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  • AIA Healthshield Support

    Frequently-Asked Questions

    Changes on your integrated shield plan (IP) - AIA HealthShield Gold Max A Plan and Riders

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    1. What are the main changes in 2022 and why are these changes necessary?

    There will be 2 main changes to your IP Plans:

    • Benefit Changes
    • Premium Adjustments

    The benefit changes are meant to bolster coverage of integrated shield plans (IPs), so policyholders continue to be provided with well-rounded, comprehensive protection. We regularly review the coverage and benefits of our plans in accordance with changes in healthcare practices.

    Premiums adjustments will only apply to AIA HealthShield GoldMax A plan and its two riders - AIA Max VitalHealth A, and AIA Max VitalCare, that provide coverage for treatments at private hospitals. There will not be any premium rate adjustments for policyholders of AIA HealthShield Gold Max B / Max B Lite / Max Standard plans.

    Our focus remains on keeping healthcare coverage affordable for our customers. However, these premium changes are necessitated by inflationary pressures on healthcare costs, particularly in the private healthcare sector, which require us – along with others within the industry - to increase premiums.


    2. What are the latest benefit changes and how will these impact the coverage and benefits for my AIA HealthShield Gold Max plan and riders?

    We have updated AIA HealthShield GoldMax A as well its two riders - AIA Max VitalHealth A, and AIA Max VitalCare - to ensure our IPs continue to provide policyholders with a wide range of benefits for well-rounded protection. We provide the highest levels of coverage in Singapore.

    Key benefit enhancements include:

    Basic plan: HealthShield Gold Max

    • Pregnancy Complications Benefit - expanded coverage for up to 28 conditions
    • Cell, Tissue and Gene Therapy - increased coverage limit from S$100k to S$250k
    • Proton Beam Therapy - increased coverage limit from S$70k to S$100k
    • Planned Medical Treatment Outside Singapore will now be covered (applicable to HealthShield Gold Max A & HealthShield Gold Max B only)*

    *For Planned Medical Treatment Outside Singapore Benefit under AIA HealthShield Gold Max, referrals must be obtained from any of the following healthcare providers:
    - Health Management International (HMI); or
    - Parkway Holdings Pte Ltd
    The list is subject to any change made on the covered healthcare providers for approved overseas hospitalisation by Medisave and we reserve the right to review and change such list as required from time to time.

    Rider: AIA Max VitalHealth & AIA Max VitalCare

    • Deductible & Co-insurance Benefit - Extended the co-payment cap of S$3,000 to include emergency confinement via A&E, even if the treating doctor is non-panel and/or without pre-authorisation

    Please get in touch with your AIA Financial Services Consultant / Insurance Representative or call our AIA Customer Care Hotline at 1800 248 8000 to learn more about the changes to your policy or if you need further assistance. 


    3. When will these changes take place?

    Policyholders should take note of the following key dates:

    • For new customers, policy changes will be implemented on/after 1 July 2022
    • For current policyholders of AIA HealthShield Gold Max and riders, policy changes will take effect from their respective policy anniversary dates on/after 1 July 2022.

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

    Customers are also encouraged to speak with their AIA Financial Services Consultant / Insurance Representative who will be best placed to share more details and advise further based on your existing portfolio and health insurance needs.


    4. Why is AIA raising premiums? What’s the percentage increase policyholders can expect? Why is there a need for AIA to adjust premiums again in 2022 when they were adjusted in 2021?

    IP premiums are reviewed regularly to ensure that the portfolios remain financially sustainable over the long-term. In recent years, rising claims costs have necessitated premium revisions amongst all IP insurers. Greater healthcare consumption and increased use of newer and costlier treatments have resulted in an increase in claims for IPs.

    With effect from 1 July 2022:

    • Premiums for AIA HealthShield Gold Max A plan will increase by 9%
    • Premiums for AIA Max VitalCare will increase by 9%
    • Premiums for AIA Max VitalHealth A will increase by 18%

    For existing policyholders, these changes will take effect from their policy anniversary date on/after 1 July 2022.

    There will not be any premium rate adjustments for policyholders of AIA HealthShield Gold Max B / Max B Lite / Max Standard plans.

