Health & Medical Insurance (PRUvalue Med-Brochure)

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Get MORE with MEDICAL PRUvalue med

description

PRUvalue Med - is the medical plan for you, that combines extraordinary values and savings. With PRUvalue med, you will never have to choose between your health and finances as your healthcare needs are what matters most to us.MORE value in every way.MORE Coverage - RM1,000,000 - RM2,000,000 coverage, No Annual Limits, No Lifetime Limit. MORE Features - Over 70 Panel Hospitals and clinics, Worldwide Emergency Medical Assistance, Outpatient Cancer &Kidney TreatmentMore Benefits - Room and Board, Income replacementMORE Savings - Choose your fund.PRUvalue med is a regular premium investment-linked medical rider that reimburses medical expensesincurred in the event of hospitalization and for outpatient treatment.Serving your health needs. For a free quotation contact:MALIK TAUFIQ 0162229063 [email protected] Prudential Assurance Malaysia Sdn Bhd

Transcript of Health & Medical Insurance (PRUvalue Med-Brochure)

Page 1: Health & Medical Insurance (PRUvalue Med-Brochure)

Get MORE with

MEDICAL

PRUvalue med

Page 2: Health & Medical Insurance (PRUvalue Med-Brochure)

Introduction:

We all know just how crucial medical care is in today’s world and

the need for healthcare becomes even more paramount as we

age. With the escalating cost of healthcare, have you ever

wondered if you are able to safeguard yourself against any

uncertainty and insufficient savings for healthcare?

Wouldn’t it be great if there is a medical plan that not only

promises you a lifetime of assurance for all your medical needs,

but also helps you save with more benefits?

Introducing PRUvalue med, a medical plan that combines

extraordinary values and savings. With PRUvalue med, you will

never have to choose between your health and finances as your

healthcare needs are what matters most to us.

Get MORE with PRUvalue med.

Page 3: Health & Medical Insurance (PRUvalue Med-Brochure)

Subsequent RM500k• 80% will be paid by Prudential• 20% will be borne by policyholder

1st RM 1.5 million• 100% of the total claims will be paid by Prudential

Total eligible claims RM2 million

Med Value PointRM1.5 million

PRUvalue med offers you

is the same asGuaranteed Renewable

100%Non-Cancellable*

MORE Savings

MORE Coverage

MORE Benefits

Med SaverMORE value in every way

PRUvalue med

Day Care ProcedureSave time &

go home

EmergencyTreatment ofOutpatient

Injury

MaternityComplication

Benefits

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Outpatient Cancer & Kidney Treatment

Take Home DrugsConsultation FeesExamination Test

HomeNursing Care

Note:PRUvalue med is non-cancellable unless there is fraud or any circumstance that makes the policy or rider voidable or null and void. This depends on all premiums being paid duly and the policy or rider being in force.

Page 4: Health & Medical Insurance (PRUvalue Med-Brochure)

PRUvalue med All about

What is PRUvalue med?

PRUvalue med is a regular premium investment-linked medical rider that reimburses medical expenses incurred in the event of hospitalization and for outpatient treatment.

What are the benefits provided under PRUvalue med?

Benefit Benefit Amount

Room & Board Benefits

a) Hospital Daily Room & Board (R&B)

Hospital & Surgical Benefits ¹

b) Intensive Care Unit / Cardiac Care Unit c) In-hospital & Related Services • Surgical Benefit • Hospital Supplies and Services • Operating Theatre • Anaesthetist Fees • In-Hospital Specialist’s Visit

Outpatient Treatment Benefits ¹

d) Pre-hospitalisation Treatment

e) Post-hospitalisation Treatment

f) Home Nursing Care g) Day Surgeryh) Day Care Procedurei) Outpatient Cancer Treatment j) Outpatient Kidney Dialysis

