June 10, 2011

PRUhealth Medical Card Schedule of Benefits & Premium Table

PRUhealth is a comprehensive regular premium medical card/rider that can be attached to PRUlink or PRUmy child investment-linked insurance policies from Prudential Malaysia. This medical rider can be purchased by people from 1 to 70 years old next birthday and expires at age 70/80/100, depending on your choice. It rewards the policy holders with No Claims Bonus (NCB) of up to RM500 if there is no medical claims for the policy year. The amount rewarded for NCB will be then used to purchased units in the investment funds linked to your insurance policy. You can also purchase PRUhealth with deductible option of RM3,000 or RM10,000.

You can enhance your medical coverage by attaching other riders (with extra premium) to the PRUhealth medical card as follow:
  1. PRUannual limit waiver: With this rider, you can claim exceeding your annual limit, of which the amount exceeding the annual limit will be subjected to 10% coinsurance fees (except room & board cost). This rider is only available for PRUhealth plan 200/300/400 only.
  2. PRUmedic overseas: With this rider, you can opt for second opinion or treatment in Singapore, China and Hong Kong for conditions related to cancer surgery, neurosurgery, coronary artery bypass, heart valve surgery and kidney/lung/liver/heart/pancreas/bone marrow transplant.
  3. PRUmedic auto upgrade: With this rider, your medical plan will be automatically upgraded to the next medical plan on the 5th and 10th medical rider anniversary. For example, if you purchased PRUhealth 100, on the 6th year, your plan with be auto upgrade to PRUhealth 150. On the 11th year, your plan with be auto upgrade to PRUhealth 200.
  4. PRUmedic retirement: This rider is available for those who purchase PRUhealth plan with deductible option. Upon retirement at age 55 next birthday, the deductible option with be auto converted to coinsurance.
PRUhealth Schedule of Benefits

PRUhealth Schedule of Benefits

PRUhealth Premium Table

PRUhealth Premium Table

PRUhealth with PRUannual limit waiver Premium Table
PRUhealth with PRUannual limit waiver rider

More details about PRUhealth can be found here.

To view the comparison of this medical plan with other leading medical cards in the market, please visit this article.

Disclaimer: The information published is for your reference only. Please refer to your insurance agent for the most up to date information.


Anonymous said...

What is limit waiver?

jutamind said...

Let's say you buy Pruhealth 200 and your annual limit that you can claim is 75k.

Let's say your are hospitalized and the total hospital bill is 95k surgery & miscellaneous charge + 5k room & board charge (total of 10k bill).

So, if you attach this PuAnnual Limit Waiver rider, you can claim for 100k total hospital bill, BUT you will need to pay 10% co-insurance of the 95k surgery & miscellaneous charges (i.e. 9.5k that you have pay yourself).

Without this PruAnnual Limit Waiver rider, you can only claim for 75k out of 100k of total hospital bill.

Hope this can clear up some thoughts.

Anonymous said...

Hi jutamind, are we paying 1k max or 9.5k (or 7.5k) in your example? Thanks!

jutamind said...

As far as I understand, you have to pay 9.5k. Please reconfirm with your prudential agent.


Greetings, Hi Anonymous & Jutamind, i would like to update on Prudential co-insurance info.

Jutamind, you are right on PruAnnual Limit Waiver..

However, con-insurance for policy holder to pay is 10% of the total bill, subject to Minimum $300, Maximum $1,000 ONLY.

Example, if ur total Bill is $100,000. 10% co-insurance is $10,000 right? But you only need to pay $1,000/=.

If total Bill is $2800, 10% is $280, but then you still need to pay $300. (Min co-insurance)

REGARDLESS any changes to Board & Room, (upgrade room ex: double to single-bed), co-insurance IS STILL 10%, subject to MIN $300 & MAX $1,000.


jutamind said...

Hi Din,

Thanks for the clear explanation. Hope this clears up on the PruAnnual Limit Waiver.

dennis said...

I heard that the outpatient for kidney dialysis and cancer treatment as charge subject to life time limit and co-insurance max RM2k. My question is does the outpatient for kidney and cancer treatment charges is subject to annual limit or life time limit?? Please help to clarify. Thanks

jutamind said...

Based on the feedback that i get, generally it's limited by annual limit, unless you have the annual limit waiver rider attached to your policy.

Anonymous said...

Pru agent is cheating. According to Policy Contract, if "PRU annual limit waiver" is attached, said for plan PRU health 200, the original annual limit is 75k. So if the actual hospitalization charge is RM700k (eg: organ transplant), policyholder need to pay FULL 10% co-insurance (1st 75k, co-ins is 1k; next 625k need to pay 62.5k, TOTAL RM 63,500.00 TO BE PAID BY POLICYHOLDER). Besides, the quotation also misleading, Prudential assumed policyholder will NEVER claim for full policy term and add the NonClaimBonus every year into the policy, with compounded interest 9%/year (if equity fund selected).

jutamind said...

@Anonymous, do you have the actual policy wording for Pru Annua Limit Waiver? Without the actual policy wordings, it hard to say that Pru agents are cheating.

We, as the learned consumers, should take proactive actions by reading through the policy wordings. You have free look for 14 days if you want to cancel the policy. If you dont understand some points in the policy wordings, you should ask your agent or post it to internet forums to ask advice from all other learned consumers out there.

Anonymous said...

What Din prudential explained on the 10% co-insurance with max 1K limit is only applicable to PRUhealth without annual limit waiver.

Eg : A plan with annual limit 75K, lifetime limit 750K & add-on the annual limit waiver benefit,if the bill is 200K, then the amount the policyholder need to pay is :

1) 1st 75K is = 1K (the maximum bracket)

2) subsequent 125K x 10% = 12,500 ( no 1K max bracket)

~ total need to pay : RM13,500 for a claim of 200K medical bill.

It stated clearly in the policy document.


Peter Lim said...
This comment has been removed by the author.
Peter Lim said...

While in PruHealth 200 with annual limit waiver, you might need to pay RM 64.5k for RM 700 medical bill in a year, how much do you need to pay for other medical card?

Let me give you the answer: between RM 500k to RM 700 (if you don't have medical card).

So, please compare with alternative before "bombarding". Sometimes it's better for a fool to keep quiet, so that you don't let others confirm it!

jutamind said...

Hi Peter Lim,

Can you elaborate more on your comment above? I do not quite get what you are trying to say.

Lucinda Cruise said...

so may i know what are the disadvantages for PRU medical card????

u didnt mention r u behind PRU agent ?

jutamind said...

Hi Lucinda,

I cant say what's the advantage and disadvantage of a medical card. It all depends on the personal situation and preference. To compare PRU medical card against its competitors, you may want to refer to this article:

PS: I'm not an agent from any insurance company. Just a normal consumer like the rest.

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