Frequently-Asked Questions

From 1 April 2021, all existing policyholders of AIA Max Essential rider will automatically be converted to the following plans, effective from their policy renewal on / after 1 April 2021*. All AIA IP riders will include the 5% co-payment features moving forward.

We will inform you of the changes with a written notification at least 31 days before the change takes effect.

*For policies with changes requested by you, where the effective dates of such changes being later than the cut-off dates of the respective written notification mail-drops (i.e. approximately 2 months prior to the policy renewal dates), the above-mentioned conversion shall take place only from the next policy renewal, i.e. from April 2022 onwards.

A deductible is the amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

After you pay the deductible, you usually will need to pay the co-insurance / co-payment for covered services before your insurance starts to pay. The amount covered by the insurance plan, is subject to the co-insurance / co-payment percentage.

Both deductibles and co-insurance / co-payment features help keep premiums affordable.

On co-payment

After paying the applicable deductible, you will need to pay minimum of 5% the remaining covered amount, out-of-pocket. This means that IP plan and rider will no longer cover 100% of medical bills.

Expenses that are not covered by AIA are not subject to the 5% co-payment as the full amount is already paid out-of-pocket by the policyholder.

On co-payment cap

The co-payment is capped at $3,000 per policy year, if the insured receives treatment from an AIA Quality Healthcare Partners specialist or a public hospital, or if the treatment is pre-authorised.

The aim of the co-payment cap feature is to protect you against large bills by limiting the out-of-pocket amount you have to pay per policy year. The minimum co-payment cap insurers can apply is $3,000.

The Deductible Waiver Pass under AIA Max VitalHealth A allows you to enjoy zero deductible on the first Private Hospital Claim under the rider regardless of doctor, subject to 5% co-payment. The deductible waiver will reset if there are no Private Hospital Claims over 3 consecutive policy years.

Private Hospital Claims without the Deductible Waiver Pass will be subject to a $2,000 deductible in a policy year.

Below is an example to illustrate how the Deductible Waiver Pass works:

Policy Year 1: From 01 February 2022 to 31 January 2023 (with Deductible Waiver Pass)

• No deductible will be applicable on your Private Hospital Claim in this policy year as the $2,000 deductible will be waived

Policy Year 2 to 4: From 01 February 2023 to 31 January 2026 (without Deductible Waiver Pass)

• During this period, if you need hospital treatment, a $2,000 deductible will be applicable if you go to a private hospital (whether through our AIA Quality Healthcare Partners (AQHP) or non-AQHP)
• No deductible will be applicable if you seek treatment from Public/Restructured Hospital

Policy Year 5: From 01 February 2026 to 31 January 2027

• If you have no Private Hospital claims over 3 consecutive policy years, no deductible will be applicable on your Private Hospital claims in this policy year.

You will have no deductible on your first AIA Max VitalHealth A claim, whether it is for treatment at a private or public hospital. The deductible waiver will reset if there are no private hospital claims over 3 consecutive policy years. You may refer to My AIA SG to find out the Deductible Waiver Pass status at any time.

You may request to switch to other riders by making a request for change. Please note that your request may be subject to underwriting.

AIA Max VitalCare policyholders may switch to:

• AIA Max VitalHealth A - No underwriting is required if the request was submitted between 01 April 2021 to 30 September 2022. Thereafter, the request will be subject to underwriting.
• AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.

AIA Max VitalHealth A policyholders may switch to:

• AIA Max VitalCare - No underwriting is required if the request was submitted between 01 April 2021 to 30 September 2022. Thereafter, the request will be subject to underwriting.
• AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.

AIA Max VitalHealth B policyholders may switch to:

• AIA Max VitalCare or AIA Max VitalHealth A - Underwriting is required.
• AIA Max VitalHealth B Lite – No underwriting is required.

AIA Max VitalHealth B Lite policyholders may switch to:

• AIA Max VitalCare, AIA Max VitalHealth A or AIA Max VitalHealth B - Underwriting is required.

