About Gather Care
What is this program?
We are a crowd sharing platform where sharers come together to share their medical bills within the Gather Care community program, previously known as Life Engineering. Gather Care Sdn. Bhd. is the administrator of the program, and we have appointed a legal firm, Ong & Manecksha Advocates & Solicitors, to manage the sharers’ funds. We have also appointed e-MAS as our professional medical auditor to handle the entire hospitalization administration process. Sharers can choose from one of the 116 private hospitals and 135 public hospitals to seek approved medical help.
I would like to sign up my children and relatives, can he or she join?
Yes. A person below the age of 18 can participate in this Program with the consent of their legal guardian such as parents, siblings, or relatives.
A guardian shall be registered as a Applicant and shall assume the financial responsibility for his or her dependents under this program. Applicant can add himself as Sharer or relative family as Sharer and pay for them.
I have my own medical insurance which is not covered for the pre-existing conditions. Am I qualified to join Gather Care?
Recently, we are building up a healthy community. But unfortunately, due to your pre-existing condition, you are not eligible to become our Sharer. We sincerely hope that you can leave your full name, contact number, date of birth, and email address. Once Gather Care has a new solution, we will get in touch with you.
Why do I need to join Gather Care since I can get free medical care at government hospitals?
Joining Gather Care is strictly on a voluntarily basis. Gather Care can be a good alternative in the event of need.
Can I participate in Gather Care and have medical insurance?
Of course. You can choose to have both if you wish, and you can choose to elect whichever method to pay for your medical bills.
What are the benefit of this program?
a. In-patient treatment and day surgery
b. Covers major hospitals
c. An initial annual limit of RM1,000,000; with additional RM200,000 additional limit for every subsequent year of being an active sharer.
d. Four bedroom or maximum RM150 per night
e. Bereavement payment
f. Healthy lifestyle education leading to lower medical costs
Do Gather Care Projects cover everything. Does this mean I do not have to worry about having to make any payments upon discharge?
We are a program predicated on the conscience and collective power of the community. Gather Care covers most of the expenses, but there are some exclusions. We advise you to check with our Program Guideline to find out what items are covered under the Gather Care Project to avoid any surprises.
What type of medical expenses does Gather Care cover and not cover?
How many Government & Private panel hospital do you have?
We have 135 of Government hospital & 116 of private hospital total of 221 panel hospital across the country including sabah & Sarawak.
How does Gather Care affect me?
Gather Care is used for two broad purposes:
The administrator does not make money from sharers. This non-profit program ensures that no premium or other payment will be collected and gained from sharers. This means that sharers contribute only to the sharing of eligible medical expenses and the annual participation fee of this program.
b) Sharers are committed to living a healthy life
This program emphasizes the concept of shared responsibility; sharers are encouraged to reduce the shared financial burden of the group as a whole. This creates an incentive for sharers to make responsible and cost-effective choices in healthcare and to live a healthy lifestyle. Health and a cost-conscious community will tend to have fewer medical incidents and better quality of health, which in turn leads to lower healthcare costs.
How does medical cost sharing keeps costs low?
The administrator has also established a strategic partnership with an established and experienced medical third party administrator (“TPA”) to administer the entire hospitalization and claim process for the program. This is to ensure that medical expenses are managed effectively, and that sharers get the best possible outcome in this program. Constant education on managing one’s health and medical costs will also be provided.
Unlike an insurance company, the administrative and operating costs of this program are kept to a minimum. More importantly, no agency fees are required to be paid out of this program, as the administrator makes use of the convenience of online channels and technology to administer and market this program to reduce costs.
How this Program works?
Sharers voluntarily commit to contribute their money (“share”) into a share pool to share the medical expenses of any sharer who is in need of medical treatment. The administrator coordinates the share to meet the eligible medical expenses on a monthly basis or any other suitable time intervals according to the program’s rules and regulations. It is important to note that the share pool does not belong to the administrator. It is held and managed by an appointed trustee who will administer the disbursement to the administrator as reimbursement.
What is a medical 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.”
If I join Gather Care and I will become 40 soon, does Gather Care remove me from this program?
No, you will continue to be a Lifetime sharer with the condition that you are not withdrawing and meeting the program guideline from the Gather Care community.
What is the step for hospital admission?
Does this mean that when I have paid for a sharing deposit of RM100.00, I don’t have to pay anything further and can be hospitalized for free?
Not really. Let us explain how it works.
Your medical bill will be reviewed and audited by our Professional Medical Auditor (TPA) - if there were non-eligible medical expenses, these costs will be paid by you personally.
Program Guideline, Section 5:
In addition, you are committed to pay the monthly crowd share amount with a limit of RM50. Assuming if there were admissions by sharers, Gather Care will pay for the bill first then the total eligible medical expenses will be crowd shared by all active sharers. If there was no admission for the month, then there is no need to crowd share for that month. The sharing deposit is determined as two times the monthly share pledge limit. Gather Care reserves the right to revise the amount.
