FAQs
About Gathercare
What is Gathercare?
Gathercare is a value-driven Medical Cost Sharing community that offers an innovative, non-insurance approach to managing large healthcare costs. As a value-driven organization, Gathercare is focused on serving our members and carrying out our community-centric social impact mission. Gathercare Members join a community of like-minded individuals who are active and engaged participants in their healthcare decision making. Together, we are tapping the power of community to create a new normal in healthcare that is high-quality, human, and transparent.
What kind of company is Gathercare?
The Gathercare Medical Cost Sharing Community is a not-for-profit Medical Cost Sharing community, focused on serving the engaged healthcare consumer. Gathercare facilitates the direct sharing of medical costs among our participating Carers (the Community).
Is Gathercare an Insurance Company?
No. Insurance arrangements are a contract whereby one party agrees to be legally responsible for and accept another party’s risk of loss in exchange for a payment—a premium. Medical Cost Sharing is an arrangement whereby Members (Carer) agree to share medical expenses through an act of voluntary giving. The Gathercare MCS Community is not an insurance scheme and hence it does not fall within the purview of the Financial Services Act 2013 (FSA) and Islamic Financial Services Act 2013 (IFSA). Unlike insurance, the focus of the Gathercare Subscription Plan is on how our members help one another with their immediate needs.
Does Gathercare use deductibles and co-payment like traditional health insurance?
No. Gathercare is not insurance, so Gathercare’s process differs significantly from insurance practices in this regard—to our Carers’ advantage. Traditional health insurance deductibles are cumulative over the course of a plan year. Co-payment is the portion of the medical expense owed by the patient. These insurance cost-shifting measures can amount to thousand ringgits in out-of-pocket costs to insurance policyholders annually. With Gathercare, when Carers incur an eligible medical expenses, that expenses will be shared among the MCS Community in principles of an Equal, Fair and Transparent Culture.
Does Gathercare charge monthly premiums?
Because Gathercare’s Medical Cost Sharing subscription plan is not insurance there are no premiums nor insurance upfronts.
Can I subscribe Gathercare Community and medical insurance in one ?
Yes. You can choose to have both if you wish, and you can choose to elect whichever method to pay for your medical bills.
What makes Gathercare Community a good alternative medical protection solution?
This program is not health insurance but an alternative healthcare option that is simple, affordable, and entirely funded by the Carers themselves. It is the most efficient and creative solution to the problems of escalating healthcare and medical costs and expensive health insurance policies. Through the use of technology, this program also offers simple and instant access to healthcare as compared to the tedious process of obtaining a traditional health insurance policy that is complex and restrictive.
Do I need to contribute on a monthly routine basis?
No. Only when the Sharing Deposit falls under 50% or below, the Carer’s Credit/Debit card will be automatically debited with an amount required to bring the balance of the Sharing Deposit back to 100%.
Guaranteed Values
What other features are included with a Gathercare Medical Cost Sharing Community subscription Plan?
Gathercare Onelife Subscription Plan also comes with access to additional tools including, medical bill audit, expert second opinions, wellness support and resources to help Carers live their healthiest lives, and medical bill negotiation services when necessary to ensure the Carers and or Gathercare Community are not overpaying for their healthcare costs.
Some subscriptions may include add-ons and/or additional products that are not provided by Gathercare but instead are provided, serviced and maintained by third parties. Gathercare makes no representations or warranties that every or all Subscription Plans include any add-on/additional product(s). Carers should utilize the Carer Portal to better understand what their Subscription Plan(s) includes.
What is Onelife Subscription Plan?
Unlike insurance allows premium re-pricing and causes rising in price, Gathercare Onelife Subscription Plan comes with a Fixed Pricing Structure. When Carer subscribed Gathercare Onelife Subscription Plan, all Pricing Costs are fixed according to the Pricing Chart up to 99-Years-Old providing that Carer continue subscribing our Plan.
What are Gathercare's Onelife Subscription Plan requirements?
Members must agree to abide by each of the Gathercare Community’s Ethical Beliefs and Principles, also known as Gathercare Community Standards. Gathercare’s Program Guidelines include other details of Subscription requirements.
Is there a lifetime or yearly maximum amount that is eligible for sharing for an individual person?
There is no lifetime maximum limit per Carer. However, Gathercare does have an annual maximum limit that is starting with MYR 1,000,000 with an annual increase of MYR 200,000 upon subscription and converted to unlimited protection after 60 months (5 years). Gathercare’s Program Guidelines include other details of Subscription’s medical coverage.
