QUOTE(clickNsnap @ Jul 12 2017, 12:34 AM)
Sorry...my mistake...I read RM300... and I unsure why it made me thought you were referring to PRUhealth med. Maybe I read some where PRUhealth med charge RM300 in my current PRUhealth med plan.
Personally, I don't think so... the co-insurance is not only RM300, the RM300 should be refer to Med Saver 300 (before 1 million point is utilised, you will bear with first RM300 for every time masuk hospital, if you masuk hospital kena charge RM301, you have to pay RM300, Prundential pay RM1). After exceed 1 million...the 20:80 co-insurance will applied. If the 20:80 split of medical fee not consider co-insurance? What should we call this 20% charges?
However, I will leave it to Prudential agent/expert to confirm how does PRUvalue med plan works, especially the 20:80 charges arrangement (should define as co-insurance or not co-insurance?)
For me, unlimited life coverage means no limit of claim for the life time = no co-insurance for the life time.
Btw, if really need 1 million for med fee...it is seroius illness, almost end of the life already lol.
I also just upgrade to PVM...
Actually for newbies, it is confusing with Pru new terms (in PVM) of Med value points , medsaver, and unlimited lifetime coverage, etc and not using old terms co-insurance terms, annual/lifetime limits, etc.
Still the same at the end. YOU are right actually for your understanding...so don't be confused by the Pru new terms or argue on the terms....
E.g. if I sign up with med saver 300 and 1 millions Med points with so call unlimited lifetime coverage and upon that Pru will still cover 80% of medical fees.
Actually equal to old terms of co-insurance of 300 and lifetime limit of 1 mil. After the 1 mil limit Pru will pay for the 80% medical fess and we pay for the balance 20%.
E.g. again. we are discussing normal heart surgery and not kidney/cancer things.
If the bill is 1.2 mil, so the payment will be
- 300 co-insurance (if medsaver 300)
- Pru cover 1 mil of bill (limit)
- 200,000 exceeded the 1 mil limit already. So split into 20:80.
- Pru will pay 80% of the excess limit, = 200k x 0.8 = 160k
- We have to pay 20% of the excess limit= 200k x 0.2 = 40k. (ignore the 300 co-in for ease of calculation)
Of coz , not necessary the bill 1 shot is 1.2 mil, could be multiple bills/ event until we use up the limit of 1 mil...(lifetime limit actually)....then after that whatever excess will split into the above 20:80 scope....forever...this is why they call it unlimited coverage...
So Pru market it as unlimited lifetime coverage (but with 20:80 split of cost after exceed the lifetime limit or they call med value points now).
Hope this is clear...from understanding of PVM customer.