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 Pru Medical card cannot claim if admit hospital?, without operation

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and85rew
post Jan 15 2023, 04:00 PM

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If overnight..by right they should pay by day
yhtan
post Jan 15 2023, 04:01 PM

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for outpatient u have to pay first then claim back later, PRU medical card has this off limit claim of RM5k annually if not mistaken, if u didn't claim then it will add on to your total limit.
RiriRuruRara
post Jan 15 2023, 04:02 PM

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QUOTE(Natsukashii @ Jan 15 2023, 02:13 PM)
Medical card suppose to be hassle free admission. Of course got limits, but generally should be usable.

Makes me worried..

Last time I use Zurich, few years ago.. no problem getting admitted.

Had to terminate because annual limit extremely low 50k.

Then I changed to Allianz.. so far haven't claim, but paying for 6 years already. This one expensive, because investment linked. I'll be frustrated if cannot claim. Agent also not responding anymore when want to ask stuff.
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normal bro, most agents will disappear once sign up. There are only a few good ones out there. My agent also can't be reached..
Starbucki
post Jan 15 2023, 04:03 PM

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Pru is the most strict claims la, deswai avoid 99
jojolicia
post Jan 15 2023, 04:04 PM

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QUOTE(joey2000 @ Jan 15 2023, 02:10 PM)
Already admitted, bill for 1 night is around 5k, and patient is jobless. 
No GL because admitted at night. Not exist prior policy.
Painful only admitted hospital, not a screening. Don't know how the doctor write.

So scary after hearing that, sound like you must be very serious only can claim.
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No GL from insurance provider, you proceed wad admission ? So you paid deposit?
Don't think medical card activation is dependent on surgery or not.

Suggest you check on dr report. Super agent also can't help you, insurance claim dept only reads dr report

What is your room&board eligibility?

Medical card is not one card flash all check all boxes.

To some may think insurance policy is medical card. Life insurance is not medical card

This post has been edited by jojolicia: Jan 15 2023, 04:19 PM
RiriRuruRara
post Jan 15 2023, 04:09 PM

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QUOTE(yhtan @ Jan 15 2023, 04:01 PM)
for outpatient u have to pay first then claim back later, PRU medical card has this off limit claim of RM5k annually if not mistaken, if u didn't claim then it will add on to your total limit.
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outpatient also you need certain forms to submit for approval right? If missing some forms like from dr won't get approve? Bcs if you need a form you have to get it while you at the hospital, if missing a form and to go back to the hospital for the form will be very difficult or even impossible bcs the dr won't entertain you? - is this true?
jojolicia
post Jan 15 2023, 04:14 PM

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Dp

This post has been edited by jojolicia: Jan 15 2023, 04:15 PM
jojolicia
post Jan 15 2023, 04:17 PM

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QUOTE(joey2000 @ Jan 15 2023, 01:52 PM)
Medical card cannot claim if admit hospital without operation ?

Prudential agent can clarify ?

Cyst problem causing pain but doctor say no need operation.
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You sure its medical card and not life insurance and critical illness policy?

This post has been edited by jojolicia: Jan 15 2023, 04:17 PM
yhtan
post Jan 15 2023, 04:19 PM

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QUOTE(RiriRuruRara @ Jan 15 2023, 04:09 PM)
outpatient also you need certain forms to submit for approval right? If missing some forms like from dr won't get approve? Bcs if you need a form you have to get it while you at the hospital, if missing a form and to go back to the hospital for the form will be very difficult or even impossible bcs the dr won't entertain you? - is this true?
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I have to ask the doctor to write an letter address to Prudential, the letter charge about RM50 for sunway hospital, the agent will up a form and then submit, the claim will be reimburse within a month. Documentation fee about RM150 unable to claim, the rest RM4k able to claim.

If u really want to claim without forking your own money, just admit in and then discharge, if u are outpatient definitely a lot of documentation require to claim it.
RiriRuruRara
post Jan 15 2023, 04:31 PM

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QUOTE(yhtan @ Jan 15 2023, 04:19 PM)
I have to ask the doctor to write an letter address to Prudential, the letter charge about RM50 for sunway hospital, the agent will up a form and then submit, the claim will be reimburse within a month. Documentation fee about RM150 unable to claim, the rest RM4k able to claim.

