Health

Medical Insurance FAQ

1. What does medical insurance cover?

Medical insurance is a type of insurance covers medical expenses incurred due to illness or injury, and insurance company will reimburse the eligible medical expenses based on the actual medical expense incurred by the insured according to the policy terms.

The coverage of medical insurance plans in the market may vary, but common covered items typically include medical expenses in the following areas:

• Pre- and post-confinement/day case procedure outpatient care expenses
  This refers to the expenses associated with consultations before hospitalization or after discharge from the hospital, as well as before and after day surgery, including doctor’s consultation fees, basic medication fee, and diagnostic test fees.
  
• Hospitalization expenses
  This refers to the expenses incurred by the patient while he or she is in the hospital, including but not limited to the following:
               o Surgeon’s fee and operation theatre fee
               o Hospital room and board
               o Doctor‘s visit
               o Hospital services
               o Hospital companion bed
• Day Case Surgery/Outpatient Surgery Expenses
  This refers to medical expenses incurred for surgeries or other medical procedures performed at a day case surgery center or on an outpatient setting without an overnight hospitalization, which may also include some necessary diagnostic tests, such as colonoscopy.
  
• Laboratory/Test Expenses
  Depending on the policy terms, this may include diagnostic tests such as blood tests, urine tests, and X-rays etc. Some plans may also cover preventive routine check-ups.
  

2. What are the things to pay attention to when purchasing medical insurance?

• Disclose medical history and lifestyle habit truthfully
  It is essential to truthfully disclose the personal health condition and related lifestyle habits, such as whether you have chronic illnesses, medical history, family medical history, smoking or drinking habits etc, when applying for insurance. Insurance companies will base on the above information to assess risk and determine if premium loading are required. Concealing any illnesses or health issues may affect the insurance company’s assessment and acceptance of application. Even if a policy has been issued, the insurance company may terminate the policy or deny claims if such information is withheld.
  
• Understand the waiting period
  Similar to critical illness insurance, medical insurance also has a waiting period, the insured cannot enjoy any coverage within a period of time after the policy is effective. The length of the waiting period varies depending on the different medical insurance plan. It is crucial to understand the waiting period when purchasing medical insurance to avoid being ineligible for claims.
• Pay attention to deductibles of medical insurance
  Deductibles refer to the portion of expenses you are responsible for out-of-pocket before your insurance plan starts to pay. Generally, for the same product, a higher deductible results in lower premiums. It is important to choose a deductible based on your needs and financial capabilities. While the premium is not overly burdensome, you should also ensure that the out-of-pocket expenses for medical treatment are not excessively high.
  
• Be aware of exclusions
  The terms of a medical insurance policy clearly outline exclusions, such as self-inflicted injuries, high-risk occupations and activities, war and riot, and cosmetic surgery etc. Medical expenses arising from exclusions will not be covered.
  

3. How to Choose a Suitable Medical Insurance Plan for Yourself and Your Family?

You may be looking for medical insurance plan for your family members. Here are some factors to consider:

• Pay Attention to Whether the Coverage is Suitable for the Insured
  The demand for outpatient care may be higher for children and the elderly. If the insured is a child or an elderly, you should pay extra attention to whether the medical insurance plan's coverage includes outpatient services and its coverage amount. For example, whether the plan covers specialist outpatient services, and whether a referral letter is required for the use of specialist outpatient services?
  
• Purchase Additional Medical Coverage (Top-Up Medical Coverage) or Medical Riders/ Supplementary Benefits
  Top-Up medical coverage and medical riders are supplementary insurances designed to enhance specific coverage and/or benefit limits on top of your existing medical coverage. Some Top-Up medical coverage in the market can be purchased independently, while medical riders/supplement benefits need to be attached to a basic plan. You can purchase insurance based your family members’ needs and existing coverage.
  

4. I am already covered by group medical insurance provided by the company. Why do I still need to purchase individual medical insurance?

Group medical insurance is an employee benefit, collectively applied by the employer for the employees. The coverage, coverage amount, and deductibles are determined by the employer. Therefore, the group medical insurance provided by the company may not be as tailored to individual needs as individual medical insurance, potentially leaving protection gap.

Once the employment relationship ends, the coverage under the group medical insurance will also be terminated. If you are not covered by an individual medical insurance, you will have no medical coverage while you wait for a new job or retire.

Remarks:

¹ If the life insured is diagnosed with cancer, heart attack, stroke or kidney failure, as defined in the respective policy provisions or benefit provisions (as the case may be), and receive medical necessary treatment under the recommendation of the attending doctor in hospital, as an extra benefit, the designated benefit’s limits will be increased. This extra benefit will end on the policy anniversary nearest to the life insured’s 75th birthday. Please see the policy provisions or benefit provisions for the details of this extra benefit, the definitions of the major illnesses, and the conditions that apply.

² Full coverage shall be subject to annual benefit limit, lifetime benefit limit and other limitations. Full coverage applies to designated benefit items only, while other benefit items are not fully reimbursable and subject to respective benefit item’s limits. Please refer to respective benefit schedule and the policy provisions or benefit provisions for details (as the case may be).

³ Pre-assessment service and cashless service, and Holistic ‘Medical Professional Support Service’ do not form part of this plan. These services are administrative arrangements and are not part of the product features. Manulife reserves the right to change our designated medical services provider(s) for each service from time to time, or terminate these services at any time without prior notice.

⁴ The medical green passage service is provided by a third party service provider which is an independent contractor and is not our agent. We reserve the right to change or terminate the medical green passage service anytime by prior notice. We make no representation, warranty or undertaking as to any service of the third party service providers. We shall not be liable to you or the life insured in any respect of any loss, damage, expense, suit, action or proceedings suffered or incurred by you or the life insured, whether directly or indirectly, arising from or in connection with the services provided or advice given by such third party service providers and/or its agents, or the availability of such service. The availability of the medical green passage service shall not be regarded as acceptance by the company of any liabilities to pay any benefits and/or reimburse any medical expenses under this plan. For details, please refer to medical green passage service terms and conditions.

⁵ International Medical Assistance is provided by a third party service provider which is an independent contractor and is not our agent. We shall make no representation, warranty or undertaking as to the availability of any medical opinions given by the medical service provider or any services given by the service providers. The service may change from time to time. For the latest Emergency Assistance Benefits Provisions for the terms and conditions of the services, please refer to Emergency Assistance Benefits Provisions for International Medical Assistance. Please visit our website for the latest Emergency Assistance Benefits Provisions for the Terms and Conditions of the International Medical Assistance service.

⁶ The policyowner may convert the plan into another designated medical plan that is offered by us at time of conversion.

The content of this website does not contain the full terms of the policy(ies), and the full terms can be found in the policy document(s). Please refer to the relevant product leaflets for product features and risks. “ManuMaster”, “ManuShine” and “ManuGuard” provide basic plan (ManuMaster Healthcare Series, ManuShine Healthcare Series and ManuGuard Medical Plan) or supplementary benefit (ManuMaster Healthcare Benefit, ManuShine Healthcare Benefit and ManuGuard Medical Benefit).

The content above is provided for general information purposes only and does not take account of your individual needs and circumstances. It should not be construed as an insurance advice and does not constitute any offer or any solicitation to offer or a recommendation of any insurance product(s). You should read the related product information on our website or request a sample of policy provisions to understand the nature, features, risks and exclusions of the product(s) and determine if the above product(s) meets your needs and circumstances before proceeding with the application.