Descriptions

limit per day,up to 150 days per year

Up to 90 days per year

limit to 2 visits per day

within 60 days before hospitalisationwithin 90 days after hospital discharge180 days per life-time

including take home drugs, examination tests & consultation

Flexible option between RM100 and RM600 per day

(Increments in multiples of

RM100 per day)

As Charged ²

As Charged ²

As Charged ² Up to 1.5 times of the chosen

Med Value Point per lifetime

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PRUvalue med All about

¹ If Med Saver is chosen, policyholder must first pay a fixed amount of RM300 out of the total Reasonable and Customary Charges of eligible benefits (excluding the cost of Daily Room & Board and Intraocular Lens) for any one disability. If Med Saver is not chosen, the fixed amount of RM300 shall not apply.

² We shall only reimburse Reasonable and Customary charges on eligible expenses which are deemed Medically Necessary.

Note:For Overseas Treatment, if the life assured chooses to have or is referred to be treated outside Malaysia, the benefits for the treatment is limited to the Reasonable and Customary and Medically Necessary charges for equivalent local treatment in Malaysia and subject to 90 days residence limit.

Benefit Benefit Amount

Other Benefits

k) Maternity Complications Benefit ¹l) Intraocular Lensm) Emergency Treatment For Accidental Injury¹

Med Value Point

Med Saver¹

Emergency Medical Assistance

for female life assured Up to RM5,000 per yearUp to RM6,000 per lifetime

Up to 10 timesof Daily R&B amount per year

Flexible option between RM1,000,000 and RM2,000,000

(Increments in multiples of RM500,000)

Yes / No

Yes

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PRUvalue med All about

MED VALUE POINT SCENARIO

TIMELINE

What is Med Value Point (MVP)?

Claims on eligible benefits will be payable in full (subject to Med Saver, if applicable) up to the chosen Med Value Point. If the total claims exceed the chosen Med Value Point, we will still pay 80% of the total cost of the eligible benefit cost.

Outpatient Cancer Treatment and Outpatient Kidney Dialysis Benefits will be up to 1.5 times of the chosen Med Value Point. Claims on Outpatient Cancer Treatment and Outpatient Kidney Dialysis Benefits will be counted as part of Med Value Point.

Mr.A age 35*, purchases PRUvalue med

*Age next birthday

MVP : 1.5 million

Expiry Age : 80 years old

Total ClaimsRM2 million

of the total costof the eligible benefits

EligibleClaims Amout

1st 250k2nd 300k3rd 350k4th 500k5th 320k6th 280k

Note:The above examples are for illustrative purposes only and all benefits are subject to waiting periods. Please refer to the Policy Document for the detailed terms and conditions.

2015

2060

ContinuousCoverage

Up to Age 801.5M 500K

Fully Paid byPrudential

Policy Purchased Expiry Age

Prudential still pays 80%

MVP

80% Prudential

400K 100K20% Customer

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MED SAVER

PRUvalue med All about

What is Med Saver?

Med Saver allows you to enjoy premium savings where the premium saved can be used to enhance your coverage and retirement funds. If Med Saver is chosen, you must first pay a fixed amount of RM300 out of the eligible benefits before Prudential pays for any expenses for any one disability (Excluding the cost of Daily Room & Board and Intraocular Lens)

How Med Saver works?

ENJOY FURTHER

PREMIUM SAVINGS

How muchdo i save?

Save up toRM6,482

per year

Use the premium saved for other goals

GET MORESAVINGS

Higher Cash Value

GET MORECOVERAGE

Better Protection

GET MOREBENEFITS

Better Medical Plan

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PRUvalue med All about

Note:* Illustration is based on a high projected investment return scenario (i.e., 9% p.a. for the first 20 years and 6% p.a. thereafter). The projected values are for illustrative purpose only. These values are neither guaranteed nor based on past performance of the investment-linked funds.

