A-Plus Health/

A-Plus Health Guard

Frequently Asked Questions

UPDATED: 5 February 2021

DISCLAIMER
For internal staff and agent reference only. This document is not a sales material and cannot be used for circulation to prospects. It
serves only as a guide to internal staff and agent for the products mentioned. In the actual selling process, the customer’s needs,
affordability and preference must be considered to deliver fair value to the customer. The detailed product benefits and cost must be
explained to help customers make informed decisions. Only AIA authorized sales materials are to be used when p rospecting.

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 Contents
Overview of A-Plus Health / A-Plus Health Guard..................................................................... 4
1. What is A-Plus Health / A-Plus Health Guard?..................................................................................................... 4
2. How long am I covered for?................................................................................................................................... 4
3. What are the benefits of A-Plus Health/ A-Plus Health Guard? ......................................................................... 4
4. Is there an annual limit or lifetime limit for A-Plus Health / A-Plus Health Guard?.......................................... 8
5. Is A-Plus Health / A-Plus Health Guard integrated with AIA Vitality?................................................................ 8
6. Are there any exclusions for A-Plus Health / A-Plus Health Guard?................................................................... 8
7. Are there any waiting period for A-Plus Health / A-Plus Health Guard?.......................................................... 10
8. When does my A-Plus Health / A-Plus Health Guard coverage cease?............................................................ 10

Deductible..........................................................................................................................10
9. What is a deductible?........................................................................................................................................... 10
10. Why choose RM300 or RM20,000 deductible amount option? ........................................................................ 10
11. What is ‘Any One Disability’? .............................................................................................................................. 11
12. How does the deductible work?.......................................................................................................................... 11

In-Patient Care....................................................................................................................12
13. What are the benefits covered under In-Patient Care?..................................................................................... 12
14. Is the number of days for Hospital Room and Board and ICU separated from each other?........................... 13
15. Is In-Hospital Physician Visit Benefit limited to 2 visits per day and 240 days per year? ................................ 13
16. Is Daily Guardian Benefit only applicable to juvenile insured below age 15?.................................................. 13
17. Is ambulance fee covered under In-Patient Care and what is the maximum limit? ........................................ 13
18. Is the In-Patient Care benefit subject to RM300 or RM20,000 deductible amount?....................................... 13

Out-Patient Care .................................................................................................................13

19. What are the benefits covered under Out-Patient Care?.................................................................................. 13
20. Is the Out-Patient Care benefit subject to RM300 or RM20,000 deductible amount?.................................... 13
21. Is there any limit for Pre- and Post-Hospitalisation besides the numbers of days and annual limit? ............ 14
22. Is there a lifetime limit for Out-Patient Kidney Dialysis and Cancer Treatment? ............................................ 14

Extra Care...........................................................................................................................14
23. What are the benefits covered under Extra Care?............................................................................................. 14
24. Is Extra Care benefits payable subject to RM300 or RM20,000 deductible amount?..................................... 14
25. What are the maternity complications covered under Extra Care? ................................................................. 14
26. What is the intraocular lens covered in Optical Support?................................................................................. 14

Health Wallet .....................................................................................................................15

27. What is Health Wallet?........................................................................................................................................ 15
28. Is the amount credited to Health Wallet only limited to the first 10 consecutive rider years? ...................... 15
29. What are the benefits offered in Health Wallet?............................................................................................... 15
30. Is Health Wallet benefit payable subject to RM300 or RM20,000 Deductible?............................................... 16
31. What is the list of the covered congenital conditions?...................................................................................... 16
32. What are the conditions covered under Cancer, Heart Attack and Stroke? .................................................... 16
33. Is there any difference between benefit of Cancer under Recovery Care and Out-patient Cancer Treatment?
............................................................................................................................................................................... 16
34. What is Mobility & Hearing Support?................................................................................................................. 17
35. What are the conditions covered under Mental Health Benefit? ..................................................................... 17
36. What benefit does Protect Boost cover? ............................................................................................................ 17
37. Can I cash out the amount available in my Health Wallet? .............................................................................. 17

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 Health Rewards...................................................................................................................17
38. What is Health Rewards? .................................................................................................................................... 17
39. What are the additional benefits under Health Rewards?................................................................................ 17
40. Will the claim of the benefits under Health Rewards reduce my annual limit or lifetime limit? .................... 18
41. How does the Health Rewards work? ................................................................................................................. 18
42. Can you show examples how does the Health Rewards work upon admission?............................................. 18
43. Will Health Wallet Booster continue to boost the Health Wallet amount even if I have made a claim? ...... 19
44. Is there any premium payable for Health Rewards? ......................................................................................... 19
45. Is there any cost of insurance charged for Health Rewards? ............................................................................ 19
46. Is there any underwriting requirement for Health Rewards? ........................................................................... 19
47. Are the Health Rewards applicable to juvenile insured below age 16?............................................................ 19
48. Will Health Rewards change if I increase or reduce the basic sum assured or rider sum assured? ............... 19
49. Will Health Rewards change if I add or delete rider of my policy?................................................................... 19
50. Will my Health Rewards cease and how will it happen? ................................................................................... 19
51. Do I have to pay a fee to become an AIA Vitality member?.............................................................................. 19

Cost of Insurance ................................................................................................................20

52. What is the cost of insurance for A-Plus Health / A-Plus Health Guard?......................................................... 20
53. Is the cost of insurance rate for A-Plus Health / A-Plus Health Guard guaranteed?....................................... 20

Policy Limits and Underwriting .............................................................................................20

54. Who is eligible to buy A-Plus Health/ A-Plus Health Guard? ............................................................................ 20
55. Can I purchase more than one (1) A-Plus Health / A-Plus Health Guard? ....................................................... 20
56. Is there a family plan in A-Plus Health / A-Plus Health Guard?........................................................................ 20
57. Can a pregnant lady buy A-Plus Health / A-Plus Health Guard? ...................................................................... 21

