PRUHealth

pruhealth, medical card prudential

» All about PRUhealth

1. What is PRUhealth?

PRUhealth is a regular premium medical rider plan that reimburses major medical expenses incurred in the event of hospitalisation, surgery or outpatient treatment. This plan also rewards policyholders with No Claims Bonus (NCB) for those who do not make any claims for the year.

2. Who is this plan for?
This plan is for people aged between 1 – 70 years old next birthday who want a plan that takes care of their medical expenses AND rewards them for staying healthy.

3. How can I take up PRUhealth?
You can take up PRUhealth when you purchase PRUlink assurance plan or PRUlink education plan policies.

4. How will the No Claims Bonus (NCB) benefit me?

If you do not make any claims for the year, Prudential will reward you with No Claims Bonus (NCB) by purchasing additional units for your investment in the following year. The amount of bonus paid depends on the plan that you have chosen.

Once you make a claim, you will not receive any bonus in the following year. However, you will receive the bonus for subsequent years as long as no claims are made.

An example of the bonus mechanism, for a 30-year old male policyholder with a PRUhealth 200 plan, expiring at age 70 and pays an annual premium of RM1,032:

5. How can I enhance the coverage of my PRUhealth plan?

You can now make claims higher than your annual limit by attaching PRUannual limit waiver – the rider plan that will waive the annual limit of your PRUhealth plan. This will ensure that you are safeguarded against any unexpected large medical claims within a policy year. PRUannual limit waiver can only be attached to PRUhealth 200, 300 and 400 plans. When PRUannual limit waiver is attached, claim amounts exceeding the annual limit will be subjected to a co-insurance amount of 10%.

6. How much premium do I need to pay?

The premium that you pay for a PRUhealth plan is determined by your age, occupation class and plan type, subject to underwriting. The premiums are payable throughout the duration of the plan. (See Appendix for Premium Rates)

Premium payment
Premiums can be paid yearly, half-yearly, quarterly or monthly via Auto Debit, Credit Card, Cash or Cheque.

7. How does PRUhealth pay for overseas medical treatment?

If you receive medical treatment overseas, the benefits are paid according to the costs of treatment that would be reasonably charged by a hospital in Malaysia. No benefit is paid if you reside overseas for more than 90 days per trip.
» Benefits

COMPREHENSIVE coverage for hospitalisation and surgery bills
PRUhealth is a plan that provides COMPREHENSIVE medical coverage by reimbursing your major medical expenses incurred in the event of hospitalisation, surgery or outpatient treatment. Get peace of mind when you need it the most!

Enjoy NO CLAIMS BONUS
An innovative medical plan that rewards you with annual bonuses(1) of up to RM500 when you do not make any claim for the year. Your bonuses will automatically be credited in the form of additional units to be invested into funds of your choice, thus increasing your investment value, or to be withdrawn(+) should you have the need to.

An option to WAIVE the annual claims limit
Worried that your medical bills might surpass your annual limit? You are now given the
flexibility to waive the annual limit of your plan by attaching an optional PRUannual limit waiver rider(2) to your PRUhealth plan which enables you to make claims above your
annual limit.

CHOICE OF PLANS to suit your budget
From as low as RM100(3) a month, you can choose from 5 different PRUhealth plans to suit your lifestyle and needs.

Coverage of up to age 100(4)
PRUhealth gives you the choice of protection through all stages in life by covering your medical bills even up to age 100!

+ Subject to a minimum of RM500 per transaction. If the value of units is less than RM500, only complete withdrawal is allowed. 
1 Amount depends on type of plan chosen.
2 Subject to additional premium in addition to your premium for PRUhealth plan and only available for PRUhealth 200, 300 and 400 plans. Total benefits payable cannot exceed your Lifetime Limit.
3 Amount depends on type of plan chosen and age at entry.
4 Subject to terms and conditions of the basic plan to which PRUhealth is attached & subject to sufficient units for deduction of insurance charges and service charges.

PRUHealth Coverage Plans
PRUHealth comes with in five plans to cater for your budget and desired protection.

For Adults:-  PRUHealth 100 gives you a coverage of RM500,000 for a premium starting as low as RM100 per month.

For Children:- PRUHealth gives you a coverage of RM500,000 for a premium starting as low as RM60 per month.

This allows you to be treated by some of the best doctors both government and private without having to worry about the expensive cost

Our most comprehensive plan PRUHealth 400 on the other hand covers medical coverage till RM1,500,000.00 !!

The complete table of the plan can be shown as below :-

pruhealth_tableWith PRUHealth as your medical card, you can be can be sure of easy hospital admission. Just present the PRUHealth medical card upon hospital admission.PRUHealth covers comprehensively the hospital bill which will include:-

a)    Doctor Consultation Fee
b)    Surgical Costs (minor and major)
c)    Medicine
d)    ICU
e)    Room Fee
f)     Pre-Hospitalization
g)    Post-Hospitalization
h)    Day Surgery Benefit
i)     Cancer Treatment
j)     Kidney Dialysis
k)    International Coverage
Note: Co-insurance is a cost-sharing arrangement under which the policyholder pays a specified percentage of the cost of an eligible benefit. The remaining balance is paid by the Company.