MED SAVER Scenario

James is a 35-year-old male customer working as an Accountant (Class 1).He had bought a PRUlink one with PRUvalue med on 1 April 2015 with yearly premium of RM5,250 invested in PRUlink equity fund and he would have the following options:

Annual Premium

Cash Value @65 years old*

Death & TPD

Critical Illnesses

Med Value Point

Room & Board

Expiry Age

Remarks

5,250

112,364

100,000

100,000

1 mil

300

80

-

DescriptionPVM Without

Med Saver(RM)

PVM with Med Saver

(RM) Investment Buy MoreCoverage

Use Premium saved for other goals

BetterMedical Plan

5,250

102,053

100,000

100,000

1.5 mil

400

80

5,250

120,413

150,000

150,000

1 mil

300

80

5,250

162,352

100,000

100,000

1 mil

300

80

4,029

74,330

100,000

100,000

1 mil

300

80

Higher Cash ValueSaved RM1,221 per year Higher Coverage

RM1,221RM1,221

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Decide on yourMed Value Point

Decide on your Expiry Age

Decide on yourMed Saver Option

Decide on your Hospital DailyRoom & Board

Amount

STEP 1

STEP 2

STEP 3

STEP 4

1 21.5

(RM, Million) (RM) (YEARS OLD)

YES

NO

100 200

300 400

500 600

70

80

90

100

PRUvalue med All about

Who can take up the plan?

PRUvalue med is available to anyone aged between 14 days to 70 years old on their next birthday.

It is also available to pre-birth child from 18 weeks onwards with a waiting period of 30 days from the

date of birth.

How much premium do I have to pay?

The total premium that you have to pay and the policy terms may vary depending on our underwriting requirements. You are given one month's grace period after the due date for the payment of premium. The premiums are payable throughout the duration of the plan up to the chosen expiry age.

We will allocate a portion of the premium to purchase units in the investment-linked fund(s). Anyunallocated amount will be used to pay commissions to agent/ wealth planner and other expenses by us. You are advised to refer to the allocation rates given in the sales illustration.

`Premiums can be paid yearly, half-yearly, quarterly or monthly via Auto Debit, Credit card, Cash or Cheque.

How do I get started with PRUvalue med?

70 80 90

Expiry Age

100Entry AgeNext Birthday

Min 14 days (prenatal is allowed to purchase)

Max 60 70

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PRUvalue med All about

What are the waiting periods that I should be aware of?

What is non-cancellable?

PRUvalue med is non-cancellable which also means PRUvalue med coverage is guaranteed unless there is fraud or any circumstance that makes the policy or PRUvalue med voidable or null and void. This depends on all premiums being duly paid and the policy or PRUvalue med being in force.

What are the key terms and conditions that I should be aware of?

1. Importance of disclosure - when answering any question asked by us, you must disclose all relevant facts such as medical condition and state your age correctly. If the insurance policy is intended wholly for your personal purposes, you must take reasonable care to disclose any facts that you know to be relevant to us and not to mislead us. Your above duty of disclosure continues until the policy is issued.

2. Free-look period - you may cancel your policy by returning the policy within 15 days after the policy has been delivered to you. We will refund to you the unallocated premiums, the value of units that have been allocated (if any) at unit price at the next valuation date and any insurance charge and other charges that have been deducted less any medical fee incurred.

3. Cash value - the cash value of the policy depends on the performance of the investment-linked fund(s) invested. The higher the level of Insurance coverage selected, the more units will be absorbed to pay for the insurance charges and the fewer units will remain to accumulate cash values under your policy. You should consider whether the allocation of insurance premiums towards protection and investment meets your financial circumstances.

4. Policy lapse - The policy will lapse when the value of investment units is insufficient to pay for the insurance and other charges.

Note:This list is non-exhaustive. Please refer to the Policy Document for the full list of terms and conditions under this product.

Specified Illnesses 120 days

Any Illnesses other than Specified Illnesses 30 days

Maternity Complications 365 days

Description Waiting Period from commencement dateor date of revival

Please note that this is an insurance product that is tied to the performance of the underlying assets, and is not a pure investment product such as unit trusts.

