Health Care Card and Guarantee Letter (GL)

Upon admission to the Panel Hospital, customer can present their Health Care Card and NRIC to the hospital’s admission counter for Guarantee Letter arrangement.

To provide sufficient time for HSD to process the Guarantee Letter for admission, it is recommended for customer to request their attending doctor to complete Part II, which is the Admission Section of the Guarantee Letter Request Form and send the completed form to HSD as soon as possible.

Hospital will assist to process the necessary documentation for Guarantee Letter request and send it to HSD for validation. Once it is confirmed that customer’s hospitalization fulfills the policy’s terms and conditions, Initial Guarantee Letter (IGL) will be issued and sent to the hospital for their handling.

If customer’s Guarantee Letter request is not approved, the Decline Guarantee Letter (DGL) will be sent to the hospital. Hospital will advise customer to pay for their medical expenses and submit the claim to GELM for reimbursement consideration.

An SMS will be sent to the servicing agent (if mobile number is registered with CAD) and customer (if customer provides their mobile number in the GL Form) to notify them of the Guarantee Letter status.

The Guarantee Letter is valid for 30 days from the date of issuance.

The decision to decline Guarantee Letter may due to the following reasons below but it is not an exhaustive list:

• Policy lapsed/termination
• Outpatient, pre-hospitalisation or post hospitalisation treatment
• Hospitalisation at non-panel hospital or non-panel specialist
• Insufficient information at the point of admission to confirm the claim is admissible
• Further verification checks are required to ensure it is not related to policy exclusions or pre-existing conditions

Note: You may contact the Healthcare Hotline for more specific information on the decline reason.

No, the Health Care Card is meant for the Panel Hospital to identify customer with GELM medical policy and cannot be used as a guarantee for hospital deposit.

Yes, most hospitals will request for deposit payment as part of the admission requirement. However, the deposit payment will be refunded by the hospital after deducting the non-covered charges such as coinsurance/deductible, telecommunication fee, extra meals, miscellaneous expenses, service tax, braces, special aids etc (if any).

No, hospital discount is not a policy entitlement so customer has to pay the published rate as advised by the hospital.

Normally, the attending doctor has to complete the medical report (Discharged Section) before hospital billing staff can prepare the hospitalisation bills. The whole process takes about a few hours subject to the hospital’s available resources.

Upon receiving the complete document from the hospital, HSD will process the FGL within 75 minutes for straightforward cases. However, if the documentation or information received is incomplete, it may take longer or until the necessary documentation has been received to process the FGL.

The list of panel hospitals and specialist is available in e-Partner under HSD or GELM website at www.greateasternlife.com/my. Please note that list of panel hospitals and specialist is subject to change and the latest listing can be viewed at both e-Partner and the website.

There are some specialists (doctors) within the appointed panel hospitals who are not included in the list of panel specialists for various reasons. Therefore, Guarantee Letter facility is not available for any admission or treatment by non-panel specialist.

Yes, customers who choose to be treated at a non-panel hospital or specialist can settle their medical expenses and submit their claim for reimbursement consideration according to the policy’s terms and conditions.

No. The Health Care Card is only applicable to GELM Panel Hospitals in Malaysia. Customer has to pay the medical expenses and submit their claim for reimbursement consideration according to policy’s terms and conditions after they return from overseas.