    Our focus remains on keeping healthcare coverage affordable for our customers. However, these premium changes are necessitated by inflationary pressures on healthcare costs which require us – along with others within the industry - to increase premiums so that we can continue to protect our customers’ health when and where they need it.AIA has been an active advocate for collaboration among stakeholders in the industry to better manage healthcare costs.

    We continue to work closely with the Life Insurance Association of Singapore, the Ministry of Health, and professional medical associations to manage healthcare cost inflation to ensure the continued accessibility of quality healthcare for our customers.


    5. Are you planning to raise premiums again for your IP and riders in the near future?

    IP premiums are reviewed regularly to ensure that the portfolio remains sustainable in the long-term.


    6. How will this affect foreigners plans and riders?

    Premium adjustments will still apply to foreigner polices if the customer is under AIA HealthShield Gold Max A plan with the rider.

    From 1 July 2022, AIA HealthShield Gold Max B and Max VitalHealth B rider will also be available to foreigners.


    1 Please refer to your policy contract for specific details of your AIA HealthShield Gold Max and AIA Max VitalHealth / AIA Max VitalCare policies.

    AIA Max Essential rider / AIA Max VitalHealth rider / AIA Max VitalCare rider

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    1. How does switching across riders work?

    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 A Value, 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 A Value, AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.

    AIA Max VitalHealth A Value policyholders may switch to:

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

    Note: Upon switching of riders, the basic plan will be switched accordingly

    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.


    2. If my AIA Max Essential policy had been converted to AIA Max VitalCare / Max VitalHealth, can I request to change back to AIA Max Essential?

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


    On Deductible and Co-insurance / Co-payment

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    1. Deductible and co-insurance / co-payment – how do they work?

    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.


    2. Co-payment and co-payment cap features – how do they work?

    On co-payment

    After paying the applicable deductible, policyholders will need to pay out-of-pocket of a minimum of 5% on their covered bills before the insurance pay-out can cover the expenses. 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.

    Note that for AIA Max VitalHealth & AIA Max VitalCare riders, the co-payment cap of S$3,000 is extended to include emergency confinement via A&E, even if the treating doctor is non-panel and/or without pre-authorisation.

    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.


    3. Deductible Waiver Pass – how does it work?

    5Existing 'AIA Max Essential A Saver' plans will be known as 'AIA Max VitalHealth A'.

    6Subject to 5% co-payment.


    4. How will policyholders know if their Deductible Waiver Pass benefit has refreshed? Will this be available on our correspondences or My AIA SG application?

    Customers can enjoy zero deductibles on the first claim, be it a claim for treatments at either private or public hospital. The deductible waiver will reset if there are no private hospital claims in the last 3 consecutive policy years. Customers and insurance representatives may refer to My AIA SG and AgIA respectively to find out the Deductible Waiver Pass status at any time.


    On Claim-based Pricing

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    1. What is claim-based pricing?

    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.


    2. How does it work?

    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.


    3. Why is there a need for claim-based pricing?

    Claim-based pricing rewards customers who actively manage their health and are judicious in their use of medical services. 


    4. How does the No Claim Discount work?

    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.


    5. What should I do if I do not want to be subject to claim-based pricing?

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

    Customers who do not want to be subject to claim-based pricing may consider switching to AIA Max VitalHealth A or AIA Max VitalHealth A Value riders. 

    When contemplating switching, customers should 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). 

    Customers are encouraged to 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.


    6. Which AIA plans offer claim-based pricing currently?

    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.


    7. Will claim-based pricing be extended to more AIA plans moving forward?

    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.


    8. What is Premium Evaluation Period?

    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.


    9. How will I be notified of my Premium Level during the Premium Evaluation Period?

    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.


    10. Will the Standard Level Premium rates still be subject to revision when my future renewal premium is subject to my claim experiences?

    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.


    11. How will the renewal premium for AIA Max VitalCare be determined if I made claims on both private hospital and restructured hospital during the relevant premium evaluation period?

    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.


    12. How would I know when is the lock-in-date for claim-based pricing premium movement, for the premium of my AIA Max VitalCare?

    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.


    AIA QUALITY HEALTHCARE PARTNERS (AQHP)

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    1. What is AIA Quality Healthcare Partners (AQHP)?

    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.


    2. Why was AIA Quality Healthcare Partners (AQHP) introduced?

    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.


    3. How can the introduction of AQHP help in managing the rising healthcare costs?

    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.


    4. How do the AQHP fees compare to the Fee Benchmarks published by MOH?

    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.