AIA Max Essential C policyholders may switch to:

• AIA Max VitalCare, AIA Max VitalHealth A, AIA Max VitalHealth B or AIA Max VitalHealth B Lite - Underwriting is required.

When contemplating switching, please do consider factors like age, pre-existing conditions, appropriate healthcare for your needs and affordability of future premiums. It is important to understand the risk of switching plans, as this could lead to an exclusion of pre-existing conditions or an increase in premiums (loading). Speak with your AIA Financial Services Consultant / Insurance Representative and he / she will be able to advise further based on your existing portfolio and health insurance needs.

No, you can’t as AIA Max Essential will no longer be available from 1 April 2021.

Claim-based pricing is a fairer pricing approach to empower our policyholders with more control over their future renewal premiums by managing their claim experience. Customers who make less claims will be rewarded with lower premiums.

It is applicable for AIA Max VitalCare only.

There are five premium levels in the claim-based pricing for AIA Max VitalCare.

With claim-based pricing, all policyholders will start off at the Standard Level premium, the lowest premium level of your age band. During each policy renewal, the renewal premium level will be determined by the previous claim made during the premium evaluation period. As long as you stay healthy, with no claims made during the premium evaluation period while your AIA Max VitalCare is at Standard Level, you will continue to enjoy the No Claim Discount on your Standard Level premium at your next policy renewal.

Find out how the different premium levels will affect you.

Claim-based pricing rewards you for actively managing your health and being prudent in your use of medical services.

When no claims are made during the premium evaluation period, and if the AIA Max VitalCare is at Standard Level Premium, policyholders will get to enjoy a specified discount rate. The No Claim Discount applies only to the AIA Max VitalCare premium, and will increase based on the number of years without claim as shown in the table below.

AIA Max Essential A policyholders who have not made any claims in the policy year prior to conversion to AIA Max VitalCare will immediately enjoy a 10% discount at the point of conversion.

AIA Max VitalCare is the only AIA IP rider which is subject to claim-based pricing.

If you do not want to be subject to claim-based pricing, you may consider switching your rider to AIA Max VitalHealth. Please click here for further details on switching of riders.

When contemplating switching, please do consider factors like age, pre-existing conditions, appropriate healthcare for your needs and affordability of future premiums. It is important to understand the risk of switching plans, as this could lead to an exclusion of pre-existing conditions or an increase in premiums (loading). Speak with your AIA Financial Services Consultant / Insurance Representative and he / she will be able to advise further based on your existing portfolio and health insurance needs.

Currently, only AIA Max VitalCare is subject to claim-based pricing. AIA Max VitalCare is a rider that is only attachable to the AIA HealthShield Gold Max A plan.

In implementing claim cost containment initiatives, we have always prioritised initiatives that will truly be effective without affecting the adequacy of the protection we provide. We will monitor and review the new claim-based pricing approach closely to ensure that we continue to strengthen our comprehensive healthcare proposition in a meaningful way.

As a leading insurer in the healthcare space, AIA Singapore is committed to journeying with our customers through their lives as well as continuously providing them with innovative solutions that truly meet their needs.

Your premium level may move up or down depending on the source of claim and the claim amount paid from your AIA Max VitalCare during each policy year. This is assessed and determined during the Premium Evaluation Period.

For the very first renewal of AIA Max VitalCare, the Premium Evaluation Period will cover the first 10 months from the issue date or renewal date of AIA Max VitalCare.

For subsequent renewals of AIA Max VitalCare, the Premium Evaluation Period will be a period of 12 months commencing from the date immediately following the previous Premium Evaluation Period.

For example, if the previous Premium Evaluation Period ended on 8 November 2020, the subsequent Premium Evaluation Period shall be from 9 November 2020 to 8 November 2021.

Your premium level may move up or down depending on the source of claim and the claim amount paid from your AIA Max VitalCare during each policy year. This is assessed and determined during the Premium Evaluation Period.

Please be assured that you will be notified of the premium level in your next renewal through the yearly Premium Notification Letter, and you can also access the information through My AIA SG.

Yes. The Standard Level Premium rates are not guaranteed and are expected to be adjusted from time to time to allow for ongoing reviews of claims experience, medical inflation, and general cost of treatments, supplies or medical services in Singapore.

