- MEMBERSHIP TYPES, FEES, BENEFITS AND EXCLUSIONS
FA has two Membership options available: Single Membership or Family Membership.
Single Membership – Covers one Member only. The named Member is the only individual authorised to make changes to or obtain information on the Membership. A third party can obtain information or make changes as required provided a legal authority to do so is received in writing or where the named Member has nominated a third party to act as an authorised representative on their behalf – either verbally or in writing.
Family Membership – Covers the primary Member and any eligible Dependants listed. A Dependant spouse will have the same level of access to Membership information as the primary Member and can access information and make changes to the Membership as required excluding resigning the Membership or removing the primary Member. All other third party requests for information are as per Clause 2.1.2. 2.1.4 All individuals must adhere to a three point identification check in order to make changes or access information on a Membership.
MEMBERSHIP FEES Membership Fees are set by the K3 Assist Sdn. Bhd. and may be amended from time to time. Any change in Membership Fee comes into effect upon the next Membership Renewal date following a Membership Fee change unless otherwise notified.
Member benefits commence at 5pm (1700 hours) GMT+8 the day after the Membership Fee is received by FA and cease at the end of the Membership Period. Refer to Section 3.0 – Membership Commencement and Qualifying Period.
Members and their eligible Dependants (if applicable) receive Member Benefits for all Emergency Cases and Clinically Necessary Non-Emergency Cases at no additional cost to the Member. In all cases transport is provided to the nearest, most appropriate medical facility. Before authorising a patient for any ambulance transport interstate, the referring health professional must contact FA and provide detailed evidence as to why the patient must attend interstate health services. FA may seek a second opinion.
Members are covered for the same benefits Malaysia wide as they would have received had they been in their primary residence. All the conditions relating to FA Services will apply to the same services received interstate. Refer to Clause 4.1 – Residential Requirements.
No invoice will be sent to the Member when a Member uses FA’s services if FA can match the transport information with the Membership details. If a Member receives a transport invoice which they believe should be covered by their Membership, the Member should make sure their membership record is up to date and then complete the relevant section on the reverse of the invoice and return to the FA Accounts Receivable Department for action. A Member may be presented with an account for transport by an interstate Ambulance Service.
Members who renew their Membership within thirty (30) days of the Renewal date may be offered Continuity of Benefits at the discretion of FA.
Cover Notes can be issued on request for a period of twenty one (21) days and all Member benefits will apply providing the Membership is paid prior to the expiry of the Cover Note. Once paid, Member Benefits will commence from 5:00pm (1700hours) GMT+8 on the day after the Cover Note was requested by the Member. Only one Cover Note per person per annum will be issued.
2. EXCLUSIONS: Membership benefits do not cover:
Ambulance Services that are not deemed an Emergency
FA Services where a patient requests to be moved to or between medical facilities for reasons that are not an Emergency. For example social or convenience reasons such as:
• The patient chooses to move to another hospital to be closer to their home and/or family Members (this includes returning back to Victoria from another State or Territory where they might have been receiving treatment);
• The patient chooses to move to another hospital in order to be treated by a preferred physician or in a preferred hospital.
• Mild conditions which do not require the patient to be admitted.
• Transport from one private home to another.
• Relocation from one accommodation facility to another or from hospital to home and return to hospital for weekend or holiday relief.
• Repatriation if the transport is not Clinically Necessary and approved by FA in advance. Note: If prior approval is not given by DA the Membership will not cover any costs incurred.
• Transport fees where responsibility for payment is ultimately the responsibility of a third party
• Non-Emergency Cases requiring FA Services during the Qualifying Period.
• Emergency Cases during the Qualifying Period where the service is required as a result of a Pre-Existing Ailment.
• Services used prior to 5pm (1700 hours) GMT+8 the day after the Membership Fee is received by FA. Refer to Membership Commencement.
3. MEMBERSHIP COMMENCEMENT AND QUALIFYING PERIOD
MEMBERSHIP COMMENCEMENT AND PERIOD
For New and Reinstated Members, Member Benefits commence at 5:00pm (1700 hours) GMT+8 on the day after the Membership Fee is received by FA.
For New and Reinstated Members, the Membership Period commences on the Membership Commencement Date and continues for period of time that the Member has made payment.
For Renewing Members, Membership benefits are continuous subject to the Membership Fee being received in full by FA no later than the due date of the Membership Renewal. Refer to Section 2.3.5.
Once a Membership has commenced it cannot be suspended.
QUALIFYING PERIOD There is a fourteen (14) day Qualifying Period from the Membership Commencement Date of all New and Reinstated Memberships (Refer clause 3.1 Membership Commencement and Period). During their Qualifying Period Members do not receive Member Benefits for:
• Non-emergency Patient Transport Ambulance Services; or
• Emergency Ambulance Services
RESIDENTIAL REQUIREMENTS Members must be Malaysian citizens or have been granted permanent or temporary residential status and have their permanent place of residence located within FA’s Operational Boundaries.