Case Management Service is a comprehensive virtual health advisory service by a dedicated Physician Case Manager to obtain medical opinions from global specialists. This is Value added service with no added cost.

Physician Case Manager is a person who will contact the eligible member by phone or email to provide guidance at every step of your medical journey.

Case Management Service will:

• Provide you with clear guidance from a team of medical experts who review your case and provide a comprehensive report to help you make the right health decisions.

• Helps you referrals to the right doctor and have your appointment conveniently arranged at PRUPanel Plus

• A dedicated local doctor will also help monitor your condition and guide you through your treatment.

• You will get ongoing support through recovery follow‑ups and proactive check‑ins 

Teladoc Health, Inc is a third-party service provider engaged by Prudential Assurance Malaysia Berhad (PAMB). Teladoc Health is a global virtual care leader in telehealth services with over 25 years in business serving millions of customers in Asia and around the world.

Your case will be handled by Malaysian Licensed doctors who are familiar with the Malaysian private healthcare landscape.

• Customer’s user policy must be in force;

• Customers must have had previous medical inquiries and consultations with at least one medical practitioner, with a prior diagnosis and in need of second medical opinion from other medical practitioner;

• Our customer has done a medical check up and has the official medical history.

We understand our customers who have serious medical conditions often feel uncertain and doubt regarding treatment options and the appropriate course of action to take. Through this service, we would like to help you get a second opinion on the medical condition faced and choose the appropriate treatment, so that you can discuss with the doctor and receive continuous support throughout your medical journey.Teledoc is a third party service provider and is contracted with PAMB

Case Management Service is available exclusively for PAMB customers who have active policies for the following products:

• PRUValue Med Booster 

• PRUMillion Med Booster

• PRUMillion Med Booster 2.0

• Active booster

• Critical Care Plus with Rider Sum Assured of at least RM250k

• Total Multi Crisis care with Rider Sum Assured of at least RM250k

• PRULive Well with Monthly income benefit of at least Rm5k

No, you do not need to pay any additional fee to use the Case Management Service. You can use Case Management Service as many as you want as long as your policy is in force.

Most second opinion services review medical reports and information to provide an independent diagnosis and recommended treatment plan. After getting a second opinion, customers often still have questions, and need to find the suitable doctor to carry out the treatment.

The Case Management Service not only provides a second medical opinion but also offers comprehensive support. Led by a Physician Case Manager, the team supports customers throughout their medical journey - from obtaining independent medical reports and second opinions from global experts, to arranging referrals and doctor’s appointments for appropriate treatment, explaining medical reports, and providing follow‑up support based on the customer’s medical needs.

It is natural that medical opinions from different doctors can vary. Teladoc Health provides an independent opinion with the purpose of helping you to make an informed decision. You are encouraged to discuss the Teladoc Health report with your treating doctor. Teladoc Health does not directly treat patients or prescribe medication. Customers shall make treatment decisions in consultation with his/her treating doctor. The aim is to empower you to make the best decision for your health.

Prudential’s customers who have an active insurance plan for selective Medical Booster and Critical Illness products are automatically eligible for the Case Management. If you wish to use Case Management Service, you will need to enroll via Prudential’s website.

Once enrolment is completed and if you are confirmed to be eligible for this service, an assigned Physician Case Manager will then contact you via phone or email and provide guidance at every step of your medical journey.

As an information security policy and to protect customer privacy so that personal data is not exposed, registration cannot be done through Case Management hotline. You can only do the enrolment through enrolment portal or email.

When you choose to use Case Management Service, you will be required to provide your consent and agree to the terms of Case Management Service for medical record collection via secure channels.

Prudential and Teladoc Health recognise the importance and sensitivity of such personal data and will only share information that is required to accurately analyse your condition and enable appropriate recommendations to be made.

The assessment of treatment is based on medical necessity. Generally, you will be referred to available treatment locally based on expertise in relevant fields.

Please note that if you decide to proceed with the treatment plan as recommended by Teladoc Health, the cost of medical treatment may or may not be covered by Policy with Prudential Assurance Malaysia Berhad. Customers are advised to confirm your policy coverage with Prudential before performing the treatment.

Yes. If you agree to the referral, Teladoc Health will assist you in making an appointment with the right physician at the earliest convenience, and you will receive appointment confirmation within 3 business days on average.

Medical Conditions that are eligible for Case Management Service

• Cancer;

• Neurological diseases;

• Ear, nose, and throat (ENT) diseases;

• Ocular diseases/ophthalmology conditions;

• Cardiovascular diseases;

• Respiratory diseases;

• Gastroenterological diseases;

• Liver diseases;

• Kidney diseases;

• Urological conditions;

• Endocrine diseases;

• Orthopaedic conditions;

• Hematological diseases;

• Metabolic diseases;

• Rheumatology/ Immunological diseases;

• Infectious diseases, including HIV/ AIDS;

• Cosmetic surgery which is medically necessary;

• Fertility-related conditions or procedures;

• Obstetric conditions;

• Sexual diseases/ sexually transmitted diseases;

• Pediatrics conditions;

• Obesity;

• Recovery/rehabilitation phase for stroke;

• Recovery/rehabilitation phase for severe burns;

• Medical conditions in the fields of dentistry;

• Combined pathologies; and

• All medical conditions other than those listed in the Exclusion List below.
  
  

Excluded Medical Conditions

Customers diagnosed with one of the following are not eligible for the Service:

• Medical emergencies;

• Accidents;

• Urgent or life-threatening situations, such as ICU admission;

• Daily or common issues, such as colds, flu, fever, occasional rash, etc.;

• Long-term chronic disease management such as chronic hepatitis, diabetes, high blood pressure, high cholesterol, etc. (however, any complications of chronic diseases shall be covered); or

• Mental health conditions such as anorexia/ bulimia, mental health-related sleeping disorder, anxiety, depression, etc.
  
  

Notes:

1. To qualify for the service, customers must have had previous medical inquiries and consultations with at least one medical practitioner, with a prior diagnosis, in a field related to the medical problem.
2. The tests, treatments, procedures, devices or medication recommended may or may not be covered by Policy with Prudential Assurance Malaysia Berhad. Customers are advised to confirm the policy coverage with Prudential before undergoing any services.