Health Insurance

Provide coverages for medical, surgical and hospitalization expenses

Health Insurance

Provide coverages for medical, surgical and hospitalization expenses

Edit
Available Coverage
MediCare Classic MediCare Premium
MediCare Classic + MediCare Premium +
MediCare Classic
Eligible Person (Age) Insurance Coverage Benefits (MMK)
6 to 75 years Hospital Cash daily (Maximum 60 days) 50,000
Death benefit 5,000,000
OPD (1 year) Up to 50,000
Surgical cash 500,000
Miscarriage 300,000
MediCare Classic+
Eligible Person (Age) Insurance Coverage Benefits (MMK)
6 to 60 years Hospital Cash daily (Maximum 60 days) 50,000
Death benefit 5,000,000
OPD (1 year) Up to 50,000
Surgical cash 500,000
Miscarriage 300,000
Critical Illness Disease Treatment 5,000,000
MediCare Premium
6 to 75 years Hospital Cash daily (Maximum 60 days) 100,000
Death benefit 10,000,000
OPD (1 year) Up to 100,000
Surgical cash 500,000
Miscarriage 300,000
MediCare Premium+
6 to 60 years Hospital Cash daily (Maximum 60 days) 100,000
Death benefit 10,000,000
OPD (1 year) Up to 100,000
Surgical cash 500,000
Miscarriage 300,000
Critical Illness Disease Treatment 10,000,000
Policy Term 1 year from the date of premium
Edit
Additional Coverage
Critical Illness Micro Health Insurance
Critical Illness

Age between 6 to 60 years old Parents/guardians are required to buy if the insured age is between 6-18 years old.

*Note - Medical Check-up is required if purchased unit is above 4 units or age is above 50 years old.

Critical Illness
Eligible Person (Age) Insurance Coverage Benefits (MMK) Unit
6 to 60 years Heart Attack 1,000,000 (per unit) 1 to 10 units
Stroke
Cancer (Life-threatening)
Renal Failure
Major Organ Transplant
Heart Valve Replacement or Repair
Coronary Artery bypass surgery
Severe Burns
Coma
Bacterial Meningitis
Micro Health Insurance
Insurance Type Eligible Person (Age) Event Benefits (MMK)
Micro Health Insurance 6 to 75 years Hospital cash daily (Maximum 60 days) 5,000
Death due to accident 500,000
Edit

• Age between 6 to 75 years old
Parents/guardians are required to buy if the insured age is between 6-18 years old.

• Can be insured individual or group. The policy term is 1 year.

Edit
Premium Payment

Bi- annually and Lump Sum for Individual customer. Monthly, Quarterly, Bi-annually and Lump Sum for Corporate customer.

Premium Rating
MediCare Classic Individual (MMK) *Stamp Fees - 1,500
Bi-Annual Lump Sum
6-30 58,900 115,500
31-40 67,400 132,000
41-50 75,900 148,500
51-60 103,900 203,500
61-75 187,900 368,500
MediCare Classic Coporate (MMK) *Stamp Fees - 1,500
Monthly Quarterly Bi-Annual Lump Sum
6-30 10,400 29,200 56,000 110,200
31-40 11,400 33,200 64,000 125,700
41-50 12,900 37,200 72,500 141,200
51-60 17,900 50,700 99,000 193,700
61-75 31,900 92,200 178,500 350,200
MediCare Classic+ Individual (MMK) *Stamp Fees - 3,000
Bi-Annual Lump Sum
6-30 81,400 159,500
31-40 106,400 209,000
41-50 137,400 269,500
51-60 198,900 390,500
MediCare Classic+ Coporate (MMK) *Stamp Fees - 3,000
Monthly Quarterly Bi-Annual Lump Sum
6-30 14,400 40,200 77,500 152,200
31-40 17,900 52,700 101,000 198,700
41-50 23,400 67,700 131,000 256,200
51-60 33,900 97,700 189,500 371,200
MediCare Premium Individual (MMK) *Stamp Fees - 3,000
Bi-Annual Lump Sum
6-30 109,400 214,500
31-40 126,400 247,500
41-50 143,400 280,500
51-60 199,400 390,500
61-75 367,400 720,500
MediCare Premium Coporate (MMK) *Stamp Fees - 3,000
Monthly Quarterly Bi-Annual Lump Sum
6-30 19,400 54,200 104,000 204,700
31-40 21,400 62,200 120,000 235,700
41-50 24,400 70,200 137,000 266,700
51-60 34,400 97,200 190,000 371,700
61-75 62,400 180,200 349,000 684,700
MediCare Premium+ Individual (MMK) *Stamp Fees - 6,000
Bi-Annual Lump Sum
6-30 154,400 302,500
31-40 204,400 401,500
41-50 266,400 522,500
51-60 389,400 764,500
MediCare Premium+ Coporate (MMK) *Stamp Fees - 6,000
Monthly Quarterly Bi-Annual Lump Sum
6-30 27,400 76,200 147,000 288,700
31-40 34,400 101,200 194,000 381,700
41-50 45,400 131,200 254,000 496,700
51-60 66,400 191,200 371,000 726,700
Critical Illness Individual (MMK) *Stamp Fees - 300 per unit
Bi-Annual Lump Sum
6-30 4,500 8,800
31-40 7,800 15,400
41-50 12,300 24,200
51-60 19,000 37,400
Critical Illness Coporate (MMK) *Stamp Fees - 300 per unit
Monthly Quarterly Bi-Annual Lump Sum
6-30 800 2,200 4,300 8,400
31-40 1,300 3,900 7,400 14,600
41-50 2,100 6,100 11,700 23,000
51-60 3,200 9,400 18,100 35,500
Micro Health Insurance
Insurance Coverage Age Group Lump Sum
Micro Health Insurance 6-30 5,000
31-40 5,500
41-50 6,500
51-60 8,500
61-75 13,000
Policy Term

