Medical

VMware provides health insuarance via AIA.

Eligibility

All regular full-time employees below age 65 are eligible to enroll. You and your eligible dependents are automatically enrolled in enhanced hospital and major surgical insurance from your commencement date of hire at VMware. Eligible dependents include:

  • Legal spouse below age 65 years
  • Unmarried dependent children upto age 18 years

Benefits

Hospital & Surgical Coverage

Limit Coverage
Hospital Room & Board up to 180 days (Private/Government) RM 350
Intensive Care Unit (ICU) up to 30 days As charged
Hospital Supplies and Services
Surgical Fees
Anesthetist Fees
Operating Theater Fees
In-Hospital Physician’s Fees (up to 180 days)
Malaysian Government Hospital Daily Cash Allowance (up to 180 days) RM 50
GST 6%
Miscarriage Benefit (due to all causes) RM 1,000
Pre-Surgical / Medical Diagnostic Services (within 60 days) As charged
Pre-Surgical / Medical Specialist Consultation (within 60 days)
Post-Hospitalization Treatment (up to 60 days, following discharge from hospital)
Ambulance Fees (emergency & non-emergency services)
Outpatient Kidney Dialysis / Cancer Treatment
Emergency Sickness Out-Patient Treatment (from 10:00pm to 6:00am) RM 100
Medical Report Fee Reimbursement RM 80
Overall Limit (per policy year) RM 100,000
Death + Total Permanent disability Benefits –Employee Only RM 5,000
Outpatient Kidney dialysis treatment As charged
Outpatient physiotherapy treatment

Exclusions

  • Cosmetic surgery or treatment
  • Experimental procedures
  • Substance abuse
  • Private nursing care
  • Sexual dysfunction or infertility
  • Pregnancy
  • Alternative therapies
  • Refractive errors
  • Dental
  • Congenital or hereditary illnesses
  • Routine physical examination
  • Psychotic, mental or nervous disorders

Important Notes

  • Any medical costs exceeding the benefit limit provided by your company will be borne by the Employee
  • Some hospitals do not include meal allowances under the Room & Board Limit
  • Some hospitals require deposit upon admission and it is refundable upon discharged
  • “Welcome gifts”, Laundry, telephone calls are not covered

Specified Illnesses

No benefits shall be payable for hospitalization, surgery and/or charges incurred which are cause directly or indirectly by Specified Illnesses and its related complications.

Definition of Specified Illnesses

Specified Illnesses shall mean the following disabilities and its related complications, occurring within the first hundred twenty (120) days of insurance of the insured person.

  1.      Hypertension, diabetes mellitus and cardiovascular disease
  2.      All tumors, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system
  3.     All ear, nose (including sinuses) and throat conditions
  4.     Hernias, hemorrhoids, fistulae, hydrocele, varicocele
  5.      Endometriosis including disease of the reproduction system
  6.     Vertebral-spinal disorders (including disc) and knee conditions

In An Emergency

Emergency shall mean treatment needed in the event whereby immediate medical attention is required within twelve (12) hours of injury, illness or symptoms which are sudden and severe failing which the member’s life could be threatened (e.g. accident and heart attack), or lead to significant deterioration of health.

  1. Seek medical care at the nearest GP Clinic or Accident and Emergency Unit (A&E) of the nearest Hospital (please note that direct specialist care is not covered as an emergency).
  2. Pay for your treatment and submit your claim to AIA. Indicate in the Claim Form that it was an emergency case, the time of visit and reason.
  3. If you are admitted, please call AIA 24 hour Call Center at 1300 8888 60/70 for a Letter of Guarantee.

Procedure for Inpatient Admission

  1. Member/Hospital to obtain the Pre-Authorization Form (PAF) from Specialist
  2. Member/Hospital to Fax the PAF to AIA call center
  3. Member/Hospital to follow up with a call
  4. AIA Call Center validates & authenticate info, issues LOG within 1 hour upon receipt of relevant documents and AIA will also send a confirmation SMS once the LOG has been issued (subject to member provides the mobile phone number to AIA upon LOG request)
  5. Member gets admitted into hospital
  6. When Member ready to be discharged
  7. Member pays for exceed limit /uncovered charges (if any)
  8. Member gets discharged

Note:

  • Pre-authorization form (PAF) needs to be completed by your attending doctor and submitted at AIA. Post which AIA would proceed issuing Letter of guarantee (LOG)
  • Hospital may collect provisional deposit although LOG is issued as per the Hospital regulation for ineligible expenses.
  • Government Hospital requires original LOG. Please send your requests at least One day earlier for AIA to send the Original LOG via courier/dispatch to be delivered to the respective hospital.

Claims Submission

  1. Complete and sign the AIA Member Claim Form which is available at your respective Human Resources Department.
  2. Attach original itemized bill, , referral letter (for specialist visit) and Medical Discharge Report form for Hospitalization claims (Attending Doctor must complete Section II of this form) and breakdown of the charges when Hospital claim exceeds RM 500 (Medical report is also required)
  3. Ensure that each member must complete Section I of the Medical Discharge Report Form
  4. Send the completed claim form with attached documents to below:
    • Attention: Corporate Solutions Department, AIA Bhd. Level 23, Menara AIA, 99 Jalan Ampang, 50450 Kuala Lumpur, Malaysia
  5. You are advised to keep a copy of all documents sent to AIA Bhd
  6. Claims must be submitted to AIA Bhd. within 30 days from the date of treatment
  7. Eligible claims with full and complete documents will be reimbursed within 21 days from the date of receipt of claims by AIA Bhd

Contributions

VMware pays 100% of the premium costs for you and your eligible dependents.

Coverage Begins

Coverage for you and your dependents will begin on your first day of active work as a VMware employee.

 Coverage Ends

Coverage for you and your dependents ends on the last day of your employment with VMware.

Contact Us

Contact HR Source [VMware network access required]
ASK HR [VMware network access required]
Phone: 1-888-869-2738


AIA Bhd
Phone: 1300-8888-60/70
Email: members@aia.com

Resources

Member Hospital Surgical Claim Form

Member Outpatient Claim Form

Dependents enrollment Guide

Medical and Life insurance manual