AIA proudly offers you AIA Health Happy Rider – a medical insurance plan designed to provide you with protection and peace of mind during the times you need healthcare the most. Whether you exercise, eat healthily, or get adequate rest, having a strong protection shield will help you get stronger and live with greater confidence.
Key Features and Coverage:
• As Charged Benefits are available for some items, with additional details provided in the benefits table.
• Double the maximum sum assured if diagnosed with a critical illness for the first time (Double CI).
◦ This double coverage will extend for 4 consecutive policy years, starting from the policy year of diagnosis.
◦ Critical illnesses covered under this condition include Acute Heart Attack, Major Stroke, Coronary Artery By-Pass Surgery, Invasive Cancer, Major Organs Transplantation or Bone Marrow Transplantation, and Surgery to Aorta.
• No maximum limit per each time of hospitalization.
• Maximum benefits per policy year of up to 25 Million Baht.
• Coverage for hospital daily room and board, and ICU room charges in aggregate, up to 365 days.
• Out-Patient Benefits are covered (applicable for Plan 25MB only).
◦ This includes fees for diagnosis directly related to in-patient treatment within 30 days before and after admission.
◦ It also covers fees for OPD treatment after discharge for follow-up treatment within 30 days after admission (limited to 2 times per confinement, excluding fees for diagnosis).
• Personal Medical Case Management benefits: Applicable for the 15-million-Baht Plan and the 25-million-Baht Plan. This service provides consultations relating to medical treatment from a team of leading physicians and specialist consultants worldwide ensuring you receive proper treatment and adequate protection.
• The portion of health insurance premiums that meet certain conditions are eligible for personal income tax deduction in accordance with the criteria stipulated by the Revenue Department.
• AIA Health Happy rider is an integrated product under the AIA Vitality program, where you receive benefits under the conditions determined by the company.
Eligibility and Coverage Period:
• Issued age: From 11 to 75 years old.
• Renewable up to the age of 98 years and provides coverage until the age of 99 years.
Choose the right insurance plan for yourself! For adequate protection and a secure future, please contact an AIA agent for further advice and detailed information on the various plans that will help you live with peace of mind and happiness
Important Notes and Recommendations:
• The applicant has the duty to provide true information in applying for insurance. Any concealment of truth or declaration of false statements may cause the insurance company to cancel the insurance contract or refuse to pay the claims under the insurance contract.
• Applicants are advised to study and thoroughly understand the benefit illustrations before making a decision to purchase the insurance. After receiving the policy, please study the details and the terms and conditions as specified in the policy contract.
• This rider is an insurance policy with a renewable one-year term. Upon renewal, the Company reserves the right to adjust the premium rate during the policy anniversary, taking into account factors such as the insured’s age, occupational class, medical inflation, or historical claim payments of the Portfolio. Any premium adjustments are subject to approval by the Registrar.
• A Copayment condition may be introduced in the renewal year if the insured meets specific criteria stipulated in the rider contract. For instance, if the insured claims for Simple Diseases from Inpatient benefits at least 3 times or more with a claim ratio equal to or greater than 200%, a 30% copayment rate of covered expenses will apply in the next policy year. Similarly, for General Diseases (excluding major surgery and 50 critical illnesses) claimed 3 times or more with a claim ratio equal to or greater than 400%, a 30% copayment rate applies. If both conditions are met, a 50% copayment rate will apply. This consideration will be re-evaluated annually based on the insured’s claims history.
• There is a waiting period for certain illnesses. Any illnesses occurring within 30 days from the effective date of the rider, or certain illnesses like all types of hernia, pterygium or cataract, tonsillectomy or adenoidectomy, and endometriosis occurring within 120 days, will not be covered initially.
• There are partial exclusions from coverage, including conditions caused by congenital abnormalities, esthetic enhancement or cosmetic surgery, and pregnancy-related conditions (miscarriage, abortion, child delivery, obstetric complications, infertility issues, sterilization, and contraception).