Policy Options.....................................................................................................................21
58. Can I upgrade or downgrade the plan of my A-Plus Health / A-Plus Health Guard after policy is issued or set
in force? ................................................................................................................................................................ 21
59. Can I extend or change the coverage term of A-Plus Health / A-Plus Health Guard at any time?................. 21
60. Can I terminate A-Plus Health / A-Plus Health Guard at any time? ................................................................. 21
61. Can I reinstate my A-Plus Health / A-Plus Health Guard after policy lapse or surrender?.............................. 22

Fees and Charges ................................................................................................................22

62. What are the fees and charges for A-Plus Health / A-Plus Health Guard?...................................................... 22

Special Offer for AIA Corporate Solutions Client ......................................................................23

63. What is the special offer for AIA Corporate Solutions client? ........................................................................... 23
64. Is this special offer available to the spouse or dependent of the eligible employee? ..................................... 23
65. How can I enrol to this special offer?.................................................................................................................. 23

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 Overview of A-Plus Health / A-Plus Health Guard
1. What is A-Plus Health / A-Plus Health Guard?
A-Plus Health / A-Plus Health Guard are unit deducting riders attachable to a regular premium
Investment-Linked Insurance plan as below:
Rider Name Attachable to Distribution channel
A-Plus Health
• Zero & 300 deductible amount option • A-LifeLink & A-Life Joy series Agency
• 20,000 deductible amount option • A-LifeLink 2 only
A-Plus Health Guard • A-LifeLink 2 only Agency
(for AIA Corporate
Solutions Employee
Benefits members only)

They provide comprehensive medical coverage with complete health solution to our customers
with deductible options as illustrated in Q3 below.

On top of the comprehensive medical coverage, A-Plus Health / A-Plus Health Guard also rewards
you when you make no claims and rewards you for staying healthy with Health Wallet and Health
Rewards respectively.

2. How long am I covered for?

You may choose the coverage term based on your needs and preference:
Rider Name Choices of coverage term
A-Plus Health 25 years or up to age 70, 80 or 100
A-Plus Health Guard up to age 70, 80 or 100

3. What are the benefits of A-Plus Health/ A-Plus Health Guard?

Please refer to the Schedule of Benefits of below for the coverage in more details.

A-Plus Health
Rider Name A-Plus Health
Guard
No. Benefits Plan 150 Plan 150 Plan 200 Plan 300 Plan 500
Annual Limit
(applicable for item no.1 to no. 12) 250,000 500,000 1,500,000 1,700,000 2,000,000

Lifetime Limit
500,0000 No Limit
(applicable for item no.1 to no. 12)
Deductible Amount Options
(applicable according to the
selected option)

• Zero deductible     
• 300 per Any One Disability
(applicable for In-Patient Care only,     
item no.1 to no. 3)
• 20,000 per Any One Disability
(applicable for In-Patient Care and     
Out-Patient Care, item no.1 to no.
8)

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 In-Patient Care
1 Hospital Room and
Board Benefit
(150 days maximum per 150 150 200 300 500
rider year)

2 Intensive Care Unit

Benefit
(150 days maximum per
rider year)

3 In- Hospital Related Fees

i. Hospital Supplies and
Services
ii. Surgical Fees Benefit
iii. Operating Theatre As Charged,
Fees subject to Annual
iv. Anaesthetist’s Fees Limit & Lifetime As Charged, subject to Annual Limit
v. In-Hospital Physician Limit
Visit Benefit
(maximum 2 visits
per day per
Physician)
vi. Daily Guardian
Benefit (applicable
for both Junior and
Senior)

Out-Patient Care
4 Pre-Hospitalisation
Benefit
(within 60 days before
Hospitalisation)
i. Diagnostic Tests As Charged,
Benefit subject to Annual As Charged, subject to Annual Limit
ii. Specialist Limit & Lifetime
Limit
Consultation Benefit
iii. Medication and
Treatment Benefit

5 Post-Hospitalisation
Treatment Benefit
(within 150 days after
Hospitalisation)
i. Diagnostic Tests
Benefit
ii. Specialist As Charged,
Consultation Benefit subject to Annual As Charged, subject to Annual Limit
iii. Medication and Limit & Lifetime
Treatment Benefit Limit
(inclusive
Physiotherapy,
Chiropractic and
Acupuncture
Treatment)

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 6 Out-patient Kidney 1,000,000
500,000
Dialysis Treatment per
per lifetime
Benefit and Out-patient lifetime
Cancer Treatment This
Benefit This amount does amount As Charged, subject to Annual Limit
not reduce does not
Annual Limit & reduce
Lifetime Limit Annual
Limit
7 Day Care Procedure and As Charged,
Surgery Benefit subject to Annual
As Charged, subject to Annual Limit
Limit & Lifetime
Limit
8 Emergency Accidental
Out-Patient Treatment As Charged,
(inclusive Dental) and 30 subject to Annual
As Charged, subject to Annual Limit
days Follow-up Limit & Lifetime
Treatment Limit

Extra Care
9 Optical Support
• Intraocular Lens 7,000 per lifetime 7,000 per lifetime

10 Specified Maternity
10,000 per
Complications Benefit 10,000 per lifetime
lifetime
11 Out-patient Dengue
Fever Treatment Benefit 1,500 1,500 2,000 3,000 5,000
(per Disability)
12 Home Nursing Care
Benefit (per Confinement)
(180 days maximum per 3,000 3,000 4,000 6,000 10,000
lifetime)

13 Emergency Medical
Evacuation and Up to USD 1 mil per event
Repatriation

Health Wallet
Yearly Health Wallet Amount 250 500 1,500 1,700 2,000
(for item no. 14 to no. 18, if
applicable) The amount above will be credited to Health Wallet at the end of the rider
year, provided no claim has been made under item no. 1 to no. 12 in the
immediate preceding year, up to a total of 10 times.

