QUOTE(ajau @ Sep 15 2010, 01:23 AM)
Let's say you got TH200, entitle you for Room & Board (R&B) up to RM200 per day.
Example: Your total eligible bill for claim is RM 5000 (A) and you are staying in a room cost RM230 per day and stay for 5 days.
Cost of the actual R&B = RM230 X 5 = RM1150 (B)
Cost of the entitle R&B = RM200 X 5 = RM1000 © - is paid by PruBSN
So you need to pay the different of room = (B) - © = RM150 (D)
The remaining bill = (A) - (B) = RM3850 (E) is subject to cost-sharing agreement between PruBSN and certificate holder. 90% is paid by PruBSN. 10% is paid by certificate holder.
90% x (E) = RM 3465 (F)
10% x (E) = RM 385 (G)
This is what you need to pay upon discharged: (D) + (G) = RM 150 + RM 385 = RM535
This is what PruBSN will pay: © + (F) = RM 4465
Usually PruBSN/Prudential agent will advice the client to take Hospital Allowance (between RM 50 - RM400 per day), so that it can cover the cost of ko-takaful/co-insurance.
In Allianz, if the above scenario happens which is staying in a room more than entitled, the cost shall be:
Cost of the actual R&B = RM230 X 5 = RM1150 (B)
Cost of the entitle R&B = RM200 X 5 = RM1000 © - is paid by Allianz
So you need to pay the different of room = (B) - © = RM150 (D)
Then ADD 20% up to max RM1k on the remaining (A) - (B) = RM3850 = RM770 (E)
So upon discharged, the required amount to pay is (D) + (E) RM150 + RM770 = RM920.
So my advice is in Allianz, do not stay in a room more than eligible. Example:
Your total eligible bill for claim is RM 5000 (A) and you are staying in a room cost RM200 per day and stay for 5 days.
Basically, Allianz will cover all the above expenses without u paying 10% co-insurance.
This is the mahor difference in these 2 cards. THanks