Page 11: Health & Medical Insurance (PRUvalue Med-Brochure)

Appendix

Sample Annual Premium Rates for Male and Female with Med Value Point of RM1,000,000. (Occupational Class 1 & 2)

Premium rates are based on standard risk and are subject to underwriting.

Expiry Age 70

Expiry Age 80

Med Saver With Med Saver Without Med Saver

Hospital Daily Room & Board (RM) 100 200 300 400 500 600 100 200 300 400 500 600

Entry Age Next Birthday

1 - 2 991 1,127 1,465 1,859 2,197 2,478 1,572 1,787 2,323 2,948 3,484 3,931

3 - 15 958 1,089 1,415 1,796 2,123 2,395 1,316 1,495 1,944 2,467 2,915 3,289

16 - 20 1,044 1,187 1,543 1,958 2,314 2,611 1,434 1,630 2,119 2,690 3,179 3,586

21 - 25 1,142 1,297 1,687 2,141 2,530 2,854 1,445 1,642 2,135 2,710 3,202 3,613

26 - 30 1,182 1,344 1,747 2,217 2,620 2,956 1,512 1,718 2,233 2,834 3,350 3,779

31 - 35 1,260 1,432 1,862 2,363 2,793 3,151 1,697 1,929 2,507 3,183 3,761 4,243

36 - 40 1,464 1,664 2,163 2,746 3,245 3,661 2,000 2,272 2,954 3,750 4,431 5,000

41 - 45 1,787 2,031 2,640 3,351 3,960 4,468 2,364 2,687 3,493 4,433 5,239 5,911

46 - 50 2,122 2,411 3,135 3,979 4,702 5,305 2,918 3,316 4,311 5,472 6,467 7,296

51 - 55 2,737 3,110 4,043 5,131 6,064 6,842 4,117 4,678 6,081 7,719 9,122 10,291

56 - 60 3,407 3,872 5,034 6,389 7,550 8,518 5,262 5,979 7,773 9,866 11,659 13,154

Med Saver With Med Saver Without Med Saver

Hospital Daily Room & Board (RM) 100 200 300 400 500 600 100 200 300 400 500 600

Entry Age Next Birthday

1 - 2 1,267 1,440 1,872 2,376 2,808 3,168 1,746 1,984 2,580 3,274 3,869 4,366

3 - 15 1,267 1,440 1,872 2,376 2,808 3,168 1,746 1,984 2,580 3,274 3,869 4,366

16 - 20 1,410 1,603 2,083 2,644 3,125 3,526 1,944 2,209 2,872 3,645 4,308 4,860

21 - 25 1,576 1,791 2,329 2,955 3,493 3,941 2,039 2,317 3,012 3,823 4,518 5,098

26 - 30 1,632 1,854 2,410 3,059 3,615 4,079 2,173 2,470 3,211 4,075 4,816 5,433

31 - 35 1,744 1,982 2,576 3,270 3,864 4,360 2,491 2,831 3,680 4,671 5,520 6,228

36 - 40 2,017 2,292 2,979 3,781 4,469 5,042 2,912 3,309 4,302 5,460 6,453 7,280

41 - 45 2,523 2,867 3,727 4,730 5,590 6,307 3,467 3,940 5,122 6,501 7,683 8,668

46 - 50 3,072 3,491 4,539 5,760 6,808 7,681 4,308 4,895 6,364 8,077 9,545 10,769

51 - 55 4,086 4,643 6,036 7,662 9,055 10,216 5,850 6,647 8,641 10,968 12,962 14,624

56 - 60 5,064 5,755 7,481 9,495 11,222 12,660 7,241 8,228 10,696 13,576 16,045 18,102

61 - 65 6,099 6,931 9,010 11,436 13,515 15,248 8,692 9,877 12,841 16,298 19,261 21,730