14 Prevention Benefit Not Applicable Not Up to 300 every year, subject to the
i. Health Screening Applicable total amount available in Health Wallet
ii. Vaccination (age 16
& above)
• Flu vaccination
• Hepatitis B
• HPV
• Shingles
• Pneumococcal

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 15 Special Care Benefit Not Applicable Not As Charged, subject to the total amount
i. Congenital Applicable available in Health Wallet.
Conditions
ii. Plastic or cosmetic
surgery due to
Accident or Cancer
16 Recovery and Support Not Applicable Not As Charged, subject to the total amount
Benefit Applicable available in Health Wallet.
i. Mobility and Hearing
Support
• Artificial Limb
• Hearing Aid

ii. Recovery Care

• Cancer
• Stroke
• Heart Attack
(applicable to low,
medium and high
severity conditions)

17 Mental Health Benefit Not Applicable Not Up to 1,500 every year, subject to the
Applicable total amount available in Health Wallet
Psychiatrist Consultation
Fees for the following
conditions:
• Major Depressive
Disorder
• Obsessive
Compulsive Disorder
• Schizophrenia
• Bipolar Disorder
• Tourette Syndrome
• Postpartum
Depression

18 Protect Boost The total amount available in Health Wallet can be:

(a) used to pay the remaining eligible medical cost if you have exhausted
the Annual Limit and/or Lifetime Limit, or
(b) paid out in lump sum upon the death of the Insured, up to 2 times of
basic sum assured.

Notes:
• All figures shown in the Schedule of Benefits above are in Ringgit Malaysia (RM) unless stated
otherwise.
• If you choose A-Plus Health that expires before age 100, the balance amount in the Health Wallet
will be locked-in upon the expiry of A-Plus Health and this amount shall be payable upon the death
of the Insured up to a maximum of 2 times of the basic plan sum assured, provided that the basic
plan is still in force.
• The benefits payable above are subject to Reasonable and Customary Charges and subject to the
limit as stipulated above, if applicable.
• The benefits shown above have been summarised and are not exhaustive. Please refer to the
policy contract for the full list of benefits, exclusions, terms and conditions.

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 4. Is there an annual limit or lifetime limit for A-Plus Health / A-Plus Health Guard?
There is a RM500,000 lifetime limit for A-Plus Health Guard but no lifetime limit for A-Plus Health.
There is an annual limit for both products, which will refresh or reset every year during the
coverage term.

5. Is A-Plus Health / A-Plus Health Guard integrated with AIA Vitality?

Yes, A-Plus Health / A-Plus Health Guard is also integrated with AIA Vitality which entitles you to
Health Rewards if you purchase A-Plus Health / A-Plus Health Guard and sign up as an AIA Vitality
member. Please refer to Health Rewards section for more details.

6. Are there any exclusions for A-Plus Health / A-Plus Health Guard?
Yes, A-Plus Health / A-Plus Health Guard does not cover any hospitalisation, surgery or charges
caused directly or indirectly, wholly or partly, by any one (1) of the following occurrences:

1. Pre-Existing Illness
For A-Plus Health:
Pre-Existing Illness prior to the Issue Date or Commencement Date, whichever is later.

For A-Plus Health Guard:

Pre-Existing Illness for a period of one (1) year from the Issue Date or Commencement Date,
whichever is later.

2. Specified Illness occurred or diagnosed 120 days from the Issue Date or Commencement
Date, whichever is later.
Specified Illness includes:
(a) Hypertension, diabetes mellitus and Cardiovascular disease;
(b) All tumours, cysts, nodules and polyps in any part of the body systems;
(c) Stones of the urinary system and biliary system;
(d) Any disease of the ear, nose (including sinuses) or throat;
(e) Hernias, haemorrhoids, fistulae, hydrocele, varicocele;
(f) Any disease of the reproductive system including endometriosis; or
(g) Any disorders of the spine (including a slipped disc) or any knee conditions.
3. 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. This will
include:
(a) hernias of all types and epilepsy, except when caused by a trauma, which occurred
after the date that the Insured Person is continuously covered under the relevant
Supplementary Hospitalisation Contract, and
(b) any congenital or hereditary conditions which has manifested or was diagnosed
before the Insured Person attains seventeen (17) years of age;
EXCEPT when it is covered under Special Care Benefit.
4. Any Disability caused by self-destruction, intentional self-inflicted injuries, wilful exposure
to danger or any attempt of self-destruction while sane or insane;
5. Any Disability caused by war, declared or undeclared, strikes, riots, civil war, revolution or
any warlike operations;
6. Service in the armed forces in time of declared or undeclared war or while under orders for
warlike operations or restoration of public order;
7. Any violation or attempted violation of the law or resistance to arrest;
8. Pregnancy, miscarriage or child birth EXCEPT the covered Maternity Complications under
Specified Maternity Complications Benefit;
9. Mental or nervous disorders (EXCEPT the covered conditions under Mental Health Benefit