If u really want to claim without forking your own money, just admit in and then discharge, if u are outpatient definitely a lot of documentation require to claim it.
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Thanks for the tip. So really hard to claim money for outpatient? Your client lucky you are still around and willing to help. I know some dr very bad temper would not entertain that request, even when asking medical question he get piss off...
sixshot
post Jan 15 2023, 04:42 PM

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QUOTE(joey2000 @ Jan 15 2023, 02:22 PM)
My medical card got no problem when admitted even though no operation. Different company.
Because the patient admitted at night. So no GL.
First time I heard this. Normally we think no problem claim using medical card.
Lucky I bought the different company and my agent is responsive.
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What kind of nonsense u talking. GL can get at any time. Day or night doesn't matter. Its 24 hours iinm. Last time i request GL at 2am, by 4.30am its ready.

One more thing, for medical card normally got 2 types. One that cover outpatient & one that cover hospitalization. Most insurance providers covers only hospitalization. Those that offers both coverage very expensive worr.
yhtan
post Jan 15 2023, 04:43 PM

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QUOTE(RiriRuruRara @ Jan 15 2023, 04:31 PM)
Thanks for the tip. So really hard to claim money for outpatient? Your client lucky you are still around and willing to help. I know some dr very bad temper would not entertain that request, even when asking medical question he get piss off...
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wa bukan agent lah, this is my experience when i cut my finger during raya 5-6 years ago, so happen i was so panic and force to go nearest hospital to stitch it back. the bill was RM4k and it shock me
RiriRuruRara
post Jan 15 2023, 05:24 PM

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QUOTE(yhtan @ Jan 15 2023, 04:43 PM)
wa bukan agent lah, this is my experience when i cut my finger during raya 5-6 years ago, so happen i was so panic and force to go nearest hospital to stitch it back. the bill was RM4k and it shock me
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that suck man. I also spend rm1k for 4 stitches on forehead few month back. You lucky your dr was willing to entertain all your request.
sexysarah1992
post Jan 15 2023, 05:44 PM

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QUOTE(yhtan @ Jan 15 2023, 04:43 PM)
wa bukan agent lah, this is my experience when i cut my finger during raya 5-6 years ago, so happen i was so panic and force to go nearest hospital to stitch it back. the bill was RM4k and it shock me
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Topkek. Cut finger only why need to go hospital? Lol. Any gp clinic can stitch it up for u for less than rm200
debonairs91
post Jan 15 2023, 05:55 PM

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QUOTE(CarroTT @ Jan 15 2023, 03:56 PM)
Admit more than 6 hours
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Not consider daycare if just 6 hours?
fantasy1989
post Jan 15 2023, 05:55 PM

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got inpatient?
cms
post Jan 15 2023, 05:57 PM

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QUOTE(sexysarah1992 @ Jan 15 2023, 05:44 PM)
Topkek. Cut finger only why need to go hospital? Lol. Any gp clinic can stitch it up for u for less than rm200
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I also cut my finger and went hospital. It was late night and many CCB clinics close early during MCO.
yhtan
post Jan 16 2023, 12:37 AM

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QUOTE(sexysarah1992 @ Jan 15 2023, 05:44 PM)
Topkek. Cut finger only why need to go hospital? Lol. Any gp clinic can stitch it up for u for less than rm200
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First day of hari raya, u think clinic ada buka?
forgotoldlogin
post Jan 16 2023, 12:52 AM

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QUOTE(joey2000 @ Jan 15 2023, 02:10 PM)
Already admitted, bill for 1 night is around 5k, and patient is jobless. 
No GL because admitted at night. Not exist prior policy.
Painful only admitted hospital, not a screening. Don't know how the doctor write.

So scary after hearing that, sound like you must be very serious only can claim.
*
What did the hospital do for one night no operation is 5k and what hospital is this?

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