Med Insure does not cover:
- Pre-existing condition;
- Any medical or physical abnormalities existing at the time of birth, as well as neo-natal physical abnormalities developing within six (6) months from the time of birth.
- Any disability caused by self-destruction, intentional self-inflicted injuries, willful exposure to danger or any attempt of self-destruction while sane or insane;
- Any disability caused by war, declared or undeclared, strikes, riots, civil war, revolution or any warlike operations;
- Service in the armed forces in time of declared or undeclared war or while under orders for warlike operations or restoration of public order;
- Any violation or attempted violation of the law or resistance to arrest;
- Pregnancy, miscarriage or childbirth;
- Mental or nervous disorders, treatment of alcoholism, or drug abuse or any other complications arising from it or any drug accident not prescribed by a doctor;
- Elective/plastic/cosmetic surgery, circumcision (except circumcision due to infection), eye examination/elective surgery for visual impairments due to nearsightedness, farsightedness or astigmatism or radial keratotomy; all corrective glasses, contact lenses and intraocular lens (except monofocal intraocular lenses in cataract surgery) or the use or acquisition of external prosthetic appliances or devices and prescriptions;
- Any form of dental care or surgery including the replacement of natural teeth, placement of denture and prosthetic services such as bridges and crowns or their replacement;
- Hospitalisation primarily for investigatory purposes, diagnosis, x-ray examination, general physical or medical examinations, not incidental to treatment or diagnosis of a covered disability or any treatment which is not medically necessary and any preventive treatments, preventive medicines or examinations carried out by a physician, vitamins/food supplements and treatments specifically for weight reduction or gain;
- Any treatment or investigation which is not medically necessary, or convalescence, custodial or rest care;
- Any specified illness, medical or physical conditions arising within the waiting period for covered injury;
- Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapon material; or
- Expenses incurred for donation of any body parts or organ by the Insured Person and acquisition of the organ including all costs incurred by the donor during organ transplant and its complications. AIA will only reimburse the reasonable and customary charges incurred on major organ/bone marrow transplant surgery for the Insured Person being the recipient, limited to once per lifetime; or
- Overseas treatment if Insured Person resides or travels outside Malaysia (excluding Singapore and Brunei) for more than 90 consecutive days.
The following conditions are excluded for coverage under the PMCM service:
- Medical emergencies;
- Accidents;
- Urgent or life-threatening situations, such as ICU (Intensive Care Unit) admission;
- Daily or common issues, such as colds, flu, fever, occasional rash etc.;
- Long term chronic diseases management such as chronic hepatitis, diabetes, high blood pressure, high cholesterol etc. (however, any complications of chronic diseases shall be covered); or
- Mental health conditions such as anorexia/bulimia, mental health-related sleeping disorder, anxiety, depression etc.
Refer to the Policy Wording here for the full exclusions under the Medical plan.