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 under A-Plus Health), treatment of alcoholism, or drug abuse or any other complications
arising from it or any drug accident not prescribed by a treating Doctor;
10. Elective/Plastic/Cosmetic Surgery (EXCEPT the Elective/Plastic/Cosmetic Surgery due to
Accident or Cancer under Special Care Benefit under A-Plus Health), 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 or the use or acquisition of external prosthetic appliances or devices
(EXCEPT the artificial limb and hearing aid for Mobility and Hearing Support under Recovery
and Support Benefit under A-Plus Health) and prescriptions;
11. 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 UNLESS
necessitated by Injury covered under the Emergency Accidental Out-patient Treatment
Benefit);
12. 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 (EXCEPT the Health
Screening under Prevention Benefit under A-Plus Health), vitamins/food supplements and
treatments specifically for weight reduction or gain;
13. Any treatment or investigation which is not Medically Necessary, or convalescence,
custodial or rest care;
14. Any medical or physical conditions arising within the first thirty (30) days of the Issue Date
or Commencement Date, whichever is later, EXCEPT for Covered Injury;
15. Ionizing radiation or contamination by radioactivity from any nuclear fuel or nuclear waste
from process of nuclear fission or from any nuclear weapon material;
16. 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. We 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;
17. Out-Patient Kidney Dialysis Treatment where the symptoms first occurred prior to or within
30 days from the Issue Date or Commencement Date, whichever is later;
18. Out-Patient Cancer Treatment Benefit where the symptoms first occurred prior to or within
60 days from the Issue Date or Commencement Date, whichever is later; or
19. Overseas treatment if Insured resides or travels outside Malaysia (excluding Singapore and
Brunei) for more than 90 consecutive days.

Note: The list of exclusion above are not exhaustive. Please refer to the policy contract for the full list of
exclusions and terms and conditions.

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 7. Are there any waiting period for A-Plus Health / A-Plus Health Guard?
The waiting period for A-Plus Health / A-Plus Health Guard from the Issue Date or
Commencement Date, whichever is later:
Description Waiting Period
Accidental Injuries No waiting period
Illnesses 30 days
Specified Illnesses 120 days

Specified Maternity Complications 1 year

Pre-existing Conditions
1 year
(for A-Plus Health Guard only)

8. When does my A-Plus Health / A-Plus Health Guard coverage cease?

Your A-Plus Health / A-Plus Health Guard shall cease automatically:
i. Upon policy expiry;
ii. If your policy lapses;
iii. Upon termination of the basic plan; or
iv. If you terminate this rider.

For A-Plus Health Guard, we reserve the right to cancel the portfolio as a whole if we decide to
discontinue underwriting this product by giving thirty (30) days prior notification in writing.

Cancellation of the portfolio as a whole shall be given by written notice to you and we will run
off all policies up the policy anniversary within the portfolio.

Deductible
9. What is a deductible?
Deductible is a fixed amount that you pay for the eligible benefits for Any One Disability and the
rest will be borne by the company.

If the RM300 or RM20,000 deductible amount option is selected, you must pay the first RM300
or RM20,000 out of the eligible benefits for Any One Disability, and we will pay for the rest of the
eligible expenses subject to annual limit and lifetime limit, where applicable.

Different deductible amount applies to the following benefits:

If you stay active in AIA Vitality, Health Rewards will waive the deductible amount up to RM300,
depending on your AIA Vitality status.

10. Why choose RM300 or RM20,000 deductible amount option?

If you choose RM300 or RM20,000 deductible amount option, you can enjoy a lower premium
and cost of insurance. In addition, if you join us as AIA Vitality member and stay active, the

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 deductible amount may be waived up to RM300 with Health Rewards, depending on your AIA
Vitality status. Please refer to Health Rewards section for more details.

11. What is ‘Any One Disability’?

‘Any One Disability’ means if more than 2 confinements are due to the same or related disability,
or to any complications arising from it, such confinements shall be regarded as 1 confinement if
each of them is not separated by more than 90 days from the discharged date.

12. How does the deductible work?

Please refer to the scenarios below on how deductible works.

If RM300 deductible amount is selected:

Scenario 1:
Claims
Date of event/ AIA Pay Customer
Claims Scenario Amount Remarks
hospitalisation (RM) Pay (RM)
(RM)
30 Nov 2021 Pre-hospitalisation claims - 1,280 1,280 0 RM300 deductible
Cancer amount not
applicable to Out-
Patient Care benefits
14 Dec 2021 In-hospitalisation treatment 100,000 99,700 300 Customer needs to
for Cancer pay the first RM300
as the RM300
deductible amount is
applicable for In-
Patient Care benefits
09 Feb 2022 Outpatient Cancer 30,000 30,000 0 RM300 deductible
Treatment amount not
applicable to Out-
Patient Care benefits
24 Feb 2022 In-hospitalisation treatment 60,000 60,000 0 This hospitalisation is
due to complications of within 90 days from
Cancer the first
hospitalisation for the
same disability, i.e.
Cancer.

Scenario 2:
Claims
Date of event/ AIA Pay Customer
Claims Scenario Amount Remarks
hospitalisation (RM) Pay (RM)
(RM)
30 Nov 2022 In-hospitalisation treatment 8,700 8,400 300 Customer needs to
for Accident Injury pay the first RM300
as the RM300
deductible amount is
applicable for In-
Patient Care benefits
14 Dec 2022 Emergency dental treatment 4,800 4,800 0 RM300 deductible
amount not
applicable to Out-
Patient Care benefits
09 Feb 2023 In-hospitalisation treatment 69,000 68,700 300 New disability.
due to Heart Attack Customer needs to
pay deductible
amount

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 18 Mar 2023 Physiotherapy after Heart 3,500 3,500 0 RM300 deductible
Attack amount is not
applicable to Out-
Patient Care benefits
30 Jul 2023 Medication and consultation 2,800 2,800 0 RM300 deductible
for Heart Attack amount is not
applicable to Out-
Patient Care benefits

If RM20,000 deductible amount is selected:

Scenario 1:
Claims
Date of event/ AIA Pay Customer
Claims Scenario Amount Remarks
hospitalisation (RM) Pay (RM)
(RM)
30 Apr 2022 Pre-hospitalisation claims - 1,280 0 1,280 RM20k deductible
Cancer amount is applicable
for both In-patient
Care and Out-patient
Care benefits.
14 May 2022 In-hospitalisation treatment 100,000 81,280 18,720 Customer needs to
for Cancer pay the first
RM20,000 (RM1,280
+ RM18,720) as
RM20k deductible
amount is applicable
for both In-Patient
Care and Out-patient
Care benefits
09 Jul 2022 Outpatient Cancer 30,000 30,000 0 The RM20k
Treatment deductible amount
has fully applied.
24 Jul 2022 In-hospitalisation treatment 60,000 60,000 0 This hospitalisation is
due to complications of within 90 days from
Cancer the first
hospitalisation for the
same disability, i.e.
Cancer.