66 - 70 7,723 8,776 11,409 14,481 17,114 19,308 10,226 11,621 15,107 19,174 22,660 25,565

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Exclusions

PRUvalue med does not cover any hospitalization, surgery or charges caused directly or indirectly, wholly or partly, by any one of the following occurrences:

1) Pre-existing conditions.2) Specified Illnesses listed below occurring during the first 120 days from the commencement date of the rider, the date it is revived, whichever is later. (a) Hypertension, diabetes mellitus and Cardiovascular disease; (b) Growths of any kind including tumours, cancers, cysts, nodules, polyps; (c) Stones of the urinary system and biliary system; (d) Any disease of the ear, nose (including sinuses) or throat; (e) Hernias, haemorrhoids, fistulae, hydrocele or varicocele; (f) Any disease of the reproductive system including endometriosis; or (g) Any disorders of the spine (including a slipped disc) and knee conditions.3) Any medical or physical conditions and its signs or symptoms occurring within the first 30 days from the commencement date of the rider or the date it is revived, whichever is later, except for traumatic bodily injury caused by an accident.4) Any neonatal medical or physical conditions including birth trauma (a physical injury sustained by an infant during birth) occurring within the first 30 days from the commencement date of the rider, the date it is revived or the date of birth, whichever is latest.5) Plastic / Cosmetic surgery, hyperhidrosis, circumcision, eye examination for nearsightedness, farsightedness or astigmatism, visual aids and refraction or surgical correction of nearsightedness (Radial Keratotomy) and the use or acquisition of external prosthetic appliances or devices such as but not limited to artificial limbs, hearing aids, cochlear apparatus, external or temporary pacemakers and prescriptions thereof. 6) Dental conditions including dental treatment or oral surgery except as necessitated by Accident to sound natural teeth occurring while the Policy and the rider are in force.7) Private nursing (except for Home Nursing Care Benefit), rest cures or sanitaria care.8) Drug abuse, under influence of alcohol, venereal disease and its sequelae, AIDS (Acquired Immune Deficiency Syndrome) or ARC (AIDS Related Complex) and HIV related diseases, and any communicable diseases required quarantine by law.9) Any treatment or surgical operation for congenital abnormalities or deformities including hereditary conditions. 10) Pregnancy, child birth (including surgical delivery), miscarriage, abortion and prenatal or postnatal care and surgical, mechanical or chemical contraceptive methods of birth control or treatment pertaining to infertility and its complications, with exception to the benefits as provided under the Maternity Complications Benefits. Erectile dysfunction and tests or treatment related to impotence or sterilization. 11) Primarily for investigatory purposes, diagnosis, X-ray examination, stem cell therapy, general physical or medical examinations, not incidental to treatment or diagnosis of a covered Disability or any treatment which is not Medically Necessary and any preventive treatments, preventive medicines or examinations carried out by a Physician, and treatments specifically for weight reduction or gain or bariatric surgery. 12) Suicide, attempted suicide or intentionally self-inflicted injury while sane or insane. 13) War or any act of war, declared or undeclared, criminal or terrorist activities, act of foreign enemies, active duty in any armed forces, direct participation in strikes, riots, civil commotion, insurrection, revolution or any war-like operations.

Page 13: Health & Medical Insurance (PRUvalue Med-Brochure)

