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Adecco IRC PLan

The document outlines the benefits and coverage details of 4 different insurance plans (Plan 1-4). It includes details on outpatient benefits like coverage for visits to general physicians and specialists. It also lists inpatient benefits such as hospital room and board, surgical fees, and ambulance fees. The plans provide varying levels of coverage for both network and non-network healthcare costs, and differ in their annual limits and optional riders like cancer treatment coverage.

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71 views1 page

Adecco IRC PLan

The document outlines the benefits and coverage details of 4 different insurance plans (Plan 1-4). It includes details on outpatient benefits like coverage for visits to general physicians and specialists. It also lists inpatient benefits such as hospital room and board, surgical fees, and ambulance fees. The plans provide varying levels of coverage for both network and non-network healthcare costs, and differ in their annual limits and optional riders like cancer treatment coverage.

Uploaded by

affodell
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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Insurance Benefit

Option 1 Plan 1 Plan 2 Plan 3 Plan 4

Option 2 Benefit Outpatients Benefits a) General Physician's Services - consultations and medication dispensed by physician for acute cases

PLAN B Network 100% Non-Network 100% up to RM20 per visit

b) Specialist Physician's Services - consultations and medication dispensed by physician - including pre-hospitalisation consultations and medication - on reimbursement basis c) Outpatient Preventive Care Childhood immunizations (by General Physician) - DTP and Polio - Measles - Hepatitis - MMR Annual gynecological examination - Pap Smear (by General Physician) - Mammography Periodic health examinations Age based preventive screening d) Outpatient Laboratory Services and Diagnostic Testing Lab,x-ray,MRI,blood work,other testing

RM200 per visit (with Referral)

RM200 per visit (with Referral)

100% 100% 100% 100% Not payable 100% 100% With Referral As based on age & health conditions, where necessary

100% With Referral

100% With Referral up to RM800 per visit

e) Long Term Medication Conditions (Optional Rider) - medications dispensed by physician for Long Term Medication Conditions (ie.13 Chronic Illnesses) - Non-Network - on reimbursement basis

Inpatient Benefits

Plan 2 Network

Plan 3 Non-Network ***

Plan 4

a (i) Hospital Room and Board - up to maximum 180 days per Any One Disability (ii) Intensive Care Unit - up to maximum 30 days per Any One Disability inclusive of Room and Board b) Hospital Supplies and Services c) Surgical Fees (including Daycare*)

Two-Bedded 100%*

RM180

100%* 100%*

90%/10% 90%/10%

d) Anaesthetic Fee

100%*

90%/10%

e) Operating Theatre

100%*

90%/10%

f) In-Hospital Physician Visit - up to maximum 180 days per Any One Disability g) In-Hospital Specialist Visit - up to maximum 180 days per Any One Disability h) Ambulance Fees i) Hospital Service Tax l) Post Hospitalisation Treatment - within 60 days from discharged from Hospital m) Daily Cash Allowance at Government Hospital - up to maximum 180 days per Any One Disability n) Worldwide Emergency Hospitalization Benefit Room and board limit/per day Maximum limit per Any One Disability (Out-patient + Inpatient)** Maximum Limit per Any One Disability Overall Annual Limit

100%*

90%/10%

100%* 100%* 100%* 100%*

90%/10% 90%/10% 5% of Room & Board 90%/10%

RM50

RM50

RM200 RM15,000 max

RM200 RM15,000 max

RM15,000 max RM30,000 max

Death Benefit with Total & Permanent Disability Benefit - Employee Only Optional Rider Outpatient Cancer Treatment & Outpatient Kidney Dialysis (Max per year, 100% reimbursement) Inclusive of Emergency Evacuation Benefit *Prior authorization is required for Network Benefit **Maximum Limit per Any One Disability and Overall Annual Limit are for all Inpatient, Outpatient, Network or Non-Network claims combined *** Admissions incurred with Non-Network providers (including 196218302.xls.ms_office Specialist consultation) will not be provided Letter of Guarantee

RM10,000

RM10,000 max

Benefit Schedule (5-10)

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