In-Patient Care
13. What are the benefits covered under In-Patient Care?
The benefits cover under In-Patient Care are stated as below:
i. Hospital Room and Board up to 150 days per year
ii. Intensive Care Unit (ICU) up to 150 days per year
iii. In-Hospital Related Fees which include the following:
• Hospital Supplies and Services
• Surgical Fees Benefit
• Operating Theatre Fees
• Anaesthetist’s Fees
• In-Hospital Physician Visit Benefit
• Daily Guardian Benefit

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 Any benefit payable shall subject to medically necessary and according to the Reasonable and
Customary Charges and annual limit, if applicable.

14. Is the number of days for Hospital Room and Board and ICU separated from each other?
Yes, the number of days for Hospital Room and Board and ICU is a separate limit from each other.
When the confinement period in ICU exceeds the maximum 150 days, the reimbursement will be
restricted to the standard Hospital Room and Board Benefit per day.

Please also note that no Hospital Room and Board Benefit will be payable for the same
confinement period where daily ICU benefit is payable.

15. Is In-Hospital Physician Visit Benefit limited to 2 visits per day and 240 days per year?
In-Hospital Physician Visit Benefit limited to 2 visits per day per Physician. There is no limit capped
at each year.

16. Is Daily Guardian Benefit only applicable to juvenile insured below age 15?
Daily Guardian Benefit is not only applicable to juvenile insured below age 15 but also for senior
insured above age 60.

17. Is ambulance fee covered under In-Patient Care and what is the maximum limit?
Yes, ambulance fee incurred for necessary domestic land ambulance services (inclusive of
attendant) to and/or from the hospital are payable as charged, subject to the Reasonable and
Customary Charges, up to Annual Limit under In-Patient Care.

Please note that payment for ambulance fee will not be made if the Insured Person is not
hospitalised.

18. Is the In-Patient Care benefit subject to RM300 or RM20,000 deductible amount?
Yes, if you choose the RM300 or RM20,000 deductible amount option, the In-Patient Care is
subject to RM300 or RM20,000 deductible amount that you select.

Out-Patient Care
19. What are the benefits covered under Out-Patient Care?
The benefits cover under Out-Patient Care are stated as follows:
i. Pre-Hospitalisation (60 days before hospitalisation)
ii. Post-Hospitalisation (150 days after hospitalisation)
iii. Out-Patient Kidney Dialysis and Cancer Treatment
iv. Day Care Procedure and Surgery
v. Emergency Accidental Out-Patient Treatment and 30 days follow up treatment

Any benefit payable shall subject to medically necessary and according to the Reasonable and
Customary Charges and annual limit, if applicable.

20. Is the Out-Patient Care benefit subject to RM300 or RM20,000 deductible amount?
Out-Patient Care is NOT subject to RM300 deductible amount. However, Out-Patient Care is
subject to RM20,000 deductible amount if you choose the RM20,000 deductible amount option.

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 21. Is there any limit for Pre- and Post-Hospitalisation besides the numbers of days and annual limit?
The benefits payable is as charged, there is no other limit besides the numbers of days and annual
limit stated in the Schedule of Benefits. However, the total benefits payable will subject to lifetime
limit, if applicable.

22. Is there a lifetime limit for Out-Patient Kidney Dialysis and Cancer Treatment?
Out-Patient Kidney Dialysis and Cancer Treatment is as charged except for Plan 150 where it
subjects to a lifetime limit of RM1 million for A-Plus Health and RM500,000 for A-Plus Health
Guard.

Please note that the Out-Patient Kidney Dialysis and Cancer Treatment claims for Plan 150 will not
reduce the annual limit and lifetime limit of the plan.

Extra Care
23. What are the benefits covered under Extra Care?
The benefits cover under Extra Care are stated as below:
i. Optical Support – intraocular lens
ii. Specified Maternity Complications
iii. Home Nursing Care
iv. Out-Patient Dengue Fever Treatment
v. Emergency Medical Evacuation and Repatriation

Any benefit payable shall subject to medically necessary and according to the Reasonable and
Customary Charges and the limit as stated in the Schedule of Benefits.

24. Is Extra Care benefits payable subject to RM300 or RM20,000 deductible amount?
Extra Care is NOT subject to RM300 or RM20,000 deductible amount.

25. What are the maternity complications covered under Extra Care?
The list of maternity complications covers under Extra Care:
(a) Abruptio Placentae
(b) Acute Fatty Liver of Pregnancy during Pregnancy
(c) Amniotic Fluid Embolism
(d) Death of Foetus
(e) Disseminated Intravascular Coagulation
(f) Eclampsia
(g) Ectopic Pregnancy
(h) Molar Pregnancy
(i) Late Miscarriage
(j) Placenta Increta/Percreta
(k) Pre-Eclampsia
(l) Postpartum Hemorrhage Requiring Hysterectomy
(m) Pulmonary Embolism of Pregnancy

The maximum amount of benefit payable is up to RM10,000 per lifetime.

26. What is the intraocular lens covered in Optical Support?

The intraocular lens includes mono focal and multifocal lens in Optical Support claimable up to
RM7,000 per lifetime.

