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Health Insurance

Introduction

This insurance program is intended to cover both locals and foreign expats residing in Myanmar.
The insured period is one year and the policy is applicable in any certified in-patient hospitals across Myanmar. The insurance policy will be covered for anywhere across Myanmar.

Age LimitationThe age limitation of insured person who is eligible to buy health insurance is 6 years to 75 years.
(If the insured person is within 10 -18 years, the approval letter from their guardian will be needed.)
Insured PeriodThe insured period of each health insurance package is one year.
Available UnitsThe insured can purchase health insurance from (1) unit to maximum (10) units.

Premium Payment

The insured can make the premium payment according to his/her preference.

Premium PaymentGroup Customers• Monthly
• Quarterly
• Semi-annually
• Annually (lump sum)
Individual Customers• Semi-annually
• Annually (lump sum)

Types of Health Insurance Package

No.Type of Health Insurance PackageCoverageCauses for ClaimBenefits (Kyats)
1.Gold

(1) Unit
- Hospitalization Due to DiseaseWhen the insured gets hospitalized for medical treatmentKs.10,000 per day for Hospitalization,
Up to (60) days
- Hospitalization Due to Accident
- DeathWhen the insured diesKs. 1,000,000
- OutpatientWhen the insured gets outpatient care for medical treatmentKs. 2,500 each time per unit,
up to 4 times
2.Platinum

(1) Unit
- Hospitalization Due to DiseaseWhen the insured gets hospitalized for medical treatmentKs.10,000 per day for Hospitalization,
Up to (60) days
- Hospitalization Due to Accident
- DeathWhen the insured diesKs. 1,000,000
- SurgeryWhen the insured has operation with the use of epidural anesthetic only- Surgical benefit shall be paid out the lesser amount of either the actual surgical cost or the surgical benefit (which is Ks. 500,000 per unit)
- Treatment for Miscarriage
(At the Hospital Only)
When the insured goes under operation or gets treatment due to miscarriage at the hospital only- One-time fixed benefit Ks.300,000 shall be paid out for getting treatment due to miscarriage (regardless of the purchased unit)
- Total maximum benefit shall be Ks. 500,000
(For both surgery and miscarriage) x purchased unit.
3.Diamond

(1) Unit
- Hospitalization Due to DiseaseWhen the insured gets hospitalized for medical treatmentKs.10,000 per day for Hospitalization, Up to (60) days
- Hospitalization Due to Accident
- DeathWhen the insured diesKs. 1,000,000
- OutpatientWhen the insured gets outpatient care for medical treatmentKs. 2,500 each time per unit,
up to 4 times
- SurgeryWhen the insured has operation with the use of epidural anesthetic onlySurgical benefit shall be paid out the lesser
amount of either the actual surgical cost or
the surgical benefit (which is Ks. 500,000
per unit)
- Treatment for Miscarriage
(At the Hospital Only)
When the insured goes under operation or gets treatment due to miscarriage at the hospital only- One-time fixed benefit Ks.300,000 shall be
paid out for getting treatment due to
miscarriage (regardless of the purchased
unit)
- Total maximum benefit shall be
Ks. 500,000 (For both surgery and
miscarriage) x purchased unit.

Premium

The premiums for Health Insurance package per are as follows:

SrInsurance PackageAge GroupIndividual
Semi-AnnuallyAnnually
1.Gold
(1) Unit
6 ~ 3010,10019,800
31 ~ 4011,80023,100
41 ~ 5013,50026,400
51 ~ 6019,10037,400
61 ~ 7535,90070,400
2.Platinum
(1) Unit
6 ~ 3014,00027,500
31 ~ 4015,70030,800
41 ~ 5017,40034,100
51 ~ 6023,00045,100
61 ~ 7539,80078,100
3.Diamond
(1) Unit
6 ~ 3018,50036,300
31 ~ 4020,20039,600
41 ~ 5021,90042,900
51 ~ 6027,50053,900
61 ~ 7544,30086,900

*(Corporate customers can receive up to 5% discount)

Health Insurance Policy Rules

  1. If the applicant has provided untruthful information through misrepresentation, fraud, omission, then the benefits of the policy shall be forfeited.
  2. The insurance coverage begins upon payment of insurance premium. The insurance policy shall expire at midnight (12:00 a.m.) one year from the day the coverage begins.
  3. There shall be no refund of the premium if the insurance policy is terminated by the insured. The insurer has the right to terminate the policy during the insured period and the premium shall be refunded proportionately for the remaining period.
  4. Exclusions;
    The policy does not cover for the following causes, symptoms and diseases:

    1. Any existing diseases that are under treatment; or for any existing symptoms
    2. Childbirth, C-sections, child delivery that are concerned with surgery except the hospitalization and surgery due to diseases that caused by pregnancy during insured period (Preeclampsia, gestational hypertension, gestational diabetes, etc.), In addition, the miscarriage is eligible to provide benefit if the insured have purchased Option (1).
    3. Psychosis and Mental Disorder
    4. Medical check-up and examinations
    5. Fertility treatment
    6. Dental surgery and treatment (except due to accident)
    7. Optical examination, surgery and treatment (except due to accident)
    8. Cosmetic surgery.
    9. Hearing aids.
    10. Physical defect or infirmity
    11. Drug or alcohol abuse
    12. Criminal Commitment
    13. AIDS/HIV
    14. Terrorism, civil unrest, riots, hostilities or warlike operations (whether war be declared or not) civil war assuming the proportions of or amounting to popular rising, rebellion revolution, insurrection, military or usurped power or any act of any person acting on behalf of or in connection with any organization with activities directed towards the overthrow by force of the government de jure or de facto or to the influencing of it by terrorism or violence or by the direct or indirect consequences of any of the said occurrences.
    15. Hospitalizations for 3 days and under (except due to accident)
    16. Fraudulent claims.
    17. Suicide or Suicidal self-injury