Can my Subscription be dropped if I have very high medical needs?
No. Members cannot be dropped from the Subscription due to their medical Needs. Neither your Subscription nor your Monthly Contribution is affected by the amount of medical expenses you or any of your family members may have.
What is Click-To-Protect?
Gathercare Click-To-Protect is enabling Carer to get protected and stay connected all remotely with a few taps of buttons with the adoption of New Technologies. Gathercare makes User Experience as a top priority, we continue to put our best efforts on providing frictionless consumer experience.
Carefree Community
How can I be sure that Gathercare really works?
The concept of Medical Cost Sharing has been highly successful in a few developed countries for more than 30 years. More than one million Medical Cost Sharing Community Members have shared over a billion USD in medical expenses over that span of time, demonstrating a strong track record of success. Gathercare believes by widening the adoption of this concept in the other corners of the world will bring new light to how we see and afford medical care as a whole.
How does Gathercare handle very large medical expenses?
There is no maximum limit to the amount that will be shared towards a specific medical Need. However, Gathercare reserves the right to negotiate medical expenses with providers, and to prorate available sharing, as necessary, in order to address all Carer’s medical expenses.
Are there any specific medical conditions that have an exclusion or waiting period?
Most medical expenses are eligible for sharing. There are, however, a number of types of medical expenses that are not eligible for sharing with the Gathercare Community or are limited in the amounts that the Community shares. Details of the medical expenses that are not shareable and other limitations can be found in the Community’s applicable Guidelines.
As Gathercare is intended to share costs associated with larger and, unexpected illnesses and injuries, many expenses related to routine preventative care, prescriptions, cosmetic surgery, dental care, are generally not shareable. Additionally, medical expenses resulting from the use of illegal drugs, or while participating in unlawful activities are not shareable.
How does the Gathercare Community share expenses related to Pre-Existing Health Conditions?
Unfortunately, people with Pre-Existing Health Conditions are not eligible to subscribe at this moment of time. However, Gathercare to assure there is no turn away for reasons of Pre-Existing Health Conditions in futures. Gathercare continues to put our best efforts on designing a special pathway to sharing medical expenses associated with a Pre-Existing Medical Condition. If you fall under this category, we sincerely hope that you can sign up for an Interest Form and Gathercare will get in touch with you in near future.
How does the Gathercare Community share expenses related to Non-Malaysian Citizen?
Unfortunately, Gathercare Subscription is Only open for All Malaysian Citizen at this moment of time. However, Gathercare to assure there is no turn away for reasons of Non-Malaysian Citizen in futures. Gathercare continues to put our best efforts on designing a special pathway to sharing medical expenses associated with Non-Malaysian Citizenship. If you fall under this category, we sincerely hope that you can sign up for an Interest Form and Gathercare will get in touch with you in near future.
Cashless Hospitalization
What is a Truly Cashless Admission process?
Gathercare’s Truly Cashless admission means an end-to-end hospitalization process from admission to discharge from any Panel Hospitals by eMas for the eligible expenses is cashless and hassle-free. Carers are allowed to use hospital services without worrying about paying hospital expenses. You need not pay for the bills and seek reimbursement from Gathercare.
The Truly Cashless Admission feature is available in two situations: scheduled hospitalization and unexpected hospitalization in the event of an emergency. Prior to being admitted to a Panel Hospital by eMas for a scheduled hospitalization, Carer needs to obtain a Referral Letter from the local's Home Clinic and present NRIC / GatherCare e-ID Card to the admission counter once admission is confirmed by the Panel Hospital’s doctors. If you are admitted to a Panel Hospital by eMas unexpectedly, contact Gathercare and or our partnered TPA, eMas for additional support.
Does the Gathercare Community share medical costs that were incurred outside of Malaysia?
No. Details please refers to Gathercare’s Program Guidelines.
What is Health Third-Party-Administrator (TPA) ?
A medical third party administrator is our official partner for medical bills auditing called e-MAS (Eximius Medical Administration Solutions Sdn.Bhd ). It is an established Malaysian company providing comprehensive medical administration solutions and auditing, and it is administered by experienced senior healthcare professionals. The company handles the entire hospitalization plus bill evaluation and the verification process for our program, using cutting-edge technology, including “cashless hospitalization.”