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 Health Wallet
27. What is Health Wallet?
Depending on the plan you choose, 0.1% of the annual limit of your plan will be credited to Health
Wallet at the end of the rider year, provided no claim has been made for benefits under In-patient
Care, Out-patient Care and Extra Care in the immediate preceding year, up to a total of 10 times.

28. Is the amount credited to Health Wallet only limited to the first 10 consecutive rider years?
We understand you may require hospitalisation or treatment in case of the unexpected happens.
Therefore, we do not restrict the 10 times credit to first 10 consecutive rider years only but any
year up to a maximum of 10 times.

29. What are the benefits offered in Health Wallet?

The benefits that are offered in Health Wallet consists the below. For Plan 150, only Protect Boost
benefit is available.

i. Prevention Benefit, up to RM300 every year

• Health Screening
• Vaccinations (age 16 and above)
- Flu vaccination
- Hepatitis B
- HPV
- Shingles
- Pneumococcal

ii. Special Care Benefit

• Congenital conditions
• Elective/plastic/cosmetic surgery due to accident or cancer

iii. Recovery and Support Benefit

• Mobility & Hearing Support
• Recovery Care starts from early stage for Cancer, Stroke and Heart Attack

iv. Mental Health Benefit, up to RM1,500 every year

• Psychiatrist Consultation Fees for the following conditions:
- Major Depressive Disorder
- Obsessive Compulsive Disorder
- Schizophrenia
- Bipolar Disorder
- Tourette Syndrome
- Postpartum Depression

v. Protect Boost
• The total amount available in Health Wallet will be payable:
- for the remaining eligible medical cost if you have exhausted the annual limit and/or
lifetime limit; or
- as a lump sum upon the death of the Insured, up to 2 times of basic sum assured.

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 However, if you choose A-Plus Health that expires before age 100, the balance
amount in the Health Wallet will be locked-in upon the expiry of A-Plus Health and
this amount shall be payable upon the death of the Insured up to a maximum of 2
times of the basic plan sum assured, provided that the basic plan is still in force.

Notes:
1) All benefit payable above are subject to the limit stated in the Schedule of Benefits (if applicable) and
total amount available in Health Wallet.

30. Is Health Wallet benefit payable subject to RM300 or RM20,000 Deductible?

Health Wallet benefit is NOT subject to RM300 or RM20,000 Deductible.

31. What is the list of the covered congenital conditions?

There is no specific list of covered congenital conditions. Congenital conditions shall mean a
structural defect or malformation, or functional abnormalities that occur during intrauterine life
and can be identified prenatally, at birth or later in life.

We cover the congenital conditions which are diagnosed or occurred after the rider has been in
force and the treatment received must be deemed medically necessary.

32. What are the conditions covered under Cancer, Heart Attack and Stroke?
The conditions covered Cancer, Heart Attack and Stroke are listed as follows:
No. CI Severity Level Critical Illness Events
1. Cancer LOW a. Carcinoma in situ
b. Early Prostate Cancer
c. Early Thyroid Cancer
d. Early Bladder Cancer
e. Early Chronic Lymphocytic Leukaemia
MEDIUM Carcinoma in situ and Other Early Cancers of Specified Organs
Treated with Radical Surgery
HIGH Cancer – of specified severity and does not cover very early
cancers
2. Stroke LOW a. Brain Aneurysm Surgery
b. Cerebral Shunt Insertion
MEDIUM Carotid Artery Surgery
HIGH Stroke – resulting in permanent neurological deficit with
persisting clinical symptoms
3. Heart LOW Cardiac Pacemaker or Defibrillator Insertion
Attack
MEDIUM Heart Attack – of specified severity

33. Is there any difference between benefit of Cancer under Recovery Care and Out-patient Cancer
Treatment?
Yes, there are differences between Recovery Care and Out-patient Cancer Treatment.
Recovery Care for cancer Outpatient cancer treatment

Severity Conditions Starts from early stage cancer Only applicable for advanced stage cancer

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 1. Medication & consultation 1. Treatment
2. Rehabilitation Therapies 2. Medication & consultation during
3. Follow up consultation after treatment only.
Coverage
curative cancer treatment /
when cancer goes into
remission.

Limit Based on Health Wallet amount Based on Annual Limit

34. What is Mobility & Hearing Support?

Mobility & Hearing Support covers the acquisition of external prosthetic appliances, i.e. the
artificial limbs and hearing aids as a result of accident or illness and loss of hearing respectively.

35. What are the conditions covered under Mental Health Benefit?
Mental Health Benefit covers the Psychiatrist consultation fees incurred for the diagnosis of Major
Depression Disorder, Obsessive Compulsive Disorder, Schizophrenia, Bipolar Disorder, Tourette
Syndrome, Postpartum Depression.

36. What benefit does Protect Boost cover?

Protect Boost allows you to utilise the total amount available in the Health Wallet:
(a) to pay the remaining eligible medical cost if you have exhausted the annual limit and/or
lifetime limit; or
(b) as a lump sum upon the death of the Insured, up to 2 times of basic sum assured.

However, if you choose A-Plus Health that expires before age 100, the balance amount in the
Health Wallet will be locked-in upon the expiry of A-Plus Health and this amount shall be
payable upon the death of the Insured up to a maximum of 2 times of the basic plan sum
assured, provided that the basic plan is still in force.

37. Can I cash out the amount available in my Health Wallet?

No, the amount available in Health Wallet cannot be cashed out but you can use the amount
available for all the benefits listed in Q29.

Health Rewards
38. What is Health Rewards?
Health Rewards are benefits provided when you sign up as an AIA Vitality member and purchase
A-Plus Health / A-Plus Health Guard. Depending on the healthy choices you make, we reward you
for your effort by providing additional benefits!

Download the My AIA mobile app to learn more about the AIA Vitality programme.