The total benefits payable in a year are subject to the Overall Annual Limit. The total benefits payable during the lifetime is subject to the Lifetime Limit. Cover begins immediately on acceptance, for hospitalisation caused by accidents and 30 days after acceptance for any other causes and 120 days for specified illnesses.

The Company will issue a PRUhealth card to you under Emergency Medical Assistance when you purchase PRUhealth. You can call up the 24-hour hotline (operated by International SOS) at any time on reverse charge from anywhere in the world to obtain assistance and services.The PRUhealth card can also be used for hospital admission under Hospital Alliance Services at a designated network of hospitals (subject to terms and conditions).

Panel Hospitals and What we Cover ?
PRUHealth can be used in all hospitals private and public hospitals.

We cover the in-hospital related services fee (room, doctors consultation, lab charges, nurse, medication, etc.) as well as the pre-hospitalization charges (30 days)  and post-hospitalization charges (90 days) .

With our hospitals alliance services, over 60+ private hospitals are our panels where you need to just pay a samll refundable-deposit usually around RM200 just for admission. We will then settle the bill accordingly directly with the hospital. No need for you to pay first and then claim back.

This panel hospitals are throughout Malaysia. Click for Hospital Panel.

Only for non-panel hospitals, should the customer need to pay first and then claim later.

Important Notes
> You must inform the Company of any change in your occupation, avocation or sports activities because it may affect the premiums, terms, conditions and benefits.

> PRUhealth is guaranteed renewable but premium rates and / or insurance charges are not guaranteed. The Company reserves the right to revise the premium rates and / or insurance charge by giving a 90-day notice if the actual claims experience is worse than expected.

> Coverage to expiry age is subject to sufficient unit deductions for insurance charges and service charges.

> You are advised to ensure that this plan will best serve your needs and that the premium payable under the policy is an amount you can afford.

> There is a free-look period of 15 days after the delivery of your policy to allow you to review it if it meets your needs. If you return your policy, the premium will be refunded subject to deduction of any expenses incurred for medical examination.

> This leaflet is for illustrative purposes only. You are advised to refer to the Prudential Medical and Health Insurance Information (MHI) Booklet checklist before purchasing a plan, and to refer to the terms and conditions in the policy document for details of the important features of the plan.

Exclusions
PRUhealth does not cover any hospitalisation, surgery or charges caused directly or indirectly, wholly or partly, by any one (1) of the following occurrences:

1. Pre-existing illness.

2. Specified Illnesses occurring during the first 120 days of continuous cover for:
a. Hypertension, diabetes mellitus and cardiovascular disease
b. All tumours, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system
c. All ear, nose (including sinuses) and throat conditions
d. Hernias, haemorrhoids, fistulae, hydrocele, varicocele
e. Endometriosis including disease of the reproduction system
f. Vertebro-spinal disorders (including disc) and knee conditions

3. Any medical or physical conditions arising within the first 30 days of the Insured Person’s cover or date of reinstatement whichever is latest except for accidental injuries.

4. Plastic / Cosmetic surgery, circumcision, eye examination, glasses and refraction or surgical correction of nearsightedness (Radial Keratotomy) and the use or acquisition of
external prosthetic appliances or devices such as artificial limbs, hearing aids, implanted pacemakers and prescriptions thereof.

5. Dental conditions including dental treatment or oral surgery except as necessitated by Accidental Injuries to sound natural teeth occurring wholly during the Period of
Insurance.

6. Private nursing (save and except for Home Nursing Care Benefit), rest cures or sanitaria care, illegal drugs, intoxication, sterilisation, venereal disease and its sequelae, AIDS
(Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related diseases, and any communicable diseases required quarantine by law.

7. Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions.

8. Pregnancy, child birth (including surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth
control or treatment pertaining to infertility. Erectile dysfunction and tests or treatment related to impotence or sterilisation.

9. Hospitalisation primarily for investigatory purposes, diagnosis, X-ray examination,general physical or medical examinations, not incidental to treatment or diagnosis
of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician,
and treatments specifically for weight reduction or gain.

10. Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane.

11. War or any act of war, declared or undeclared, criminal or terrorist activities, active duty in any armed forces, direct participation in strikes, riots and civil commotion or
insurrection.

12. Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material.

13. Expenses incurred for donation of any body organ by an Insured Person and costs of acquisition of the organ including all costs incurred by the donor during organ transplant
and its complications.

14. Investigation and treatment of sleep and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies, including
but not limited to chiropractic services, acupuncture, acupressure, reflexology, bone setting, herbalist treatment, massage or aroma therapy or other alternative treatment.

15. Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Insured and Disabilities arising out of
duties of employment or profession that is covered under a Workman’s Compensation Insurance Contract.

16. Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations).

17. Costs / expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit / pack and other ineligible nonmedical
items.

18. Sickness or Injury arising from racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing
apparatus, winter sports, professional sports and illegal activities.

19. Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.

20. Expenses incurred for sex changes.

Stay healthy and get rewarded today!

For personal assistance call 012-6727957 (syaihan) or e-mail at syaihan@prubsn.my

Get a Free Quotation Today!!

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