Are you entitled to claim from the CTF if your COVID-19 test shows a negative result?
The answer is, YES, but how? Continue reading to see if you fulfilled certain criteria to claim it from the Covid-19 test fund.
So, what is the Covid-19 test fund (CTF)?
The CTF is an RM8 million fund set up by the insurance and takaful industry to support the Ministry of Health's (MoH) efforts to conduct more COVID-19 testing.
The fund will provide a fixed cash reimbursement up to RM300 for the cost of COVID-19 testing for individuals covered under individual or group Medical and Health Insurance policies/takaful certificates.
Now the question, what are the products that qualify for the RM300 under CTF?
Medical and Health Insurance/ Takaful products that qualify for the RM300 reimbursement from the COVID-19 Testing Fund shall include products defined in the Bank Negara Malaysia's Guidelines on Medical and Health Insurance/ Takaful.
This includes medical expenses plans, hospital, and surgical plans, hospital income plans, and critical illness/dread disease plans, and other similar insurance/ Takaful plans offering similar benefits. Only plans with policy/certificate term more than or equal to 12 months are eligible for CTF regardless of the mode of premium/contribution payment.
The COVID-19 Testing Fund is extended to Malaysians and NonMalaysians residing in Malaysia. However, the CTF is not extended to the Foreign Worker Hospitalisation Scheme.
So, who is eligible to claim from the CTF?
The CTF is only applicable for insurance policyholders/ takaful certificate holders with group*/individual Medical and Health-related insurance policies and takaful certificates, who have been referred by registered doctors for COVID-19 testing at recognized private labs as listed on the MoH COVID-19 website.
*For employees only, excluding dependants For third party policy/certificate, only life assured/insured person/covered person is covered.
Your insurance policy/takaful certificate must be in force as of 27 March 2020 and at the time the COVID-19 test is conducted.
Some will ask, "If I have more than one Medical and Health Insurance Policy/Takaful certificate with different insurance and takaful companies, can I claim from more than one company?"
The CTF will pay out up to a maximum of RM300 per individual regardless of the number of COVID-19 tests. You can only claim once from the CTF even though you have more than one Medical and Health Insurance Policy/Takaful certificate.
Then, who can be tested for COVID-19 under this CTF?
You can claim for the Covid-19 test under the CTF if you have carried symptoms of COVID-19 (i.e. acute respiratory infection (sudden onset of respiratory infection with at least one of shortness of breath, cough, or sore throat) with or without fever AND have been referred by a doctor registered with the Malaysian Medical Council that you are medically necessary to go for Covid-19 testing.
You can also claim from CTF if you have met with the Case definition of COVID-19 defined in Annex 1 of Guidelines COVID-19 Management in Malaysia No.05/2020 issued by the Ministry of Health (updated on 25 March 2020) as the following:
1. Person Under Investigation (PUI) of COVID-19
A. have an acute respiratory infection (sudden onset of respiratory infection with at least one of shortness of breath, cough, or sore throat) with or without fever AND
B. Have traveled to / resided in a foreign country within 14 days before the onset of illness OR
C. Have been in close contact* in 14 days before illness onset with a confirmed case of COVID-19** OR
D. Have attended an event associated with a known COVID-19 outbreak
2. **Confirmed Case of COVID-19
A person with laboratory confirmation of infection with the COVID-19
*Close contact defined as:
- Healthcare-associated exposure without appropriate Personal Protective Equipment (including providing direct care for COVID-19 patients, working with healthcare workers infected with COVID-19, visiting patients, or staying in the same closed environment of a COVID-19 patient).
- Working together in close proximity or sharing the same classroom environment with a COVID-19 patient.
- Traveling together with a COVID-19 patient in any kind of conveyance.
Note: This CTF does not cover Drive-Through tests offered by some private hospitals/laboratories.
Now an important question after the above clarifications. Are you entitled to claim from the CTF if your COVID-19 test shows a negative result?
Yes, you are eligible to claim from the CTF regardless of the test results.
Then, if you require further treatment for COVID-19, can you still claim from the CTF?
This CTF is specially set up for COVID-19 tests. If you require further treatment, you should contact your insurer/takaful operator to find out if these treatments are covered under your insurance policy/certificate.
But, can you claim from the CTF if your COVID-19 test is conducted at home?
Yes, you can claim from the CTF if the test is conducted at home, provided that you were referred to take the test by a registered doctor, fulfilled the criteria set and the test was conducted by laboratories approved by the Ministry of Health. Currently, Doctor2U and DoctorOnCall are approved for reimbursement for home testing assuming the eligibility claims criteria is met.
Then you may ask. "Can I go to any hospital or recognized laboratory to be tested without seeing a doctor first and still claim from CTF?"
No, you must see a registered doctor, and upon meeting the criteria, you need to get a doctor’s request or instruction to get tested.
But when is the funding available and is there a closing date to apply?
The CTF is available for COVID-19 tests done on and from 27 March 2020 based on claims submitted on a ‘first-come-first-served’ basis. Once the RM8 million is paid out, the funding will stop.
Is there any specific private hospital/private laboratory that I can conduct the COVID-19 test?
While you may visit any registered doctor at a private or public clinic or hospital, if you meet the criteria and are advised by the registered doctor to get tested, the test sample may be collected there and then.
Alternatively, you may be directed to go to a recognized laboratory listed by the Ministry of Health on its website. Please note that at this moment, only PCR (Polymerase Chain Reaction) test for COVID-19 is accepted as per the recognized labs by MOH. Rapid Test will not be accepted.
So, what if you have done a test on a complimentary basis, can you still claim the RM300?
No. You are not entitled to claim the RM300 if you have done the test on a complimentary basis.
Let's say if your doctor advised you to do a COVID-19 test for surgery or hospital admission, are you entitled to claim the RM300?
No. The CTF does not cover the COVID-19 test for surgery or hospital admission.
Now comes to the claims process. If you guys have any questions about how to make a claim for this, kindly contact us or email us at email@example.com. or even give us a call. And we will provide you with more information.
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