Good health is definitely the best wealth to have. With our sedentary lifestyle (blame automation & technology), there are higher cases of people with diseases like diabetes, heart diseases, obesity etc. According to the Institute for Health Metrics and Evaluation (IHME), as of 2017, Ischemic heart diseases, lower respiratory diseases and stroke are the top three conditions for causing deaths in Malaysia.

Needless to say, it is imperative to own health/medical insurance policies in order to secure funds for such unplanned ailments and subsequent medical care.



  • INCREASE IN NUMBER OF VARIOUS DISEASES – In recent years we have seen increase in various diseases. These diseases affect the productive workforce from 35 to 60 years of age and also heart diseases have become very common in people. So, looking at the increasing medical cost and demand for top medical facilities, health insurance is growing as an alternative.
  • BETTER FINANCIAL AND HEALTH CARE PLANNING – Accidents and medical emergencies can happen any time and health insurance will ensure the financial stability during that time. Knowing the accurate amount to be spent on health & wellbeing in a year is very difficult but taking a health insurance policy will prepare you for any emergencies.
  • TAX BENEFITS – There are certain tax benefits also provided by the government to those who buy health insurance.
  • VALUE FOR MONEY – Besides taking care of hospital charges, in some cases health insurance also provides other benefits like daily cash allowance for food, charges spent on travelling to hospital and all other daily expenses in hospital.



  1. Hospitalization and surgical insurance: As per the time limit fixed under the policy, which maybe annual or life time, this insurance reimburses medical expenses in the event of surgery or treatment received in the hospital for conditions as per coverage.
  2. Critical illness insurance: A specified lump sum amount is provided under this cover upon being diagnosed of the listed 36 conditions in the policy. Some of the conditions are heart attack, cancer, stroke, kidney failure. This policy also covers surgical procedures such as brain surgery, bypass surgery etc.
  3. Disability income insurance: If an injury or illness displaces the policy holder from work, this kind of insurance covers a portion of their income.
  4. Long term care insurance: Those with no family to take care of, or for those who live alone, h-Home Care coverage provides for a caregiver or a therapist for up to seven days a week, or the maximum benefit the policy assures. Long term care also provides for assisted living, adult daycare, Alzheimer’s facilities and so on.
  5. Hospital income insurance: Per day cost of hospitalization for any covered illness, or injury is paid for under this policy. A limit for the number of days will be laid out in the policy.



As with all insurance policies, there are things which are covered and not covered. Typically, hospitalisation or surgeries may cover accommodation, nursing expenses, surgery costs, tests (in-patient) and doctor’s expenses. These are mentioned as inclusions.

But factors like congenital issues, injuries arising from high risk activities like racing, cosmetic surgeries, oral surgeries etc are generally not covered and mentioned as exclusion.

Pre-existing conditions will be excluded under most policies. There are also 12 specified illnesses which are not covered like gastritis and tumours.



Once you have purchased the policy, there is a waiting period of 30 days before you can claim. Only in case of accidental injuries, coverage begins immediately. Some conditions like diabetes, hypertension, tumours and others have a longer waiting period. If any of these specified illnesses cause the policy holder to be admitted or treated within 120 days of date of policy, no money will be payable.



There are two payment schemes, fully insured plans and cost sharing plans.

A fully insured plan will insure you against the full amount of the medical fees incurred (subject to limits). However, under a cost sharing plan, there are three types:

  1. Annual deductible: Before the insurance company begins paying, a fixed amount is paid by the customer every year for all medical conditions.
  2. Pre-condition deductible: Very similar to the annual deductible, a pre-condition deductible has different deductible amounts for different medical conditions.
  3. Copay or co-insurance: Before the company begins to pay, a fixed percentage is paid by the policy holder.

Choose a policy that covers all your needs and for a premium that you can afford. Visit www.smartgenie.com to check out various Malaysian insurance providers and their health/medical insurance policies.

Disclaimer: All information provided in this article/blog, published on this website is strictly for general information purpose only. SmartGenie does not provide any warranty about the authenticity and accuracy of such information. SmartGenie will not be held responsible for any loss and/or damage that arises or is incurred by use of such information. Please visit the websites of respective insurance companies/ banks/ financial institutions for more details about products.

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