The policy term is 1 year and the coverage starts after the premium payment

Edit

Benefits do not cover for injuries, diseases, hospitalization, surgery or death that related directly or indirectly with the following situations;

1. Undergoing medical treatment, already having the doctor’s approval for a medical treatment, having a prior disease symptom

2. Delivery, miscarriage and hospitalization due to pregnancy and having a surgery, (-section, surgeries of childbirth are not entitled for benefits. Note: Hospitalization and surgeries due to diseases which are caused by a pregnancy {Eclampsia, pre- eclampsia, gestational diabetes etc.). And in the event of miscarriage, the benefit is entitled if optional coverage (1) is purchased.

3. Insanity, hospitalization and surgery due to mental illnesses

4. Hospital visits for medical check-ups

5. Hospitalization and having surgeries to procreate.

6. Hospitalization and surgeries for dental treatment except accidental injuries.

7. Having eye sight check-ups including spectacles, treatments for visual impairments, eye treatment, hospitalization and having surgery for vision correction except accidental injuries

8. Hospitalization and having cosmetic/plastic surgery

9. Hospitalization for surgery for hearing implant

10. Congenital defects

11. Drug abuse

12. Committing crimes

13. AIDS/HIV

14. Vadalizing, protest and war and war-like terrorism

15. Treatments which only last 3 days for hospitalization for a disease

16. Fraudulent requests

17. Suicide

18. Getting an acute disease treatment for cancer; which is classified as an internal disease; starting from the first day of initial policy to next 90 calendar days.

19. Getting acute disease treatment for the cancer in cell layers through a tract of intraepithelial/neoplasm

Edit

1. What documents are needed to insure?

Ans.  i. NRC copy

ii. Proposal,

iii. Checklist

iv. Medical Check-up is required if purchased unit is 4 units and above or age is above 50 years old.

2. What are the types of insurance for health?

Ans:  i. Health Insurance

ii. Critical Illness Insurance

iii. Micro Health Insurance

3. How long does it take to produce health policy?

Ans: Normally, it takes about an hour if the documents are all set.

4. What are the premium rating for health insurance?

Ans: The premium amount is depend on the insured’s age and insurance package as there are (4) types of package in health insurance. Can be insured individual or group and the policy term is 1 year. Premium payment method are bi- annually and lump sum for individual customer and monthly, quarterly, bi-annually and lump sum for corporate customer.

5. When does the insurance coverage start?

Ans: Insurance coverage starts after the premium payment by customer.

6. How many times can be claimed in a year? Is there any benefit for those who don’t have a claim?

Ans: The claim amount can be different based on the insurance package and the insured can claim within the limited amount. The insurance policy will be cancelled automatically when policy date is end and there is no other benefit for those who don’t have a claim.

7. Can health insurance be renewal?

Ans: Health insurance cannot be renewal. If the insured want to renew, he/she must buy a new policy number.

8. What are needed to change insured’s name?

Ans: Cannot be able to change the name and endorsement in health insurance.

9. What are needed to cancel health insurance policy?

Ans: There is no refund policy in health insurance. Policy will be cancelled automatically if the insured is late to pay premium.

10. Is there door to door service for health insurance ?

Ans: Yes, AYA SOMPO Insurance has door to door service.