    5. What are the benefits of choosing AQHP specialists over other specialists?

    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 working day*. 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.

    6. Who can have access to AQHP?

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


    7. How does AIA select the medical specialists to partner with as an AQHP specialist?

    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.   


    8. Where can I get more information on the list of AQHP specialists?

    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.


    APPOINTMENT REQUESTS

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    1. How can I request for an appointment with an AQHP specialist?

    You can request for an appointment with your preferred AQHP specialist using the following methods:

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

    Alternatively, you may also contact your AIA Financial Services Consultant or Insurance Representative for assistance.


    2. Can I request for an appointment on behalf of another person, who is an insured under AIA HealthShield Gold Max plan?

    Yes, you may request for an appointment on behalf of another insured. Please submit your request here.


    3. How do I know if my request for an appointment has been processed and confirmed?

    Upon submission of your request, we will contact you via SMS/call on the status of your appointment within 1 working day*.

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


    4. What is the earliest appointment date that I can request for an appointment with the AIA Quality Healthcare Partners?

    If your appointment request is submitted:

    • Before 1 pm, the earliest appointment date you may request for is on the next working day.
    • After 1 pm, the earliest appointment date that may be requested for will be the day after the next working day.

    Please note that the confirmed appointment date will be subject to the specialist's availability.

    Example:

    Appointment request submitted

    Earliest possible appointment

    Monday, before 1:00pm

    Next working day, Tuesday

    Monday, after 1:00pm

    Day after next working day, Wednesday

    Friday, before 1:00pm

    Next working day, Monday

    Friday, after 1:00pm

    Day after next working day, Tuesday

    Working days exclude Saturdays, Sundays, Public Holidays and eve of selected Public Holidays.


    5. Why I can’t request for an appointment with an AQHP specialist on Saturdays, Sundays and Public Holidays?

    Most of the specialist clinics have short consultation hours on Saturdays, hence their appointment timeslots are usually full. They also do not operate on Sundays and Public Holidays.


    6. Can I change or cancel my appointment request or for a confirmed appointment?

    You may call our medical concierge at 1800 248 8000 to make changes to your appointment or contact the clinic directly to make the changes.


    7. What do I need to bring on the day of my appointment?

    Please bring along the following items:

    • Your NRIC, Birth Certificate, Work Permit or Passport (where applicable)
    • Any medication you are currently taking or the names of the medication
    • Relevant medical reports, x-rays or scans

    The availability of the items will help the specialist to better understand your current medical condition.


    8. How do I request for an appointment for my follow-up visit?

    You can arrange for follow-up appointments directly at the clinic after your consultation. You do not need to go through us again to make the follow-up appointment.


    9. Can I contact the AQHP specialist clinics directly to make an appointment?

    We do encourage you to let us help connect you with an AQHP specialist to make an appointment as we strive to provide you with the best experience possible.


    10. How can I request for an appointment in the event of emergency?

    In the event of an emergency, please proceed directly to the Accident & Emergency department of a hospital nearest to you.


    TELEMEDICINE

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    1. What is Telemedicine?

    Telemedicine is the remote diagnosis and treatment of patients using telecommunications devices i.e. a smartphone with camera.


    2. Why introduce WhiteCoat Telemedicine service for AIA HealthShield Gold Max customers?

    Along with the rest of our healthcare proposition, such as AIA Quality Healthcare Partners (AQHP) and Teladoc Health, Whitecoat telemedicine allows us to provide primary care that is accessible and yet affordable to our customers. AQHP and Teladoc Health supports our healthcare proposition with hospitalisation and post-hospitalisation services, forming a holistic healthcare solution for AIA HealthShield Gold Max customers.


    3. When should I use WhiteCoat’s telemedicine services?

    Telemedicine is suitable for everyone who is seeking (i) treatment for non-emergency medical issues*; (ii) chronic conditions like hypertension, hyperlipidaemia and diabetes; or (iii) advice or a second opinion on a pre-existing condition.

    *List of conditions as follows:
    a. flu, cough, cold or sore throat;
    b. fever, or headache;
    c. diarrhea, constipation or vomiting;
    d. rash, or cold sores;
    e. conjunctivitis;
    f. urinary tract infection;
    g. dermatological conditions; and
    h. other non-emergent medical issues


    4. Do I need to launch the WhiteCoat App via the AIA Healthcare App to enjoy the consultation fee of S$12?

    Simply download and login to WhiteCoat App to enjoy the consultation fee of S$12 as an AIA HealthShield Gold Max customer.


