1. Who is the Third Party Administrator (TPA) of TMLM?
Our TPA is MiCare Sdn Bhd.
2. How to enquire the status or decision of Guarantee Letter.
You may call our TPA at 603-7843 9459 who operates 24 hours a day, 7 days a week.
3. Can I admit to any hospital using the medical card?
Guarantee Letter is only applicable to TMLM’s panel hospitals. If you admit to a
non-panel hospital, you shall pay first and file a claim with us, then we will assess
accordingly. Please refer
here to locate the panel hospitals.
4. Can I utilise the Guarantee Letter without presenting the
medical card to hospital?
Yes. You may present your NRIC and referral letter (if any) at the hospital’s admission
counter. The hospital will liaise with our TPA for issuance of Guarantee Letter.
5. Why is deposit required for some hospitals?
Some hospitals require admission deposit. However, this deposit is refundable upon
discharge after deducting the uncovered charges incurred.
6. Can I stay in a ward room that charges higher than my Room
and Board limit?
Yes, you will need to pay the difference (excess Room and Board). On the other hand,
if you are insured with medical plan which comes with Co-payment, you will have
to bear additional 20% of the eligible claim amount.
7. How long does MiCare take to issue initial Guarantee Letter?
MiCare will take approximately 45minutes to issue the initial Guarantee Letter from
the time when the last admission documents are received .
8. What are the common reasons for declination of Guarantee
Letter?
Guarantee Letter could be declined due to the following reasons:
- policy has lapsed or terminated
- admitting condition falls under specified illnesses, general exclusion or personal
exclusion
- possible pre-existing condition which warrants a claim investigation
- admission is for investigation purpose only - treatment can be managed on outpatient
basis
9. What should I do next if my Guarantee Letter has been declined?
You may pay first and file a claim with us. Any claims payout shall be strictly
in accordance with the policy terms and conditions. We will reassess upon receipt
of the claim documents.
10. What are the common uncovered items?
- admission fee, medical record fee or registration fee
- telephone charges
- TV rental
- excess Room and Board - Co-insurance or Co-payment
11. Can I pay the admission bill before final Guarantee Letter
is issued?
Yes. You may inform hospital for self-pay, and then file a claim with necessary
documents
12. Can I enjoy this medical card service overseas?
We regret to inform you that the Guarantee Letter is only applicable to TMLM’s panel
hospitals in Malaysia. You may file a claim with us and the claim will be assessed
in accordance with the policy terms and conditions.
13. If I have lost my medical card, what should I do?
You may call our Customer Service Hotline at 03-2603 3999 for medical card replacement.