39. What are the additional benefits under Health Rewards?

The additional benefits covered under Health Rewards are:
i. Deductible Waiver;
ii. Room and Board Upgrade; and
iii. Health Wallet Booster.

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 40. Will the claim of the benefits under Health Rewards reduce my annual limit or lifetime limit?
No, any claim of the benefits under Health Rewards will not reduce your annual limit or lifetime
limit.

41. How does the Health Rewards work?

The benefits under Health Rewards are depending on your AIA Vitality status. You will enjoy the
benefits under Health Rewards by staying active and healthy as shown below:

42. Can you show examples how does the Health Rewards work upon admission?
Example 1:
Say Mr. Tan purchased A-Life Link 2 with A-Plus Health rider (Plan 200 with RM300 Deductible) 3
years ago. He has been active in AIA Vitality and achieve Gold status upon his admission for an
injury due to car accident and required to undergo a surgery with a medical bill of RM15,000
during the hospitalisation and RM3,000 for physiotherapy.

Date of event/ Claims Scenario Claims Amount Is Mr. Tan entitled to enjoy AIA Pay Customer
hospitalisation (RM) Health Rewards (RM) Pay (RM)
30 Nov 2022 Surgery and 15,000 Yes, he will get 15,000 0
treatment for 1. Full Deductible Waiver
Accident Injury 2. R&B Upgrade from
RM200 to RM300

14 Dec 2022 Physiotherapy 3,000 N/A 3,000 0

Example 2:
Say Mr. John purchased A-Life Link 2 with A-Plus Health rider (Plan 200 with RM20,000 Deductible)
3 years ago. He has been active in AIA Vitality and achieve Gold status upon his admission for an
injury due to car accident and required to undergo a surgery with a medical bill of RM45,000
during the hospitalisation and RM3,000 for physiotherapy.

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 Date of event/ Claims Scenario Claims Amount Is Mr. Tan entitled to enjoy AIA Pay Customer
hospitalisation (RM) Health Rewards (RM) Pay (RM)
30 Nov 2022 Surgery and 45,000 Yes, he will get 25,300 19,700
treatment for 1. Deductible Waiver up to
Accident Injury RM300
2. R&B Upgrade from
RM200 to RM300
14 Dec 2022 Physiotherapy 3,000 N/A 3,000 0

43. Will Health Wallet Booster continue to boost the Health Wallet amount even if I have made a
claim?
Health Wallet Booster will continue to boost the Health Wallet amount even if you have made a
claim. If your AIA Vitality status is Gold or Platinum, Health Wallet Booster will increase the total
Health Wallet amount by 5% or 10% every year, respectively.

44. Is there any premium payable for Health Rewards?

No, there is no additional premium required for Health Rewards.

45. Is there any cost of insurance charged for Health Rewards?

No, there is no cost of insurance charged for Health Rewards.

46. Is there any underwriting requirement for Health Rewards?

There is no additional underwriting requirement for Health Rewards.

47. Are the Health Rewards applicable to juvenile insured below age 16?
Health Rewards are not applicable to juvenile insured below age 16, but this benefit will become
available when they join AIA Vitality from age 16 onwards.

48. Will Health Rewards change if I increase or reduce the basic sum assured or rider sum assured?
No, increase or reduce in basic sum assured or rider sum assured will not affect the Health
Rewards.

49. Will Health Rewards change if I add or delete rider of my policy?

The addition or deletion of other riders to your policy will not affect the benefits of Health
Rewards. However, if you delete this A-Plus Health / A-Plus Health Guard rider, Health Rewards
will no longer be available.

50. Will my Health Rewards cease and how will it happen?

Health Rewards will cease if your policy with A-Plus Health / A-Plus Health Guard rider and/or your
AIA Vitality membership is lapsed or terminated.

51. Do I have to pay a fee to become an AIA Vitality member?

You only need to pay RM10 per month as AIA Vitality membership fee to become an AIA Vitality
member.

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 Cost of Insurance
52. What is the cost of insurance for A-Plus Health / A-Plus Health Guard?
The cost of insurance for A-Plus Health / A-Plus Health Guard is based on the chosen plan, age,
gender, occupation and health conditions of the Insured, where applicable.

53. Is the cost of insurance rate for A-Plus Health / A-Plus Health Guard guaranteed?
The cost of insurance rate is not guaranteed. We reserve the right to revise the cost of insurance
rate by giving the policy owner 30 days prior written notice.

You may need to top up the premium if the Cost of insurance rate is revised.

Policy Limits and Underwriting

54. Who is eligible to buy A-Plus Health/ A-Plus Health Guard?
The entry age varies by coverage term and the basic plan that the rider is attached to, as shown
in the table below:

Entry age limit for A-Plus Health:

A-Life Joy series A-LifeLink series
Coverage Term Pre-natal Post-natal
Min Max Min Max Min Max
Up to age 70 14 35 Age 60 Age 60
Up to age 80 gestational gestational 14 days Age 70 Age 70
Up to age 100 weeks weeks Age 70 Age 16 Age 70
25 years
n/a n/a Age 16 Age 70 Age 70
(A-LifeLink 2 only)
Note: The 20,000 deductible option is attachable to A-LifeLink 2 only.

Entry age limit for A-Plus Health Guard:

A-Life Joy series A-LifeLink 2
Coverage Term
Pre-natal Post-natal Min Max
Up to age 70 Age 55
Up to age 80 n/a Age 16 Age 60
Up to age 100 Age 60

55. Can I purchase more than one (1) A-Plus Health / A-Plus Health Guard?
You may purchase more than one A-Plus Health rider, provided that:
• Only one A-Plus Health in one basic policy; and
• You have not exceeded the maximum Room and Board allowable of RM1,000 per life with
underwriting approval.