    5. What are the other costs other than consultation fee?

    There are other costs like GST, medication cost and delivery cost.


    6. Do I need to call the AIA Quality Healthcare Partners Hotline to make an appointment for a telemedicine consultation with WhiteCoat?

    No, you do not need to request for an appointment with WhiteCoat. WhiteCoat’s teleconsultation services are on-demand, with an average waiting time of less than 5 minutes.


    TELADOC HEALTH

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    1. Why is AIA offering Personal Case Management Services to our customers?

    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.


    2. How does Personal Case Management differ from a second opinion?

    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.


    3. Who can have access to the Personal Case Management service?

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


    4. Is the Personal Case Management service free?

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

    Tests, treatments, procedures, devices or medication recommended by Teladoc Health may be subject to additional charges that are not covered by your plan. Please consult your AIA Financial Services Consultant for more details.


    5. What are the serious medical conditions that qualify for the Personal Case Management service?

    Please click here for the list of eligible medical conditions.


    6. How does Teladoc Health obtain my medical information and reports?

    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.


    7. Will Teladoc Health refer me for treatment abroad?

    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.

    The coverage for such overseas treatment will be subject to the benefit entitlements as per the policy contract.  Please consult your AIA Financial Services Consultant for more details.


    8. How does Teladoc Health complement AIA Quality Healthcare Partners (AQHP)?

    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.


    9. What if the treating doctor disagrees with Teladoc Health’s recommendation?

    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.


    10. What happens in the case of a wrong medical recommendation?

    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.

    AIA Singapore is not involved in the recommendations that Teladoc Health provides as the intent is for Teladoc Health to give independent advice.


    AIA HEALTHSHIELD PRE-AUTHORISATION

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    1. What is AIA HealthShield Pre-authorisation service?

    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.


    2. Who can request for an AIA HealthShield Pre-authorisation?

    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.


    3. Which hospitals and/or clinics does AIA HealthShield Pre-authorisation apply to?

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


    4. How many days in advance do I need to apply for AIA HealthShield Pre-authorisation prior to my admission/ surgery?

    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.


    5. What can I expect after AIA approves the pre-authorisation request?

    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.


    6. What happens if my AIA HealthShield Pre-authorisation request is declined?

    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.


    7. Is the AIA HealthShield Pre-authorisation service applicable for hospital surgeries or admission due to an emergency?

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


    8. Do I need to apply for Letter of Guarantee (eLOG) for deposit waiver after my pre-authorisation request is approved?

    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.


    Early Detection Screening

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    1. What is Early Detection Screening benefit?

    We introduced the Early Detection Screening benefit for AIA HealthShield Gold Max with rider* in 2019 as part of our efforts to help our customers stay healthy and manage their health for the long term. Appropriate screening can help to detect potentially serious medical condition(s) in advance to facilitate early diagnosis and treatment, helping you to lead a healthier, longer and better life.

    *Applicable only for AIA Max Essential A Saver, AIA Max Essential A, AIA Max VitalHealth A and AIA Max VitalCare riders. 


    2. Who are eligible for the Early Detection Screening benefit?

    All insured customers under the following plans who have reached the eligibility age* on the policy anniversary are entitled to the Early Detection Screening benefit:

    • AIA Max Essential A Saver
    • AIA Max Essential A
    • AIA Max VitalHealth A
    • AIA Max VitalCare

    In addition, the rider must have been in-force for at least 2 consecutive years and the premiums for the next policy year must have been duly paid and received by AIA.

    *Please refer to Question 3 for the eligibility criteria.


    3. What are the types of screening available under the Early Detection Screening benefit?

    The screenings available under the Early Detection Screening benefit are:

    No.

    Screening

    Insured Eligibility

    Frequency

    1.

    Colonoscopy

    Males and Females, age 50 and above

    Every 10 years from the policy year of the last screening voucher’s issuance date

    2.

    Mammogram

    Females, age 40 to 69

    Every 2 years from the policy year of the last screening voucher’s issuance date

    The first screening voucher will be issued on the policy anniversary when the insured meets the eligibility criteria, or when the premium for the next policy year is paid and received by AIA, whichever is later.