If at any one point the sharing deposit is lower than the monthly share pledge limit, the sharer’s payment card shall be debited with an amount required.
Program Participation Withdrawal and Refund Policy
You can withdraw your program participation at any time by pressing the withdrawal button on our app. Upon confirmation of your withdrawal from the program, you remain responsible for your current monthly share of medical costs. Unutilized credit balances, if any, shall not be refunded for any reason whatsoever. We have the discretion to utilize the credits to meet the medical expenses and the operating expenses incurred in connection with this program.
How to re-join as a sharer?
A sharer who has previously withdrawn from the program, may re-join the program by signing up again by Applicant:
Sign-up as a new sharer. Each Rejoin Sharer shall observe waiting period again.
A sharer who has previously been disqualified from the program, may apply to re-join the program subject to the approval of the administrator which will be granted on a case-by-case basis, and on such reasonable terms and conditions that may be imposed by the administrator.
Will the sharer be refunded for the money that they put in but never claimed?
No. Sharers come together to share each other’s medical expenses, not simply as a matter of convenience or cost savings, but because they are driven by their conscience to support, care, and help each other during times of crises. The sharer can withdraw anytime by pressing the withdraw button in the system. He/she will not get the refund of the annual participant fee in the period the crowd share he/she chose to terminate. The balance of the sharing deposit will be refunded from trustee to him/her after that.
How much do I have to pay during registration?
A total of RM360 Annual Participation Fee and RM100 Sharing Deposit will be collected and the breakdown details as below:
• RM160 Annual Participation Fee + RM100 Sharing Deposit + RM2.99 Payment gateway charges = RM262.99 (Initial payment)
• Balance RM200 Annual Participation Fee after 30 days of initial sign up cost paid. RM200 is second payment.
Is there any approval needed?
(i) Once the system accepts your registration, no further approval is required. Unless you have declared yourself not a healthy person and have been diagnosed with certain pre-existing conditions and/or are currently on long-term medication. In that event we will require you to provide us with more information such as your medication history and your latest medical report. We shall forward it to our TPA for further evaluation.
(ii) I’m registered, but the app shows me that I was not in Gather Care’s approved age range. Gather Care’s current age range is from 6 to 40 years old. We are unable to process your enrollment at this time, but we do have plan to expand the age range in the future. We will publish any update of our policy change on our website and will keep you informed.
How do you calculate the crowd share amount?
For example: Say that the total medical bills for the period is RM200,000, and it will be divided by the total active sharers of 10,000 people. Hence, the specific monthly crowd share amount per sharer is only RM20.
In the event where the total specific monthly share amount is more than the monthly share pledge limit (crowd share amount limit) of RM50, the specific monthly share amount shall be capped at RM50.
Now let’s say that the total medical bills for the period is RM600,000, with an active sharer base of 10,000 people. The specific monthly crowd share amount per share is RM60. However, the specific monthly share amount shall be capped at RM50. Then the RM10 will be carried forward to next crowd share.
What is the difference between a Gather Care plan and investment-linked health insurance?
We are different in many ways. We are not an insurance company; we don’t collect money upfront and Sharer do not need to pay monthly premium. We don’t collect more than the necessary medical cost sharing, we only collect when there is medical case. All money that is collected are used for medical cost sharing.
Do I need to contribute the money every month?
If in the month there were admissions by sharers, then the total eligible medical expenses will be crowd shared by all active sharers.
If there was no admission for the month, then there is no need to crowd share for that month.
During the waiting period, should I contribute to the monthly share amount as well?
Yes, you are required to contribute to the specific monthly share amount during the waiting period.
Are there any medical sharing limits?
Sharing beyond the ability of sharers to contribute, financial limits to sharing of eligible medical expenses are required to be in place to ensure a fair utilization of the share pool:
(i) Minimum Sharing Amount.
Once accepted and approved by PMA, all eligible medical expenses will be eligible for sharing. No minimum is set at this point.
(ii) Annual Sharing Limit
An initial annual limit of RM1,000,000; with additional RM200,000 additional limit for every subsequent year of being an active sharer.
(iii) Lifetime Sharing Limit
Per Annual Limit
Does Gather Care reward sharers who have contributed not utilized anything?
What sharers get in return is:
a. A strong community.
b. A community marching towards better lifestyles and health
c. A community power to generate revenue together to lower medical costs and better rebates. We get our life back, the best investment return that one can have.
Maximum charges for the crowd share amount is RM 50.00. Are there any hidden costs?
There are no hidden costs. We only crowd share the exact bill amounts that are received from our panel hospital. Crowd share amounts range from RM0.00 to the maximum cap of RM50.00. (*Smoker commit 1.2 times the usual crowd share amount)
Can the Sharer contact eMAS ?