11. What is the difference between having a health insurance with an agent and personally at office?

Ans: There is no differences between them. AYA SOMPO Insurance give same services for all customers.

12. How do the insured do if he/she want insurance service by connecting with bank?

Ans: Customers need to attach with the bancassurance in AYA banks and must also bring the necessary documents.

Available Coverage
MediCare Classic MediCare Premium
MediCare Classic + MediCare Premium +
MediCare Classic
Eligible Person (Age) Insurance Coverage Benefits (MMK)
6 to 75 years Hospital Cash daily (Maximum 60 days) 50,000
Death benefit 5,000,000
OPD (1 year) Up to 50,000
Surgical cash 500,000
Miscarriage 300,000
MediCare Classic+
Eligible Person (Age) Insurance Coverage Benefits (MMK)
6 to 60 years Hospital Cash daily (Maximum 60 days) 50,000
Death benefit 5,000,000
OPD (1 year) Up to 50,000
Surgical cash 500,000
Miscarriage 300,000
Critical Illness Disease Treatment 5,000,000
MediCare Premium
6 to 75 years Hospital Cash daily (Maximum 60 days) 100,000
Death benefit 10,000,000
OPD (1 year) Up to 100,000
Surgical cash 500,000
Miscarriage 300,000
MediCare Premium+
6 to 60 years Hospital Cash daily (Maximum 60 days) 100,000
Death benefit 10,000,000
OPD (1 year) Up to 100,000
Surgical cash 500,000
Miscarriage 300,000
Critical Illness Disease Treatment 10,000,000
Policy Term 1 year from the date of premium
Additional Coverage
Critical Illness Micro Health Insurance
Critical Illness Age between 6 to 60 years old Parents/guardians are required to buy if the insured age is between 6-18 years old. *Note – Medical Check-up is required if purchased unit is above 4 units or age is above 50 years old.
Critical Illness
Eligible Person (Age) Insurance Coverage Benefits (MMK) Unit
6 to 60 years Heart Attack 1,000,000 (per unit) 1 to 10 units
Stroke
Cancer (Life-threatening)
Renal Failure
Major Organ Transplant
Heart Valve Replacement or Repair
Coronary Artery bypass surgery
Severe Burns
Coma
Bacterial Meningitis
Micro Health Insurance
Insurance Type Eligible Person (Age) Event Benefits (MMK)
Micro Health Insurance 6 to 75 years Hospital cash daily (Maximum 60 days) 5,000
Death due to accident 500,000

• Age between 6 to 75 years old
Parents/guardians are required to buy if the insured age is between 6-18 years old.

• Can be insured individual or group. The policy term is 1 year.

Premium Payment

Bi- annually and Lump Sum for Individual customer.
Monthly, Quarterly, Bi-annually and Lump Sum for Corporate customer.

Premium Rating

MediCare ClassicIndividual (MMK)*Stamp Fees – 1,500
Bi-AnnualLump Sum
6-3058,900115,500
31-4067,400132,000
41-5075,900148,500
51-60103,900203,500
61-75187,900368,500
MediCare ClassicCoporate (MMK)*Stamp Fees – 1,500
MonthlyQuarterlyBi-AnnualLump Sum
6-3010,40029,20056,000110,200
31-4011,40033,20064,000125,700
41-5012,90037,20072,500141,200
51-6017,90050,70099,000193,700
61-7531,90092,200178,500350,200
MediCare Classic+Individual (MMK)*Stamp Fees – 3,000
Bi-AnnualLump Sum
6-3081,400159,500
31-40106,400209,000
41-50137,400269,500
51-60198,900390,500
MediCare Classic+Coporate (MMK)*Stamp Fees – 3,000
MonthlyQuarterlyBi-AnnualLump Sum
6-3014,40040,20077,500152,200
31-4017,90052,700101,000198,700
41-5023,40067,700131,000256,200
51-6033,90097,700189,500371,200
MediCare PremiumIndividual (MMK)*Stamp Fees – 3,000
Bi-AnnualLump Sum
6-30109,400214,500
31-40126,400247,500
41-50143,400280,500
51-60199,400390,500
61-75367,400720,500
MediCare PremiumCoporate (MMK)*Stamp Fees – 3,000
MonthlyQuarterlyBi-AnnualLump Sum
6-3019,40054,200104,000204,700
31-4021,40062,200120,000235,700
41-5024,40070,200137,000266,700
51-6034,40097,200190,000371,700
61-7562,400180,200349,000684,700
MediCare Premium+Individual (MMK)*Stamp Fees – 6,000
Bi-AnnualLump Sum
6-30154,400302,500
31-40204,400401,500
41-50266,400522,500
51-60389,400764,500
MediCare Premium+Coporate (MMK)*Stamp Fees – 6,000
MonthlyQuarterlyBi-AnnualLump Sum
6-3027,40076,200147,000288,700
31-4034,400101,200194,000381,700
41-5045,400131,200254,000496,700
51-6066,400191,200371,000726,700
Critical IllnessIndividual (MMK)*Stamp Fees – 300 per unit
Bi-AnnualLump Sum
6-304,5008,800
31-407,80015,400
41-5012,30024,200
51-6019,00037,400
Critical IllnessCoporate (MMK)*Stamp Fees – 300 per unit
MonthlyQuarterlyBi-AnnualLump Sum
6-308002,2004,3008,400
31-401,3003,9007,40014,600
41-502,1006,10011,70023,000
51-603,2009,40018,10035,500
Micro Health Insurance
Insurance CoverageAge GroupLump Sum
Micro Health Insurance6-305,000
31-405,500
41-506,500
51-608,500
61-7513,000