    Note: This Early Detection Screening benefit is for healthy individuals and is not intended for use by customers who have existing symptoms of breast or colorectal conditions, or who have a prior history of breast or colorectal conditions. Customers may refer to the Terms and Conditions stated on the Early Detection Screening vouchers for more details.


    4. When will I receive the Early Detection Screening voucher?

    AIA will send the notification letter, with the voucher enclosed, to your mailing address upon your policy anniversary or when payment for your next policy year’s premium has been duly received, whichever is later.


    5. Is it mandatory for me to go for the screening upon receiving the Early Detection Screening voucher?

    No, this complimentary screening is completely optional. If you would like to go for the screening, please make an appointment with your preferred screening partner in advance.


    6. How do I utilise this Early Detection Screening benefit?

    You can utilise the benefit in 3 simple steps upon receiving your letter.

    Step 1: Make an appointment
    Schedule an appointment with your preferred clinic / imaging centre from our list of participating screening partners.

    Step 2: On the day of screening
    Please bring along your
    a) AIA Early Detection Screening Voucher (original copy); and
    b) NRIC / FIN / Passport

    Step 3: Collect your health report
    Collect your health report directly from the screening partner.


    7. What is the validity period of the Early Detection Screening voucher?

    The voucher is valid for 1 year from the policy anniversary date.


    8. I did not utilise my Early Detection Screening voucher before the expiry date. Can I request to extend the validity?

    The voucher has a validity period of 1 year (from policy anniversary date) and no extension is allowed.

    To ensure that you secure your preferred appointment date and time, we strongly encourage you to make an appointment with your preferred screening partners listed in the letter in advance. You may reach them via voice call, SMS, WhatsApp, and/or Email as indicated in the letter. 


    9. I lost my Early Detection Screening voucher. Can I request for another voucher?

    Yes, you can request for a reprint of the voucher by contacting AIA Customer Care at 1800 248 8000 from Monday – Friday, 8.45am – 5.30pm, excluding Public Holidays.

    Upon receiving your request, a new voucher will be issued and sent via post to your mailing address. Please note that the existing voucher will be considered void.


    10. Are there any other costs that I need to pay when utilising this complimentary screening?

    Please refer to Terms and Conditions stated on the Early Detection Screening voucher.


    11. After my complimentary screening, I was advised to go for further investigations and treatments. Can I claim these from my AIA HealthShield Gold Max A policy?

    Coverage of further investigations and treatments will depend on whether these fall within the benefits of your AIA HealthShield Gold Max A policy, as well as any other applicable terms and conditions in your policy. The admissibility of claims for any such expenses will be assessed under and in accordance with the terms of the policy.


    Home Palliative Benefit

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    1. What is the Home Palliative benefit?

    Home Palliative care refers to the provision of palliative services in the patient’s home. Common palliative services include changing of wound dressings, feeding tubes, stoma care, urinary tube changes, provision of supportive medicines and nutritional feeds.

    Home Palliative care provides patients with greater sense of independent living and comfort in familiarity for terminally ill cancer patients. The Home Palliative care benefit provides coverage for eligible items up to $15,000 per month with maximum lifetime limit of $45,000.


    2. How do I know if I am eligible for Home Palliative benefit?

    Home Palliative Benefit is available to Insureds who are diagnosed with terminal cancer with expected survival period of 12 months or less under the following rider: 

    - AIA Max VitalHealth A

    - AIA Max VitalHealth A Value

    - AIA Max VitalCare


    3. How can I apply for the Home Palliative benefit?

    To apply for the service, you need a referral letter* from your oncologist to the AIA Appointed Home Palliative Care Provider(s).

    Step 1: Insured requires home palliative care service
    Step 2: Insured / referring oncologist contacts AIA Appointed Home Palliative Care Provider to submit referral letter*
    Step 3: AIA Appointed Home Palliative Care Provider contacts the insured.

    *Note: The referral letter must include a declaration that the insured is diagnosed with Terminal Cancer with an expected survival period not exceeding 12 months


    4. Who are the AIA Appointed Home Palliative Care Providers?

    Please see below table for the Appointed Provider(s) for this service.