However, you are not allowed to purchase more than one A-Plus Health Guard rider. Each
customer is only eligible to attach A-Plus Health Guard once per lifetime.

56. Is there a family plan in A-Plus Health / A-Plus Health Guard?

No, there is no family plan in A-Plus Health / A-Plus Health Guard.

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 57. Can a pregnant lady buy A-Plus Health / A-Plus Health Guard?
Yes, pregnant lady can buy A-Plus Health and A-Plus Health Guard. However, the acceptance of
coverage under A-Plus Health shall subject to underwriting approval.

Policy Options
58. Can I upgrade or downgrade the plan of my A-Plus Health / A-Plus Health Guard after policy is
issued or set in force?
You can upgrade your A-Plus Health / A-Plus Health Guard or downgrade your A-Plus Health plan
after policy is issued or set in force, subject to the terms & conditions below:

i. Upgrading of plan
• Policyholder can only upgrade his/her plan at the next monthly anniversary, e.g.
For A-Plus Health
- from A-Plus Health Plan 150 to any plan available within A-Plus Health, subject to
the maximum Room and Board limit of RM1,000 per life; or
- from RM20,000 deductible amount option to RM300 deductible amount option or
zero deductible amount option.

For A-Plus Health Guard

- From A-Plus Health Guard to any plan available in A-Plus Health, subject to the
maximum Room and Board limit of RM1,000 per life;
Note: If you decided to drop the A-Plus Health Guard rider or when you switch to A-
Plus Health rider, the pre-existing conditions cover under A-Plus Health Guard will
cease.
• Any upgrade of plan shall be subject to underwriting.
• You may need to pay additional premium when you upgrade to a higher plan. Please
refer to the ILP sustainability quotation.

ii. Downgrading of plan

• Policyholder of A-Plus Health may request to downgrade the plan at the next monthly
anniversary, subject to the plan available within A-Plus Health.
• There is no plan option for A-Plus Health Guard to downgrade to.

59. Can I extend or change the coverage term of A-Plus Health / A-Plus Health Guard at any time?
You can extend or change the coverage term of A-Plus Health at any time during the rider
coverage term and no underwriting is required. However, you may need to pay additional
premium when you extend to a longer coverage term. Please refer to the ILP sustainability
quotation.

A notification letter will be sent 60 days prior to A-Plus Health expiry date to inform the
policyholder of the option to extend the rider coverage term.

No change of rider coverage term is allowed for A-Plus Health Guard rider.

60. Can I terminate A-Plus Health / A-Plus Health Guard at any time?
You may terminate A-Plus Health / A-Plus Health Guard at any time but thereafter, you will not
be covered with the benefits under A-Plus Health / A-Plus Health Guard. The pre-existing
conditions cover available under A-Plus Health Guard will also cease.

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 61. Can I reinstate my A-Plus Health / A-Plus Health Guard after policy lapse or surrender?
If your policy has lapsed, you can reinstate your policy inclusive of A-Plus Health / A-Plus Health
Guard within 2 years from the lapse date, subject to the terms and conditions stated below:
i. You have to make a written application to reinstate the policy; and
ii. The Insured Person is within the allowable age limits as determined by us at the time of
reinstatement; and
iii. The Insured Person has to provide evidence of insurability that is satisfactory to us;
iv. You have to make payment of all overdue regular premiums and A-Plus Saver premiums
(if any); and
v. You have to make payment of any indebtedness which we may require.

Please note that any reinstatement shall only cover loss or the insured event which occurs after
the reinstatement date, subject to the waiting period of respective benefits where relevant.

If you have surrendered your policy, you are not allowed to reinstate it .

Fees and Charges

62. What are the fees and charges for A-Plus Health / A-Plus Health Guard?
i. Medical Service Charge
There will be a medical service charge of RM3 per month if A-Plus Health / A-Plus Health
Guard is attached to the policy, which will be charged by deducting sufficient units at the
unit price every month on the Monthly Anniversary date. AIA Bhd. reserves the right to
revise the charges by giving 3 months prior written notice.

ii. Cost of Insurance

The Cost of Insurance will be charged by deducting sufficient units at the unit price every
month on the Monthly Anniversary date.

Cost of Insurance rate is not guaranteed, the Company reserves the right to revise the Cost
of Insurance by giving the policyholder 30 days prior written notice. Policyholder may need
to top up the premium if the Cost of insurance rate is revised.

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 Special Offer for AIA Corporate Solutions Client
63. What is the special offer for AIA Corporate Solutions client?
Any employee of Malaysian nationality covered under AIA employee benefits scheme is able to
purchase A-LifeLink 2 with A-Plus Health Guard on Guaranteed Issuance Offer (GIO) basis, i.e.
NO health declaration and medical check-up is required. In addition, we cover pre-existing
conditions after 12-month waiting period.

This special offer is a fixed package with A-LifeLink 2 attached with A-Plus Health Guard rider,
where:
- Basic plan: A-LifeLink 2 with basic sum assured fixed at RM10,000
- Rider: A-Plus Health Guard (Room and Board 150 with RM20,000 deductible)

64. Is this special offer available to the spouse or dependent of the eligible employee?
This special offer is available to employees of the corporate client only.

65. How can I enrol to this special offer?

If you are an AIA Corporate Solutions Life Planner, you may start talking to the HR of your
corporate clients (with at least 20 headcounts and with an employee-employer scheme) to
spread this good news and book the GIO period by scanning the QR code below and follow the
simple steps as shown in the picture below.

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 If you are NOT an AIA Corporate Solutions Life Planner yet, start attending the training on how
to sell any AIA Corporate Solutions group coverage product to the SMEs with at least 20
headcounts. You can then offer the above special offer to the employees of your corporate
client to help more Malaysians getting comprehensive medical coverage and encourage them to
live healthier, longer, better lives.

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 25
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