosurgery procedure are not included in this portion of the benefit. 6 For AIA HealthShield Gold Max B, all Eligible Expenses incurred are subject to the Pro-ration Factor, if such expenses are incurred in a private hospital/private medical institution or any hospital outside of Singapore. For AIA HealthShield Gold Max C, only Eligible Expenses incurred for Surgical Procedures under Surgical Benefit is subject to the Pro-ration Factor if such expenses are incurred in a private hospital/private medical institution or any hospital outside of Singapore. 7 Pregnancy complications covered are Ectopic pregnancy, Pre-eclampsia or eclampsia, Disseminated Intravascular Coagulation (DIC), Miscarriage (after 21 weeks of pregnancy), Acute Fatty Liver Pregnancy and Choriocarcinoma and Hydatidiform Mole. 8 Reimburse Eligible Expenses incurred during the first 24 months from date of birth of the child. 9 Eligible Expenses incurred under the Outpatient Benefit are not subject to the Deductible but are subject to Co-insurance. The Final Expense Benefit and Waiver of Premium for 1 Year Benefit (upon TPD) are not subject to either the Deductible or Co-insurance. Eligible Expenses incurred under all other benefits are subject to the Deductible and Co-insurance. 10 The benefit expires on the policy anniversary occurring on or immediately following the insured s 70 th birthday. Please refer to the policy contract for the exact definitions of Total Permanent Disability. 11 For ages 82 and above next birthday, please refer to the product summary. 12 Exclude day surgery, short stay ward in an emergency department of a hospital, hospitalisation in a community hospital, hospitalisation overseas due to emergency and hospitalisation due to psychiatric condition. 13 These benefits are not payable if the insured is diagnosed and confined in a hospital due to a psychiatric condition. 14 Maximum entry age is 75 years old next birthday. Premium rates for ages 76 and above next birthday are for renewal only. Please refer to the product summary. Important Notes: These insurance plans are underwritten by AIA Singapore Private Limited (Reg. No R) ( AIA ). All insurance applications are subject to AIA s underwriting and acceptance. This brochure is not a contract of insurance. The precise terms and conditions of these plans, including exclusions whereby the benefits under these plans may not be paid out, are specified in the relevant policy contracts. You are advised to read the policy contracts. This is only product information provided by us. You should seek advice from a qualified adviser if in doubt. Buying health insurance products that are not suitable for you may impact your ability to finance your future healthcare needs. You are discouraged from switching from an existing accident and/or health insurance policy to a new one without considering whether the switch is detrimental, as there may be potential disadvantages with switching. A penalty may be imposed for early policy termination and the new policy may cost more or have fewer benefits at the same cost. AIA HealthShield Gold Max is issued under a joint insurance arrangement with the Central Provident Fund (CPF) Board to enhance the coverage provided by MediShield. Please note that you can use your CPF Medisave account to purchase only one Medisave-approved medical insurance scheme per Insured at any one time. The information is correct at the time of printing (16 January 2013). About AIA Group AIA Group Limited and its subsidiaries (collectively AIA or the Group ) comprise the largest independent publicly listed pan-asian life insurance group. It has operations in 16 markets in Asia Pacific wholly owned branches and subsidiaries in Hong Kong, Thailand, Singapore, Malaysia, China, Korea, the Philippines, Australia, Indonesia, Taiwan, Vietnam, New Zealand, Macau, Brunei, a 92 per cent subsidiary in Sri Lanka and a 26 per cent joint-venture in India. The business that is now AIA was first established in Shanghai over 90 years ago. It is a market leader in the Asia Pacific region (ex-japan) based on life insurance premiums and holds leading positions across the majority of its markets. It had total assets of US$119,494 million as of 31 May AIA meets the savings and protection needs of individuals by offering a range of products and services including retirement savings plans, life insurance and accident and health insurance. The Group also provides employee benefits, credit life and pension services to corporate clients. Through an extensive network of agents and employees across Asia Pacific, AIA serves the holders of more than 24 million individual policies and over 10 million participating members of group insurance schemes. AIA Group Limited is listed on the Main Board of The Stock Exchange of Hong Kong Limited under the stock code 1299 with American Depositary Receipts (Level 1) traded on the over-the-counter market (ticker symbol: AAGIY ).

9 AIA Singapore Private Limited (Reg. No R) 1 Robinson Road, AIA Tower, Singapore Monday - Friday 8.45am pm AIA Customer Care Hotline: aia.com.sg SGPD