When there were claims made for both private hospital and restructured hospital treatment during the premium evaluation period, only private hospital claims made will be used to ascertain the next renewal premium level for AIA Max VitalCare.

All AIA Max Essential A policyholders will automatically be converted to AIA Max VitalCare at Standard Level premium on/from April 2021. Those who have not made a claim in the policy year prior to conversion will receive a 10% No Claim Discount on their Standard Level Premium.

Customers who do not wish to remain on AIA Max VitalCare (with claim-based pricing) can choose to switch to AIA Max VitalHealth (no claim-based pricing). Please click here for further details on switching of riders.

With claim-based pricing, you will start off at the Standard Level premium, the lowest premium level of the relevant age band. During each policy renewal, the renewal premium level will be determined by the previous claims made during the premium evaluation period. Any changes to your premium level will be implemented on your next policy renewal.

The lock in date for AIA Max VitalCare’s renewal premium level is T – 2 calendar months, where T is the next policy anniversary date.

No, you can’t as AIA Max Essential will no longer be available from 1 April 2021.

AIA Quality Healthcare Partners or AQHP, is our panel of private specialist doctors exclusively curated for AIA HealthShield Gold Max customers. Each of them has at least 5 years of specialist experience and a clean professional track record.

Forming AQHP is one of the measures that the Company has put in place to manage rising healthcare costs. The formation of such preferred provider panels was one of the recommendations of the Health Insurance Task Force to ensure that health insurance premiums remain sustainable in the long run.

We have negotiated fee agreements with AQHP, which was set with reference to MOH published fee benchmarks, to help ensure treatment and charges are in line with what is reasonable and customary. This will ultimately benefit consumers as it will help moderate the rate of premium increases in the long run.

AQHP fees take reference from MOH’s Fee Benchmarks. They are generally set at the midpoint between the upper and lower bounds, but there may be some deviations from this based on our negotiations with our panel. We set a fixed fee instead of a range so that there is more clarity for doctors and policyholders as to the expected charges.

With AQHP, we have made it easy for you to gain access to more than 380 specialists. It is also convenient for you to request for an appointment with your preferred AQHP specialist using the following methods:

• On AIA Healthcare mobile app
• Submit your request via our website 
• Call our medical concierge at 1800 248 8000
  

Upon submission of your request, we will contact you via SMS/call on the status of your appointment within 1 hour*. You will also get to enjoy pre-negotiated outpatient consultation fees with our AQHP specialist as an AIA HealthShield customer.

(*For requests submitted on Mondays to Fridays, between 8.45am to 5.30pm. Excludes Public Holidays)

Notes:

• We will try our best to arrange an appointment with your preferred specialist within 3 working days. However, there may be times when this is only possible with an alternative specialist in the same field.
• Consultation or treatment with any AQHP specialists does not mean that the bills will be claimable. Claims eligibility will be subjected to the terms and conditions of the AIA HealthShield Gold Max policy.
  

All existing and new AIA HealthShield Gold Max customers will enjoy exclusive access to services provided by AQHP.

Our AQHP specialists are carefully selected based on their professional track record and a minimum 5 years of specialist experience. We also ensure that we have a healthy mix of medical fields when selecting our AQHP specialists to cater to your medical needs.   

You can access our AQHP specialists’ profiles here. 

For easy access on the go, you can also access the list on the AIA Healthcare mobile app, which is available for download from the Apple App Store and Google Play Store.

We understand that customers who have serious medical conditions often feel uncertain about the best course of action and face a lot of stress along the care journey. Through this service, we would like to help our customers get accurate diagnosis and select the best course of treatment, by providing them access to independent global expert medical advice, as well as on-going support throughout their medical journey.

Most second opinion services review medical reports and information to provide an independent diagnosis and recommended treatment plan. Following the second opinion, a patient is often left with questions, as well as the need to find the best doctor and hospital to administer the treatment. With Personal Case Management, the customer is never alone. The customer will be supported by a dedicated case management team, led by the physician case manager, at all times throughout the medical journey from diagnosis, treatment, through to recovery.

