Health Insurance
Objective
Health insurance is a type of coverage that offers financial support and covers medical expenses for the insured and their family in the event of unexpected health conditions. Hospitalization due to illness, hospitalization due to accidents, death, surgical treatments, miscarriages, and medical treatments in hospitals or clinics provide financial support and medical treatment benefits. This helps alleviate anxiety for individuals worried about the associated costs and supports public healthcare.Age Limitation
Age (6) to (75) years(If the insured person is within 6 -18 years, the approval letter from their guardian will be needed.)
Policy Term
(1) yearAvailable Units
The insured can purchase health insurance from (1) unit to maximum (25) units.
Premium Payment
| Premium Payment | |
| Group Customers | Monthly |
| Quarterly | |
| Semi-annually | |
| Annually (lump sum) | |
| Individual Customers | |
| Semi-annually | |
| Annually (lump sum) |
Types of Health Insurance Package
| Type of Health Insurance Package | Coverage | Causes for Claim | Benefits (Kyats) |
|---|---|---|---|
| Gold (1) Unit |
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| Hospitalization Due to Disease | |||
| When the insured gets hospitalized for medical treatment | Hospitalization benefits MMK 10,000 per day: (However, a maximum of MMK 600,000 x the sum of guaranteed units.) | ||
| Hospitalization Due to Accident | |||
| Death | When the insured dies | MMK 1,000,000 | |
| Outpatient | When the insured gets outpatient care for medical treatment | Hospital/Clinic: MMK 2,500 each time per unit: (However, a maximum of MMK 10,000 x the sum of guaranteed units.) | |
| Platinum (1) Unit |
|||
| Hospitalization Due to Disease | |||
| When the insured gets hospitalized for medical treatment | Hospitalization benefits MMK 10,000 per day: (However, a maximum of MMK 600,000 x the sum of guaranteed units.) | ||
| Hospitalization Due to Accident | |||
| Death | When the insured dies | MMK 1,000,000 | |
| Surgery | When the insured has an operation with the use of epidural anesthetic only | Actual direct surgery costs: (However, a minimum of MMK 500,000 per unit.) | |
| Treatment for Miscarriage (At the Hospital Only) | When the insured goes under operation or gets treatment due to miscarriage at the hospital only |
One-time fixed benefit MMK.300,000 shall be paid out for getting treatment due to miscarriage (regardless of the purchased unit)
Total maximum benefit shall be MMK. 500,000 (For both surgery and miscarriage) x purchased unit.
|
|
| Diamond (1) Unit |
|||
| Hospitalization Due to Disease | |||
| When the insured gets hospitalized for medical treatment | Hospitalization benefits MMK 10,000 per day: (However, a maximum of MMK 600,000 x the sum of guaranteed units.) | ||
| Hospitalization Due to Accident | |||
| Death | When the insured dies | MMK 1,000,000 | |
| Surgery | When the insured has an operation with the use of epidural anesthetic only | Actual direct surgery costs: (However, a minimum of MMK 500,000 per unit.) | |
| Treatment for Miscarriage(At the Hospital Only) | When the insured goes under operation or gets treatment due to miscarriage at the hospital only |
One-time fixed benefit MMK.300,000 shall be paid out for getting treatment due to miscarriage (regardless of the purchased unit)
Total maximum benefit shall be MMK. 500,000 (For both surgery and miscarriage) x purchased unit. |
|
| Outpatient | When the insured gets outpatient care for medical treatment | Hospital/Clinic: MMK 2,500 each time per unit: (However, a maximum of MMK 10,000 x the sum of guaranteed units.) |
The premiums for the Health Insurance package are as follows:
| Insurance Package | Age Group | Individual | |
|---|---|---|---|
| Semi-Annually | Annually | ||
| Gold (1) Unit |
|||
| 6 ~ 30 | 10,100 | 19,800 | |
| 31 ~ 40 | 11,800 | 23,100 | |
| 41 ~ 50 | 13,500 | 26,400 | |
| 51 ~ 60 | 19,100 | 37,400 | |
| 61 ~ 75 | 35,900 | 70,400 | |
| Platinum (1) Unit |
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| 6 ~ 30 | 14,000 | 27,500 | |
| 31 ~ 40 | 15,700 | 30,800 | |
| 41 ~ 50 | 17,400 | 34,100 | |
| 51 ~ 60 | 23,000 | 45,100 | |
| 61 ~ 75 | 39,800 | 78,100 | |
| Diamond (1) Unit |
|||
| 6 ~ 30 | 18,500 | 36,300 | |
| 31 ~ 40 | 20,200 | 39,600 | |
| 41 ~ 50 | 21,900 | 42,900 | |
| 51 ~ 60 | 27,500 | 53,900 | |
| 61 ~ 75 | 44,300 | 86,900 | |
Benefits will not be paid for the following issues, whether directly or indirectly: injuries, illnesses, hospital attendance, surgical treatments, or death.
Undergoing medical treatment, obtaining a doctor's approval, or having pre-existing symptoms.
Childbirth, Cesarean sections, and Obstetric surgery are covered, excluding hospitalization and surgery for diseases caused by pregnancy during the insured period (Preeclampsia, gestational hypertension, gestational diabetes, etc.). In addition, the miscarriage is eligible for benefits if Option (1) has been purchased by the insured.
Psychosis and Mental Disorders.
Hospitalization for medical check-ups and rest.
Fertility treatment.
Dental surgery and treatment (except due to accident).
Optical examination, surgery, and treatment (except due to accident).
Cosmetic surgery.
Hearing aids.
Physical defect or infirmity.
Drugs or controlled substances.
Criminal Commitment.
AIDS/HIV.
Terrorism, civil unrest, riots, hostilities or warlike operations (whether war be declared or not) civil war assuming the proportions of or amounting to popular rising, rebellion revolution, insurrection, military or usurped power or any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the government de jure or de facto or to the influencing of it by terrorism or violence or by the direct or indirect consequences of any of the said occurrences.)
Hospitalizations for 3 days and under.
Fraudulent claims.
Suicide or Suicidal self-injury.
Undergoing medical treatment, obtaining a doctor's approval, or having pre-existing symptoms. Childbirth, Cesarean sections, and Obstetric surgery are covered, excluding hospitalization and surgery for diseases caused by pregnancy during the insured period (Preeclampsia, gestational hypertension, gestational diabetes, etc.). In addition, the miscarriage is eligible for benefits if Option (1) has been purchased by the insured.Psychosis and Mental Disorders.Hospitalization for medical check-ups and rest.Fertility treatment.Dental surgery and treatment (except due to accident).Optical examination, surgery, and treatment (except due to accident).Cosmetic surgery.Hearing aids.Physical defect or infirmity.Drugs or controlled substances.Criminal Commitment.AIDS/HIV.Terrorism, civil unrest, riots, hostilities or warlike operations (whether war be declared or not) civil war assuming the proportions of or amounting to popular rising, rebellion revolution, insurrection, military or usurped power or any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the government de jure or de facto or to the influencing of it by terrorism or violence or by the direct or indirect consequences of any of the said occurrences.)Hospitalizations for 3 days and under.Fraudulent claims.Suicide or Suicidal self-injury.