    List of AIA Appointed Home Palliative Care Provider(s)
    Centre Name Email Address Contact Number Operating Hours
    Vickycares Pte Ltd support@vickycares.sg +65 8668 8360 Mondays to Fridays, excluding Public Holidays
    8.30am - 5.30pm
    List of AIA Appointed Home Palliative Care Provider(s)
    Centre Name Vickycares Pte Ltd
    Email Address support@vickycares.sg
    Contact Number +65 8668 8360
    Operating Hours Mondays to Fridays, excluding Public Holidays
    8.30am - 5.30pm

    Note: This list of Appointed Provider(s) is correct as of 01 April 2021 and may be subject to change.


    5. What are the eligible items covered under Home Palliative benefit?

    The Home Palliative benefit covers eligible items - doctor’s attendance fee, nurse’s attendance fee, prescription drugs and/or supportive medicine (e.g. pain relief medications, total parenteral nutrition), medical consumables (e.g. wound dressings) and procedures (e.g. feeding tube changes, stoma wound care). If other items are required, AIA reserves the right to determine whether they are considered as Reasonable and Customary.


    6. What else do I need to take note of if I want to claim for Home Palliative benefits

    To submit a claim, the following criteria must be fulfilled:

    1. Service is provided by AIA Appointed Home Palliative Care Provider;
    2. Claim is accompanied by an oncologist’s referral letter with declaration that the patient has Terminal Cancer with an expected survival period not exceeding 12 months;
    3. Claim is linked to a main claim episode for which the claim has been approved. This main claim episode may be an inpatient admission or an outpatient chemotherapy episode within the last six (6) months (Note: This is determined based on the date of the first Home Palliative claim);
    4. Claim is admissible only for eligible items required for the delivery of Home Palliative. Refer to question 5 for eligible items; and
    5. All claims submitted for Home Palliative benefit should be within 12 consecutive months from date of the first Home Palliative benefit claim, subject to the Limit of Compensation stated in the Schedule of Benefits.

    7. Who can I reach out to if I need more information on Home Palliative benefit?

    Please contact AIA HealthShield Hotline at 1800 248 8000 if you need further assistance.


    AIA HEALTHSHIELD CLAIMS

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    1. How do I file my claim?

    Claims are to be submitted to us by the Medical Institutions through the system set up by the Ministry of Health of Singapore in accordance with the terms and conditions under the CPF Act and the MediShield Life Scheme Act 2015 (where applicable), as amended from time to time. Once you have given the medical institution the authorisation to submit your claim for you, the medical institution will submit a claim to the insurer on your behalf.

    This will not be applicable to claims under Pre-Hospitalisation Benefit, Post-Hospitalisation Benefits, Congenital Abnormalities of Insured’s Biological Child from Birth (for female Insured), Non-insured Donating an Organ to Insured, Emergency Overseas (outside Singapore) Medical Treatment Benefit and Post-Hositalisation Psychiatric Treatment under the Benefits Provisions of this Policy. Claims must be notified through the submission of a completed Accident and Hospitalisation Claim with other proof of loss documents as may be determined by us to our satisfaction.


    2. Which medical treatments would require additional criteria to be met before the full claim can be paid?

    Please refer to the link provided here for further details.


    3. How do the deductible and co-insurance work?

    The deductible is the portion of costs the policyholder is liable for before any benefits are payable and is applied to the claimable amount, not the total bill amount. The claimable amount is calculated based on the schedule of benefit limits.

    The deductible is applied on a policy year basis. Once the total claimable amount for claims arising within the same policy year exceed the deductible, the deductible will not apply to further claims arising within the same policy year. No deductible is applied for out-patient claim.

    Co-insurance is the fixed percentage the policyholder is liable for in excess of the deductible and is applied to both in-patient and out-patient claims.


    4. What is the definition of “pre-existing illnesses” in AIA HealthShield Gold Max Policy?

    It is defined as “any pre-existing illnesses, disease or impairment from which the insured is suffering prior to the Policy Date, other than those defined in Serious Illness, unless declared in the Application form and specifically accepted by the Company”.


    5. The policyholder will be posted overseas for a few years. Does his HealthShield Gold Max policy cover him whilst he is overseas?

    Except in the case of an “Emergency”, overseas medical treatments are not covered. “Emergency” means a serious illness or injury or the onset of a serious condition, which in our opinion requires urgent remedial treatment to avoid death or serious impairment to the Insured’s immediate or long-term health.