Policy Term

The policy term is 1 year and the coverage starts after the premium payment

Benefits do not cover for injuries, diseases, hospitalization, surgery or death that related directly or indirectly with the following situations;

1. Undergoing medical treatment, already having the doctor’s approval for a medical treatment, having a prior disease symptom

2. Delivery, miscarriage and hospitalization due to pregnancy and having a surgery, (-section, surgeries of childbirth are not entitled for benefits. Note: Hospitalization and surgeries due to diseases which are caused by a pregnancy {Eclampsia, pre- eclampsia, gestational diabetes etc.). And in the event of miscarriage, the benefit is entitled if optional coverage (1) is purchased.

3. Insanity, hospitalization and surgery due to mental illnesses

4. Hospital visits for medical check-ups

5. Hospitalization and having surgeries to procreate.

6. Hospitalization and surgeries for dental treatment except accidental injuries.

7. Having eye sight check-ups including spectacles, treatments for visual impairments, eye treatment, hospitalization and having surgery for vision correction except accidental injuries

8. Hospitalization and having cosmetic/plastic surgery

9. Hospitalization for surgery for hearing implant

10. Congenital defects

11. Drug abuse

12. Committing crimes

13. AIDS/HIV

14. Vadalizing, protest and war and war-like terrorism

15. Treatments which only last 3 days for hospitalization for a disease

16. Fraudulent requests

17. Suicide

18. Getting an acute disease treatment for cancer; which is classified as an internal disease; starting from the first day of initial policy to next 90 calendar days.

19. Getting acute disease treatment for the cancer in cell layers through a tract of intraepithelial/neoplasm

1. What documents are needed to insure?

Ans.  i. NRC copy

ii. Proposal,

iii. Checklist

iv. Medical Check-up is required if purchased unit is 4 units and above or age is above 50 years old.

2. What are the types of insurance for health?

Ans:  i. Health Insurance

ii. Critical Illness Insurance

iii. Micro Health Insurance

3. How long does it take to produce health policy?

Ans: Normally, it takes about an hour if the documents are all set.

4. What are the premium rating for health insurance?

Ans: The premium amount is depend on the insured’s age and insurance package as there are (4) types of package in health insurance. Can be insured individual or group and the policy term is 1 year. Premium payment method are bi- annually and lump sum for individual customer and monthly, quarterly, bi-annually and lump sum for corporate customer.

5. When does the insurance coverage start?

Ans: Insurance coverage starts after the premium payment by customer.

6. How many times can be claimed in a year? Is there any benefit for those who don’t have a claim?

Ans: The claim amount can be different based on the insurance package and the insured can claim within the limited amount. The insurance policy will be cancelled automatically when policy date is end and there is no other benefit for those who don’t have a claim.

7. Can health insurance be renewal?

Ans: Health insurance cannot be renewal. If the insured want to renew, he/she must buy a new policy number.

8. What are needed to change insured’s name?

Ans: Cannot be able to change the name and endorsement in health insurance.

9. What are needed to cancel health insurance policy?

Ans: There is no refund policy in health insurance. Policy will be cancelled automatically if the insured is late to pay premium.

10. Is there door to door service for health insurance ?

Ans: Yes, AYA SOMPO Insurance has door to door service.

11. What is the difference between having a health insurance with an agent and personally at office?

Ans: There is no differences between them. AYA SOMPO Insurance give same services for all customers.

12. How do the insured do if he/she want insurance service by connecting with bank?

Ans: Customers need to attach with the bancassurance in AYA banks and must also bring the necessary documents.

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