Yes it is a medical card that pays for medically necessary and with a high deductible that you can afford it helps to save on the insurance charges especially at older age.

The insurance charges at age > 75 can be as high as Rm10k per year without a high deductible.

This post has been edited by roystevenung: May 16 2017, 12:20 PM

Fixed

Which medical card are you referring to? If PruValue Med it works like this:-

Day 1 Kidney Dialysis, Need to Pay RM300
Day 43 Kidney Dialysis, RM0
Day 103 Kidney Dialysis, RM0
Day 193 Kidney Dialysis, RM0
Day 373 Kidney Dialysis, Need to Pay RM300 as the last treatment date is over the 90 days from the last treatment in day 193 (but it wont be needed as there is no gap of over 90 days for Kidney Dialysis)

As per above.

For Outpatient Kidney Dialysis it is pay and claim, but for Cancer treatment it can be issued with GL if able to pre-plan (eg, next week only go for chemo)

No, for PruHealth the Outpatient, it is subject to a minimum co-insurance of 10% and up to a maximum of RM2,000.

Hospitalization for investigation purpose is not covered for all medical cards.

Example 1:-

Client had a chest pain, near blackout, shortness of breath - admitted to ICU. Angiogram later reveals that she has 40% block artery.

Dr gave some meds and consultation. No further treatment or ballooning.

Claim under Guarantee Letter as angiogram cannot be done at home and the condition is medically necessary.

Example 2:-


Client went for routine blood test and health screen -> not claimable unless the blood test shows something that needs to be medically treated.

In simpler term, as long as the last treatment date (for the same illness) is not over the 90 days, you don't need to pay the RM300 (if you had opt for the Med Saver RM300).

If full claim, then you don't need to pay the RM300. However, having the RM300 Med Saver means that you are paying lesser premiums.

Example Plan with Med Saver may cost RM250/mth while a full claim plan will cost RM300/mth. That means you are saving RM600/year if you opt for Med Saver.

If 10 years no claim, that means a savings of RM6,000 and it is not always we get admitted. In fact, no one likes to be at the hospital.

For older medical cards, for Prudential, we normally encourage the agents to have a 10% slack.

Eg, if your premium is RM250/mth, RM25 slack is recommended.

However for newer medical cards like PruValue med, it is recommended to have at least 15% slack due to the higher insurance charge (due to higher coverage).

The purpose of the slack is to build up the cash value and it is not utilized for any insurance charges.

As you may already know, the insurance charges will increase as we grow older and the medical insurance charges is the highest of all the other riders.

I hope that you are being briefed that for PruValue Med, the insurance charges for the medical rider for (expiry age 80) can be as high as RM8.7K/annum at age 70?

When you are working, it is possible to save but when we are retired, to ask you for more money due to insufficient cash values would be very difficult, don't you agree?

It will depend on whether the policy has accumulated sufficient cash value in order to maintain the policy. If it has, then there is no issue.

You may check the cash value by login to PruAccess, Customer Online Portal..

Yes

Yes the agent is right as the slack (un-utilized premium) is about RM5.++ only.

For PruValue Med, since the insurance charges is higher than the rest of the medical card, it would be recommended to have at least 15% slack (of the total premium).

However, even by doing that it could not guarantee whether you need to top up in later years as the higher insurance charges at older age (eg at age 70, the medical insurance charges can be as high as RM10,887/year) may deplete your cash values. You may see the projected insurance charges from our online brochure << HERE >> and compare to the projected cash value that you'll accumulate at age 70.

Secondly, as you may already know the funds performance is not guaranteed.

If you want to have minimum slack now (which is not wrong if you have a investment vehicle that can get better/higher returns) then be prepared to top up more in later years.

This post has been edited by roystevenung: Jun 19 2017, 09:52 PM

I am sure other insurer has the same arrangement to built up the cash values as the principle of how the insurance charges goes up as you grow older is the same.

The best scenario is to be able to upgrade the PruHealth directly to PruValue Med if no health complications existed during the upgrade. There is no waiting period for upgrade.

However, there may be cases that one may want to maintain the PruHealth and buy another Pruvalue med AND the health complication exist during the upgrade (eg, benign cyst, benign tumor, hypertension etc).

