Claim Policy

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  1. Claims for items and condi2ons listed under Exclusions in your Medical Plan Summary are
    not covered.
  2. To submit a claim, you must complete all mandatory informa2on. Incomplete submissions
    will not be processed.
  3. Required documents for different claims:
    o General Practitioner/Dental/Op-cal:
    ▪ Official Receipt
    ▪ Itemized Bill (for bills above RM100)
    o Medical Examination (full health screening):
    ▪ Official Receipt
    ▪ Itemized Bill
    ▪ Approval LePer from HR or Doctor
    o Pharmacy:
    ▪ Official Receipt
    ▪ Prescrip2on from doctor (except with Direct Access)
    o Specialist Hospital:
    ▪ Official Receipt
    ▪ Referral LePer for 1st 2me visit or Appointment Card for Follow up visit
    (except with Direct Access)
    ▪ Itemized Bill
    o Inpatient:
    ▪ Official Receipt
    ▪ Doctor’s Report
    ▪ Itemized Bill
    ▪ Discharge Summary
  4. One claim submission is valid for one receipt only.
  5. Claims are processed based on your company policy.
  6. Submitting the same claim to multiple payers is strictly prohibited.
  7. Medkad reserves the right to reject and take appropriate action against claims found to be fraudulent or submitted for duplicate reimbursement.
  8. Claim processing typically takes 7-14 working days.