SMIplan_HSTable

Beneficial Life Agency

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WILL & TRUST

Service. Value. Protection.

SCHEDULE OF BENEFITS

Hospital & Surgical Care

Plan 350
(RM)

Plan 200
(RM)

Plan 150
(RM)

Plan 80
(RM)

1. In - Hospital Care

1.1   Hospital Room & Board (max daily benefit)
          ( i ) Ordinary Room (up to 120 days max per disability)
          ( ii ) Intensive Care (up to 20 days max per disability)

500

350

200

150

500

1.2 Hospital Supplies & Services

1.3 Surgical Fees

1.4 Anaesthetic Fees

1.5 Operating Theatre Charges

1.6 In - Hospital Physician Fees
(up to 120 days max. per disability)

1.7 Hospital Service Tax
(on eligible Room & Board charges paid)

2. Ambulatory Care

Full Reimbursement

2.1 Pre-Surgical / Medical Diagnostic Services
(within 60 days)

2.2 Pre-Surgical / Medical Specialist Consultation
(within 60 days)

2.3 Second Surgical Opinion

2.4 Post-Hospitalization & Daycare Procedure Follow-up Treatment
(up to 60 days)

2.5 Outpatient Accidental Treatment
(within 24 hours up to 60 days)

2.6 Daycare Procedure (Surgical/Medical)

2.7 Ambulance Fees (max. per disability)

2.8 Medical Report Fee Reimbursement (max. per disability)

2.9 Outpatient Rehabilitation Therapy, Chemotherapy, Radiation Therapy, Kidney
Dialysis

Overall Limit (per policy year)

Full Reimbursement

100,000

50,000

30,000

10,000

5,000

3,000

3. Compassionate Allowance (all causes)

NOTE: Overall Limit - The maximum benefit payable within the policy year regardless of number of disabilities.
* Please refer to the Insurance Policy for a detailed description of the benefits.