When we already have a pre exiting illness when we do the upgrade, a loading or exclusion may be imposed on the upgrade. This means that if your previous policy does not have any exclusion upgrading on the existing policy may impose a loading or exclusion.

That is why it is recommended to have a separate policy (with exclusion or loading) whilst maintaining the existing one.

That way if there are any claims that falls under the exclusion, it may still be claim under the old policy.

Buying a new plan to replace the existing one is not recommended as you start all over, even the waiting period.

You may email to customer.mys@prudential.com.my or call 603 2116 0228 (Mon~Fri 8.30am~5.15pm excluding PH)

PruMedic Overseas (PMO) is an optional added rider therefore it is not mandatory to be included if you purchase PruHealth/PruValue med.

It is an added amount if you choose to get treated overseas as overseas treatment can be costlier, example treatment for cancer in Singapore.

Yes if you purchase PH/PVM, you may use it to get treated overseas subject to the 90days restriction. Bills will be on reimbursement basis subject to reasonably charged.

However with PMO, the bills will be reimbursed based on the Reasonable and Customary Charges of the
country of treatment and there will be no 90 days restriction.

No it does not mean that it excludes outpatient cancer treatment and outpatient kidney dialysis. It excludes out the Take Home Drugs, Long Term Meds and Consultation Charges. So long these are in the bill, it will be excluded.

The chemo or surgery related to the cancer will still be covered subject to the annual/lifetime limit of the PruHealth. The same goes to the outpatient kidney dialysis.

You may contact your agent on the possibility of upgrading it to the PruValue Med which includes the Take Home Drugs, Long Term Meds and Consultation Charges.

On top of that, it provides with a minimum cover of RM1.5M for cancer treatment & kidney dialysis.

A Pre-Existing Illness is defined as any illness that had existed (and known to you) when you do any upgrade/revival of the policy.

The terms of the new policy or even the upgrade will depend on the severity of the said illness.

For example, I had just upgraded my existing client from PruHealth to PruValue Med. When he bought PruHealth he is healthy, never claimed before using his medical card.

However he is now having High Blood Pressure (HBP). However the HBP is fully control and an Medical Exam was perform. Reading 120/80 most of the time with control meds. Everything was declared in the upgrade form.

His result, no loading and no exclusion was imposed since the readings are good and he is constantly being monitored by a Doctor on his HBP.

If the Medical Exam reveals higher reading than normal, then most probably a loading on the PruValue Med will be imposed.

1. No it is not compulsory to add in PruParent Payor, if you have sufficient Death/TPD/CI (or other source of income) to even pay for your child's insurance policy in the event of death/TPD/CI.

The question is if you are not around (touch wood) who is going to pay the premium for the child?

2. The Emergency Treatment for Accidental Injury comes default with the room selected (included in PVM), eg if RM200 R/B, it is RM2K/year Emergency Treatment for Accidental Injury. Ask for a full quote from the agent and you can see it in the quotation.

3. PruAcciMed also pays for the following due to accidental injury:-
- up to RM1.5K lifetime for traditional/complementary treatment
- overseas companion allowance
- up to RM1K for Prosthesis/ Wheelchair Allowance

Get the agent to generate a quote in detail.

Yes you may exclude if you wish to. Its not mandatory

If it is accidental and you get treated at the clinics then it is covered, pay and claim.

The question is whether you have it treated at the clinic or not as it is minor injury..

Yes to add PruAcci med a min of Rm20k of PruAcci Guard is required.

If the EAT is insufficient, most of the time the condition is more serious and needs to be examined by a specialist, that means the medical admission.

As mentioned earlier, if the accident condition is far more serious than local clinical Dr can handle, they will recommend you to go get it treated at a hospital by a specialist Dr and that means the usage of the medical card.

Whether there is admission or not it does not matter as the medical card can also be use to treat day surgery provided that it is a medically necessary.

In the event you opt for a higher room Just pay the differences in the room rates, no other penalties.

Personally I recommend the Rm100 (4-6 bedded) and if you require and are OK to pay the variance for a 2 bedded or better room. It is not always you get hospitalized and the bed is for resting or recuperating, not a hotel room!

Though some people just wants privacy (and/or worried of cross contamination from other patients) when getting admitted, therefore they opt for a double or single bed.