Exclusions

14) Ionising radiation or contamination by radioactivity from any nuclear fuel or nuclear waste from process of nuclear fission or from any nuclear weapons material. 15) Expenses incurred for donation of any body parts or organ by a Life Assured and acquisition of the organ including all costs incurred by the donor during organ transplant and its complications. 16) Investigation and treatment of sleep apnoea and snoring disorders, hormone replacement therapy and alternative therapy such as treatment, medical service or supplies, including but not limited to chiropractic services, acupuncture, acupressure, reflexology, bonesetting, hyperbaric oxygen therapy, herbalist treatment, massage or aroma therapy or other alternative treatment.17) Care or treatment for which payment is not required or to the extent which is payable by any other insurance or indemnity covering the Life Assured, and Disabilities arising out of duties of employment or profession that is covered under a Workman's Compensation Insurance Contract. 18) Psychotic, mental or nervous disorders (including any neuroses and their physiological or psychosomatic manifestations). 19) Costs / expenses of services of a non-medical nature, such as television, telephones, telex services, radios or similar facilities, admission kit/pack and other ineligible non-medical item. 20) Participating in racing of any kind (except foot racing), hazardous sports such as but not limited to skydiving, water skiing, underwater activities requiring breathing apparatus, winter sports, professional sports and illegal activities.21) Private flying other than as a fare-paying passenger in any commercial scheduled airlines licensed to carry passengers over established routes.22) Expenses incurred for sex changes.

YOU SHOULD SATISFY YOURSELF THAT THIS PRODUCT WILL BEST SERVE YOUR NEEDS. YOU SHOULD READ AND UNDERSTAND THE INSURANCE POLICY AND DISCUSS WITH THE AGENT OR CONTACT THE INSURANCE COMPANY DIRECTLY FOR MORE INFORMATION. IT IS IMPORTANT THAT ANY RECEIPT THAT YOU RECEIVE SHOULD BE KEPT AS PROOF OF PAYMENT OF PREMIUMS.

Note:This list is non-exhaustive. Please refer to the Policy Document for more details about the major exclusions under this policy.

Page 14: Health & Medical Insurance (PRUvalue Med-Brochure)

Important Notes

• This brochure is for illustrative purposes only. You are advised to refer to the Product Disclosure Sheet and Sales Illustration before purchasing a plan, and to refer to the terms and conditions in the policy document for details of the important features of the plan.

• You should assess the affordability and suitability of the product (including optional benefits) in relation to your financial goals and risk appetite. To achieve that, we recommend that you speak to your agent or Wealth Planner who will perform a needs analysis and assist you in making an informed decision.

• You must inform us of any change in your occupation, avocation or sports activities because it may affect the premiums, terms, conditions and benefits.

• PRUvalue med is guaranteed to be renewable but premium rates and / or insurance charges are NOT guaranteed. We reserve the right to revise the premium rates and / or insurance charges at policy anniversary by giving you a 30-day notice.

• Coverage to expiry age is subject to sufficient funds for insurance charges and service charges.

• Non-payment of premiums may cause your policy to cease.

• There is a free-look period of 15 days after the delivery of your policy to allow you to review if it meets your needs. If the policy (which PRUvalue med is attached to) is cancelled within this period, the value of units (at next pricing day) plus the unallocated premiums, service charge, and insurance charges less medical expenses will be refunded.

• If you cancel the policy (which PRUvalue med is attached to) in the early years, you may not be able to obtain the full value from the amount you have paid in. Upon surrender, the benefits under PRUvalue med will cease.

• Prudential Assurance Malaysia Berhad (PAMB) is a licensed insurance company and is regulated by Bank Negara Malaysia.

• PRUvalue med is not a Shariah Compliant product.

Prudential Assurance Malaysia BerhadMember of PIDM

Prudential Assurance Malaysia Berhad (PAMB) is a member of Perbadanan Insurans Deposit Malaysia (PIDM). As a member of PIDM, some of the benefits insured under the insurance policies offered by PAMB are protected against loss of part or all of insurance benefits by PIDM, in the unlikely event of an insurer member failure. For further details of the protection limits and the scope of coverage, please obtain a PIDM information brochure from PAMB or visit PIDM website (www.pidm.gov.my) or call PIDM toll free line (1-800-88-1266).

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Prudential Assurance Malaysia Berhad (107655-U)

Menara Prudential, 10 Jalan Sultan Ismail,50250 Kuala Lumpur, Malaysia.

Tel: 03-2116 0228 Fax: 03-2032 3939Email: [email protected]

www.prudential.com.my

04/2015