    6. AIA only reimbursed part of the policyholder’s hospital expenses. He wants to claim the balance from his company insurer. How should he proceed?

    He needs to submit the original final hospital bill to his company insurer and a copy of our settlement letter to claim the balance of the hospital bill not covered under the integrated plan.


    7. Does the Policy covers all charges for medications prescribed by my doctors?

    All medically necessary medications prescribed by the attending physician related to the hospitalisation is claimable, subject to the terms and conditions of the Policy. This does not include supplement, experimental drugs etc.


    8. How do I apply for approval for use of high-cost technologies? High-cost technologies refer to CAR T-cell therapy and Proton beam therapy.

    These technologies are currently not approved locally and under review by MOH. Thus, we are unable to review the request for such treatment as it is falls under the general exclusion. We will provide more information on the application process once they are approved for use locally. 


    9. How does deductible, co-insurance and co-payment work on my AIA HealthShield Gold Max policy?

    AIA HealthShield Gold Max covers the majority of your medical bill. Here is an example to illustrate*:

    John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K.

    With AIA HealthShield Gold Max A

    John pays deductible:
    $3,500

    John pays
    co-insurance: $9,650

    [10% x ($100,000 - $3,500)]

    HSG Max A (including
    Medishield Life) pays: $86,850

     

    * Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

    10. How does deductible, co-insurance and co-payment work on my AIA HealthShield Gold Max with AIA Max VitalHealth A if I have activated pre-authorisation before treatment and my policy has a Deductible Waiver Pass?

    AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

    Here is an example to illustrate*:

    John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K. As the policy has a Deductible Waiver Pass, John does not need to pay $2,000 deductible. And, in view that the treatment was pre-authorised, there is a co-payment cap of $3,000 and hence John only needs to pay $3,000 from his own pocket. The remaining bill is covered under his policies.

    With AIA HealthShield Gold Max A and AIA Max VitalHealth A (with Deductible Waiver Pass + Certificate of Pre-Authorisation)

    AIA Max VitalHealth A
    (which covers
    deductible and co-
    insurance) pays:
    $10,150

    John pays
    co-payment:
    $3,000

    HSG Max A (including Medishield Life)
    pays: $86,850

     

    * Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

    11. How does deductible, co-insurance and co-payment work on my AIA HealthShield Gold Max with AIA Max VitalHealth A if I have activated pre-authorisation before treatment but my policy does not have a Deductible Waiver Pass?

    AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

    Here is an example to illustrate*:

    John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K. As the policy does not have a Deductible Waiver Pass, John needs to pay $2,000 deductible from his own pocket. There is a co-payment cap of $3,000 because the treatment was pre-authorised. In total, John has to pay $5,000 from his own pocket and the remaining bill is covered under his policies.

    With AIA HealthShield Gold Max A and AIA Max VitalHealth A (No Deductible Waiver Pass but with Certificate of Pre-Authorisation)

    John pays deductible:
    $2,000

    AIA Max VitalHealth A
    (which covers the
    remaining deductible
    and co-insurance)
    pays: $8,150

    John pays
    co-payment:
    $3,000

    HSG Max A (including Medishield Life)
    pays: $86,850

     

    * Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

    12. How does deductible, co-insurance and co-payment work on my AIA HealthShield Gold Max with AIA Max VitalHealth A if I have not activated pre-authorisation before treatment but my policy has a Deductible Waiver Pass?

    AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

    Here is an example to illustrate*:

    John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K. As the policy has a Deductible Waiver Pass, John does not need to pay $2,000 deductible. However, in view that the treatment was not pre-authorised, the co-payment cap of $3,000 does not apply and John would need to pay a total of $5,000 from his own pocket. The remaining bill is covered under his policies.

    With AIA HealthShield Gold Max A and AIA Max VitalHealth A (with Deductible Waiver Pass, No Certificate of Pre-Authorisation)

    AIA Max
    VitalHealth A
    (which covers
    deductible and co-
    insurance) pays:
    $8,150

    John pays co-
    payment:
    $5,000

    HSG Max A (including Medishield Life)
    pays: $86,850

     

    * Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

    13. How does deductible, co-insurance and co-payment work on my AIA HealthShield Gold Max with AIA Max VitalHealth A if I have not activated pre-authorisation before treatment and my policy does not have a Deductible Waiver Pass?

    AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

    Here is an example to illustrate*:

    John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K. As the policy does not have a Deductible Waiver Pass, John would need to pay $2,000 deductible. And, in view that the treatment was not pre-authorised, the co-payment cap of $3,000 does not apply and John would need to pay a total of $6,900 from his own pocket. The remaining bill is covered under his policies.

    With AIA HealthShield Gold Max A and AIA Max VitalHealth A (with No Deductible Waiver Pass, No Certificate of Pre-Authorisation)

    John pays deductible:
    $2,000

    AIA Max VitalHealth
    A (which covers the
    remaining
    deductible and co-
    insurance) pays:
    $6,250

    John pays
    co-payment:
    $4,900

    HSG Max A (including Medishield Life)
    pays: $86,850

     

    * Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

    14. How does deductible, co-insurance and co-payment work on my HealthShield Gold Max with AIA Max VitalCare if I have activated pre-authorisation before treatment?

    AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalCare covers deductibles and co-insurance, subject to 5% co-payment.

    Here is an example to illustrate*:

    John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K. As there is a co-payment cap of $3,000 because the treatment was pre-authorised, John only needs to pay $3,000 from his own pocket and the remaining bill is covered under his policies.

    With AIA HealthShield Gold Max A and AIA Max VitalCare (With Certificate of Pre-Authorisation)

    AIA Max VitalCare
    (which covers
    deductible and co-
    insurance) pays:
    $10,150

    John pays
    co-payment:
    $3,000

    HSG Max A (including Medishield Life)
    pays: $86,850

     

    * Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

    15. How does deductible, co-insurance and co-payment work on my HealthShield Gold Max with AIA Max VitalCare if I have not activated pre-authorisation before treatment?

    AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalCare covers deductibles and co-insurance, subject to 5% co-payment.

    Here is an example to illustrate*:

    John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K. In view that the treatment was not pre-authorised, the co-payment cap of $3,000 does not apply and John would need to pay $5,000 from his own pocket. The remaining bill is covered under his policies.

    With AIA HealthShield Gold Max A and AIA Max VitalCare (No Certificate of Pre-Authorisation)

    AIA Max VitalCare
    (which covers
    deductible and co-
    insurance) pays:
    $8,150

    John pays co-
    payment:
    $5,000

    HSG Max A (including Medishield Life)
    pays: $86,850

     

    * Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

    16. How does deductible, co-insurance and co-payment work on my AIA HealthShield Gold Max with AIA Max VitalHealth A Value?

    Example: John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K.

    With AIA HealthShield Gold Max A and AIA Max VitalHealh A Value (with Certificate of Pre-Authorisation)

    John pays deductible:
    $3,500

    AIA Max VitalHealth
    A Value (which
    covers the remaining
    deductable and co-
    insurance) pays:
    $3,650

    John pays co-
    payment:
    $6,000

    HSG Max A (including Medishield Life)
    pays: $86,850

    With AIA HealthShield Gold Max A and AIA Max VitalHealh A Value (No Certificate of Pre-Authorisation)

    John pays deductible:
    $3,500

    AIA Max VitalHealth
    A Value (which
    covers the remaining
    deductable and co-
    insurance) pays:
    $0

    John pays co-
    payment:
    $9,650

    HSG Max A (including Medishield Life)
    pays: $86,850

     

    However, should John be admitted to A Ward Class of a Restructured hospital, the out-of-pocket will be capped at $3,000 as shown below:

    With AIA HealthShield Gold Max A and AIA Max VitalHealh A Value (A Ward Class of a Restructured hospital)

    John pays deductible:
    $0

    AIA Max VitalHealth
    A Value (which
    covers the remaining
    deductable and co-
    insurance) pays:
    $10,150

    John pays co-
    payment:
    $3,000

    HSG Max A (including Medishield Life)
    pays: $86,850

     

     

    OTHERS

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    1. How can I update my personal particulars?

    Please contact your AIA Financial Services Consultant/Insurance Representative or call our AIA Customer Care Hotline at 1800 248 8000 to update your personal particulars.


    2. How can I check my policy details?

    You may consult your AIA Financial Services Consultant/Insurance Representative or call our AIA Customer Care Hotline at 1800 248 8000.

    Alternatively, you can also access your policy details on the go via My AIA SG mobile app.


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    • Request for an appointment

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    Singapore 049246

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