This service is exclusively available for our insured customers with AIA Max VitalHealth A, AIA Max VitalCare, AIA Max Essential A/A Saver, AIA Power Critical Cover, AIA Triple Critical Cover with Power Upgrade Rider, and AIA Beyond Critical Care plans.

This service is complimentary for our insured customers with AIA Max VitalHealth A, AIA Max VitalCare, AIA Max Essential A/A Saver, AIA Power Critical Cover, AIA Triple Critical Cover with Power Upgrade Rider, and AIA Beyond Critical Care plans.

Please click here for the list of eligible medical conditions.

When you choose to use Teladoc Health’s Personal Case Management service, you will be required to sign the service enrolment and authorisation form, as well as submit all relevant medical information and reports at hand. This approval will also allow Teladoc Health to obtain any missing medical reports from various sources.

AIA and Teladoc Health recognise the importance and sensitivity of such personal data and will only share information that is required to accurately analyse the customer’s condition and enable appropriate recommendations to be made.

Teladoc Health’s assessment of treatment is based on medical necessity. As Singapore has a highly developed healthcare system, Teladoc Health does not expect that there will be a need to refer patients abroad. However, Teladoc Health will consider recommending consultation or treatment abroad in the rare instances where there is a lack of local expertise in relevant fields.

Please note that the AIA HealthShield Gold Max A with AIA Max VitalHealth A, AIA Max VitalCare and AIA Max Essential A/A Saver plans only cover emergency treatments abroad, subject to the overall benefit limits of the policies. Scheduled overseas treatment expenses will not be claimable.

AQHP specialists are selected based on their qualifications and experience to deliver quality affordable healthcare.

This partnership with Teladoc Health complements the AQHP, by providing patients with additional access to local and global expertise and ongoing support. Teladoc Health does not directly treat patients but works in collaboration with the treating doctor to ensure that the best possible care is delivered. This enhances the ability of our AQHP to deliver quality care.

In such a situation, with the patient’s permission, Teladoc Health will discuss the case with the treating doctor and collectively agree upon the best course of action for the patient. At the end of the day, the decision on how to proceed with the suggested treatment plan lies with the patient.

Teladoc Health provides a case management service to empower patients to make informed decisions and be proactive participants in their medical care. It is important to note that Teladoc Health does not treat patients directly, nor prescribe medications. The decision regarding treatment is made by the patient, in consultation with the treating doctor. Hence, Teladoc Health does not take on the responsibility for medical malpractice.

It is a service where AIA approves coverage for a hospital admission and/or day surgery based on your policy coverage, benefit entitlement and medical information provided by your doctor prior to the actual event. This provides customers with peace of mind knowing that their planned procedure or admission will be reimbursed.

All AIA HealthShield Gold Max customers can submit an AIA HealthShield Pre-authorisation request for non-emergency hospital or surgical bill (including day surgery), before admission or surgery.

AIA HealthShield Pre-authorisation is applicable for non-emergency hospital admissions and day surgeries in all private hospitals and ambulatory centres.

You will have to send in your request for pre-authorisation and ensure that your doctor completes and submits the e-form at least 3 working days prior to the planned surgeries or hospital admissions.

Once the AIA HealthShield Pre-authorisation request has been approved, we will issue you a Certificate of Pre-authorisation stating the approved amount for the specified medical diagnosis, treatment date and procedures. A copy of the Certificate of Pre-authorisation will also be provided to the admitting hospital.

We will call you if your pre-authorisation request is declined or partially approved and provide the reasons for rejection. We will also offer alternative solutions and assist you on your care journey.

AIA HealthShield Pre-authorisation is not applicable for emergency cases admitted through the hospital’s A&E department.

There is no need to apply for eLOG as the Certificate of Pre-authorisation also includes waiver of deposit at the point of admission. The hospital will only need to collect the deductible and co-insurance (if applicable) at the point of discharge and we will settle the rest of your medical directly with the hospital.

Note: Subject to acceptance of the Certificate of Pre-authorisation by the hospital.