YES. In general, sharers do not need to deal directly with eMAS. Hospital admin will handle both admission and discharge. However, in the event of dispute or queries with regards to hospital admission eligibility as well as final medical bills at discharge, sharers may contact eMAS directly.
Why i should upload my NRIC in the apps, is it safe?
Yes, it is safe. Also, this is one of requirement for registration and hospitalization usage.
What is Bereavement Payment?
Bereavement Payment is the amount which Gather Care will crowd share among the sharer will give to sharer family member once the sharer had passed away.
In a month, how many time will do crowd share, is the any specific date?
For time being, we only do once a month on every month 24th.
How long It will take to issue a guarantee letter from the TPA side ?
There are 2 scenario:
i.) Emergency Cases
When our Sharer admitted to hospital, the panel hospital will send sharer medical report to TPA (e-mas) for evaluations, within 30 minutes the GL (Guarantee Letter) will be issue by PMA (e-MAS).
ii.) Non-Emergency Case
The Panel hospital will be send sharer’s medical report to our TPA. TPA will evaluate and GL (Guarantee Letter) approval will be issued within 3-7 working days.
Why is Project GC suitable for me?
We do not make money from crowd share of this medical cost sharing program. Sharers share actual medical costs plus only pay a small annual participation fee. If you are looking to manage your medical care costs effectively and at an affordable level, Gather Care would be a good option. Your maximum contribution is capped at RM 50 per month. (*Smokers commit 1.2 times the usual crowd share amount)
Now I am joining in a healthy stage, after 5 years found that have heart attack. Am I still qualify to stay in community?
Yes, you still qualify to stay in community. The purpose to build this community is to prevent for future if any unfortunate medical case happen among the sharer to help each others.
After crowd share top up deduction, where can i view the transaction details?
Once the payment deducted from our sharer's payment card, sharer can view the payment deductions details in the transactions history through system profile.
Only sickness is eligible to share, how about accident is it included?
Accidents are shared subject by TPA (e-MAS) approval.
If there is crowd share happened, where can i view the crowd share details?
Sharer can view all the crowd share history details through LE system/website.
If I am a smoker, is it the monthly commitment amount will be different?
Yes, because smokers are at a higher risk, they have to pay extra 1.2 times. In simple terms, if you share RM50.00 for the current month, smokers would have to share RM60.00.
I already register but when i try to make payment proceed to the payment page then later on its shown “card added failed”?
There are few scenario and issue could be happened for the payment error:
i. If there is insufficient amount in the bank account, the payment cannot be done successfully.
ii. If the bank card is not registered for the mobile number to receive the OTP number or TAC code means the transaction won't be successful. Kindly contact your bank for further clarification.
iii. The bank card might be blocked by the bank side.
If it is not an insurance company how come Gather Care is working with insurance company?
We are working with insurance company is to help manage the risk of crowd sharing without earning profits and sharers feels worry free.
Can foreigner join?
No, this LE program is open for All Malaysian Citizen only.
Is this program an alternative to health insurance?
This program is not health insurance but an alternative healthcare option that is simple, affordable, and entirely funded by the sharers 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.
How do you help people who need help?
Medical costs are rising each day, and we are more prone to becoming ill more often and at a younger age. We provide an alternative solution for people to address their rising medical costs by pooling together the right and like-minded people to join the Gather Care community (become one of the sharers) to crowd share their medical costs whenever some of them are hospitalized and require medical treatment.
We are an alternative solution.
a. We don’t collect a premium upfront and every month
b. You share actual medical costs incurred with others active sharers
c. We don’t add additional costs to the amount of the crowd share
d. Your commitment is kept safe with an appointed Trustee
e. Risks are shared by all Sharers
What kind of help do you provide?
We made an arrangement with major hospitals in Malaysia through eMAS (TPA) whereby they will allow sharer’s admission for hospitalization. As long as their hospital admission and medical bills meet the Program Guideline, eMAS will issue guarantee letter and only then gather all bills at the end of the month or a specified period to share amongst the community of sharers.
Am I eligible to join?
a. Must be a Malaysian
b. Aged 6 to 40
c. Currently healthy and active
d. Honest community player
e. Pass the underwriting questions
Gather Care may gradually expand the age limit of this program to include those aged outsides of that range, and they may be subject to a different multiplication factor on monthly crowd share amounts, which would be reflective of their respective health risk due to age. For this guideline, age is defined as “Age last birthday”
i.e. the person’s age at a particular time followed by the last birthday.
If a person whose birthday falls on 12/03/1983, his age would be 34 from the date 01/01/2018 to 11/03/2018, but he would be 35 after 12/03/2018.
Why do you need to join the Gather Care program?