PERSONAL MEDICAL CASE MANAGEMENT

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 PMCM, the customer is never alone. This 24/7 service accompanies the customer at all times, throughout the journey of diagnosis, treatment, monitoring the treatment progress until recovery. 

This service is exclusively available to our AIA Max VitalHealth A and existing AIA Max Essential A/A Saver policyholders, so they can receive support through their entire medical journey for serious medical conditions, with our compliments. 

This optional service is provided complimentary for our AIA Max VitalHealth A and existing AIA Max Essential A/A Saver policyholders.

However, additional charges may apply as any tests, treatments, procedures, devices or medication recommended by Medix will be subject to the overall benefit limits of your AIA HealthShield Gold Max A, AIA Max VitalHealth A and AIA Max Essential A/A Saver policies and may not be covered.

Please click here for the list of eligible medical conditions.

When you choose to use the Medix service, you will be required to sign the service acceptance form and confidentiality waiver form, as well as submit all relevant medical information and reports at hand. This approval will also allow Medix to obtain any missing medical reports from various sources.

AIA and Medix 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.

Medix’s assessment of treatment is based on medical necessity. As Singapore has a highly developed healthcare system, Medix does not expect that there will be a need to refer patients abroad. However, Medix 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 and existing 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 Medix complements the AQHP, by providing patients with additional access to local and global expertise and ongoing support. Medix 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 panel to deliver quality care. 

In such a situation, with the patient’s permission, Medix 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 is the patient’s.

The decision of treatment is always taken jointly with the patient’s treating doctor, together with the patient’s consent. It is important to note that Medix does not treat patients directly, nor prescribe medications, nor execute treatments or procedures. Hence, Medix would not be able to take on the responsibility of the treating doctor. However, Medix does have Professional Medical Liability Insurance and takes full responsibility for its medical recommendations.

Since Medix’s establishment in 2006, Medix is proud to share that there have been no cases in which an incorrect recommendation was made.

AIA Singapore is not involved in the recommendations that Medix provides as the intent is for Medix to provide independent medical advice. 

Medical conditions that are eligible for Medix Personal Medical Case Management Service

1. Medical Conditions without Diagnosis 

For medical conditions without diagnosis, the medical inquiry and consultation process must include a consultation with at least one specialist in a field related to the medical problem. 

2. Medical Conditions in which the Diagnosis matches one of the following medical categories 

Customers are eligible for personal medical case management services if they have one or more of the following conditions, provided they have already consulted at least one specialist in a field related to the medical problem.  

1. Cancer;

2. Liver diseases;

3. Kidney diseases;

4. Chronic gastroenterological diseases experienced during a period of at least 30 days;

5. Cardiovascular diseases;

6. Neurological diseases and invasive procedures into the central or peripheral nervous system;

7. On-going Orthopedic diseases experienced; 

8. Elective invasive procedues following disease with the intent of treating a disease/medical condition and excluding diagnostic reasons;

9. Hematological diseases;

10. Rheumatological diseases;

11. Metabolic diseases;

12. Endocrine diseases;

13. Ear, nose and throat (ENT) diseases and related invasive procedures;

14. Immunological diseases;

15. Pulmonary diseases;

16. Infectious diseases experienced during a period of at least 7 days;

17. Ocular diseases;

18. Orphan diseases;

19. Combined pathologies: several diseases requiring multidisciplinary treatment and, consequently, coordination between at least two specialists from different fields of expertise;

20. Any medical problem that requires hospitalisation or a medical problem that requires hospitalisation due to complications following a procedure or treatment, lasting more than 3 consecutive days; and

21. In addition to the above-mentioned categories, a pediatric patient whose case matches one of the following descriptions is also eligible for the Service:

• Elective surgery, i.e., a non-urgent procedure prescheduled following the recommendation of a specialist from a pediatric clinic (including outpatient clinics);
• Chronic disease; 
• Hereditary disease; 
• Congenital anomaly; and
• Developmental impairments following a period of at least 6 months of consultation and treatment at a pediatric development centre and consultation with at least two specialists in fields related to the medical problem.

3. Excluded Medical Conditions

Customers diagnosed with one of the following medical conditions are not eligible for the Service:

1. Emergency care and or any medical conditions of urgent invasive and/or urgent surgical procedures; 

2. Diabetes;

3. Short Stature as sole medical condition; Medix will cover congenital syndroms that are represented by various medical conditions, which may include short stature but not as stand alone.

4. Endocrine conditions that affect only fertility;

5. Snoring surgery and sleep apnea 

6. Cosmetic/Aesthetic surgery;

7. Excluded medical conditions in the pediatric medical field: 

Pediatric gastroenterological diseases of the following types: 

• failure to thrive;
• eating disorders (e.g. anorexia, bulimia);
• attention deficit/hyperactivity disorder (ADHD); and
• any medical condition pertaining to premature babies during initial hospitalisation after birth or during the first 6 months of life. 

8. Excluded disorders:

• ADHD;
• Anorexia/Bulimia and other related eating disorders; and 
• Sleeping disorders.  

9. Fertility-related conditions or procedures, with the exception of cases of 3 or more consecutive miscarriages;

10. Obstetrics;

11. Child, youth, and adult psychiatric and/or mental diseases;

12. Conditions related directly or indirectly to issues of looks and aesthetics, including obesity, with the exception of reconstructive breast surgery following a mastectomy;

13. Medical conditions in the fields of dentistry;

14. Fibromyalgia disease;

15. Chronic fatigue syndrome;

16. Complete and irreversible blindness;

17. Acute Cerebrovascular accident (CVA); 

18. Severe burns if patient is hospitalised;

19. Allergies;

20. Sexual diseases; STD

21. HIV;

22. Obesity; 

23. Any condition that necessitates urgent medical attention; and

24. Any condition resulting from substance, drug or alcohol addiction.