COVID-19 Insurance Coverage AIA

“Medically Necessary” is defined in the policy contracts/certificate documents of the respective medical plans.
Please refer to the respective policy contract/certificate documents for the complete definition

Briefly explained, Reasonable and Customary Charges refer to charges for medical care which are medically necessary. Charges shall be considered reasonable and customary to the extent that it does not exceed the general level of charges being made by other medical providers of similar standing within Malaysia.
 
For the complete definition of “Reasonable and Customary Charges” please refer to the respective policy contract/certificate documents.

Yes, guarantee letter for hospitalization will be issued if the admission takes place at any of AIA Panel Hospital. This Guarantee Letter facility shall only be applicable for cashless medical plan. For non-cashless medical plan, the admission would be on a reimbursement basis.
 
AIA will assess the Pre-Admission form together with the supporting documents/reports such as blood tests, imaging reports and etc. to determine if the claim falls under the “medically necessary” clause and other terms and conditions as defined in the policy / certificate.

The issuance of guarantee letter facility would be available from 13^th September 2021 to 31^st December 2021 (Please refer to the Agency Circular 008/09/2021/AHS/CIR: COVID-19 Medical Coverage for AIA Individual Customers).

No, the issuance of Guarantee Letter facility is only applicable from 13^th September 2021 to 31^st December 2021 only and any further extension to the said period would be subject to AIA’s sole discretion.

You are entitled to claim based on reimbursement if your medical plan does not have the clause that excludes coverage for communicable diseases that require quarantine by law. The amount of reimbursement is based on Reasonable and Customary Charges. The Residence Overseas clause still applies.

Your medical coverage on COVID-19 is still subject to a Waiting Period as defined in your policy/certificate. For the on-shelf medical plans, the Waiting Period is 30 days. Other terms and conditions apply.

All AIA medical plans will cover medical treatments for any complications or side effects which requires hospital admission after taking the approved COVID-19 vaccine, subject to the benefits’ limits and terms and conditions of the policy or certificate.

The documents required are as follows:
i.          Hospitalization Claim Form (Individual)
ii.           Original Hospital invoice, itemized bills and payment receipts
iii.           All Imaging and laboratory reports such as x-rays and blood test results e.g. COVID-19 RT PCR test results, Chest X-ray & etc.
 
Failure to submit complete documentation will result in the claim being delayed or declined.
Please submit all documents to the branch. Kindly note that the list of documents above may be revised as and when required.