PRUmy medical plus

Designed for your needs

A comprehensive solution using PRUwith you as the basic plan. PRUmy medical plus can provide you with long term coverage to meet your protection needs.

With PRUmy medical plus, you have the flexibility to choose the medical plan that suits your unique needs – from a basic medical coverage that rewards you for staying healthy, to high medical coverage that will safeguard you from rising medical costs in the years to come.

 

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Highlights

01

3 medical plans that are unique, each giving you different levels of coverage and benefits - from a basic medical coverage that rewards you for staying healthy, to high medical coverage that will safeguard you from rising medical costs in the years to come, so you can decide what suits you best.

02

Crisis Care rider provides coverage for specific Critical Illnesses that is in addition to your basic sum assured.

03

3 accidental protection riders provide lump sum benefit, medical reimbursement and income in the event of a disability due to accidental causes.

Product Details

Payment Term

Premium is payable throughout the coverage term

Coverage Term

Up to age 100 (Age Next Birthday [ANB])

Issue Age

Pre-birth: After 14 weeks into pregnancy

Post-birth: 1 – 70 years old (Age Next Birthday)

Minimum Sum Assured

RM10,000 and subject to the minimum sum assured multiple

Maximum Sum Assured

Subject to underwriting

Benefit
  1. Death Benefit
  2. Total and Permanent Disability Benefit up to age 70
  3. Maturity Benefit

 Please refer here for details on coverage.

Premium

Minimum annual premium for:

  • Children (prenatal to 18 ANB) is RM50 per month
  • Adults (19 ANB to 70 ANB) is RM100 per month
Riders that can be bought with this policy

Hospital & Surgical

Critical Illness

Accident

Payor Benefit

Savings

Pregnancy and Child Care Benefits

 

*PRUmedic overseas can only be attached when PRUvalue med or PRUmillion med is attached.

** These riders can only be attached when PRUsaver or PRUsaver kid and respective payor basic are attached.

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For more information and special offers.

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PRUmy medical plus

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PRUmy medical plus is a comprehensive solution using PRUwith you, as the basic plan. Attached with critical illness, medical, accidental and payor riders, it is a comprehensive insurance solution that will meet your protection needs. With PRUsaver, this plan would then also function as a savings plan for your retirement fund.

 

PRUmy medical plus package

  1. PRUwith you
  2. PRUvalue med / PRUmillion med / PRUhealth
  3. Crisis Care
  4. Acci Guard Plus
  5. Acci Income Plus
  6. Acci Med Plus
  7. Payor Basic

Riders attachable

Medical Riders

The flexibility to choose the medical plan that suits your unique needs – from a basic medical coverage that rewards you for staying healthy, to high medical coverage that will safeguard you from rising medical costs in the years to come.

To extend your medical safety net overseas, you can attach PRUmedic overseas which enables access to treatment in Singapore, Hong Kong or China for 5 covered illnesses.

 

Table of Benefits

 

PRUvalue med PRUmillion med

PRUhealth

Coinsurance3, Med Saver2 or Deductible2

  • Med Saver RM300
  • Deductible RM20,000
  • Deductible RM50,000
  • Deductible RM75,000
  • Deductible RM100,000
  • Without Med Saver / Deductible

Med Saver RM300

  • Coinsurance
  • Med Saver RM3,000

 

Room & Board Benefits

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

 

RM100, RM200, RM300, RM400, RM500 or RM600 per day

Up to 150 days per year

RM200, RM250, RM300, RM400 or RM500 per day

Up to 120 days per year

RM100, RM150, RM200, RM300 or RM400 per day

Up to 120 days per year

Hospital & Surgical Benefits

b. Intensive Care Unit

As charged1

Up to 90 days per year

As charged1

Up to 120 days per year

As charged1

Up to 30 days per year

c. In-hospital & Related Services

  • Surgical Fees
  • Hospital Supplies and Services
  • Operating Theatre Fees
  • Anaesthetist Fees
  • In-Hospital Specialist’s Visit

As charged1

d. Organ/Bone Marrow Transplant Benefit

As charged1 (under surgical fees)

As charged1 (once per lifetime)

As charged1 (under surgical fees)

Outpatient Treatment Benefits

e. Pre-hospitalisation Treatment

As Charged1

Within 60 days before hospitalisation

As Charged1

Within 30 days before hospitalisation

f. Post-hospitalisation Treatment

As Charged1

Within 90 days after hospital discharge

g. Day Surgery

As Charged1

(includes Day Care Procedure)

As charged1

h. Home Nursing Care

Up to 180 days per lifetime

As charged1

Up to 20 times of Hospital Daily R&B amount per confinement

As charged1

i. Outpatient Cancer Treatment

j. Outpatient Kidney Dialysis

As charged1

Up to 1.5 times of the initial Med Value Point per lifetime

(including take-home drugs, examination tests & consultation)

As charged1

(including take-home drugs, examination tests & consultation)

As charged1

(excluding take-home drugs, examination tests & consultation)

k. Outpatient Physiotherapy Treatment Benefit

Within 90 days after hospital discharge

As charged1 (under post-hospitalisation treatment)

 

Up to:

Plan 200: RM6,000

Plan 250: RM 8,000

Plan 300: RM 10,000

Plan 400: RM 12,000 or

Plan 500: RM 14,000

per year

As charged1 (under post-hospitalisation treatment)

l. Outpatient Dengue Fever Treatment Benefit

NA

Up to 10 times of Hospital Daily R&B amount per diagnosis

NA

Other Benefits

m. Maternity Complications Benefit for female Life Assured only

Up to RM5,000 per year

NA

NA

n. Intraocular Lens

Up to RM6,000 per lifetime

As charged1

o. Emergency Treatment For Accidental Injury

Up to 10 times of Hospital Daily R&B amount per year

Up to 20 times of Hospital Daily R&B amount per accident

Up to 10 times of Hospital Daily R&B amount per year

Annual Limit

No Annual and Lifetime Limit, subject to Med Value Point of RM1 million, RM1.5 million or RM2 million.

If the total claims paid exceed the chosen Med Value Point plus any accumulated MVP bonus, we will pay 80% of the excess eligible benefit cost.

Plan 200: RM1.38mil

Plan 250: RM1.68mil

Plan 300: RM 1.78mil

Plan 400: RM 1.88mil

Plan 500: RM 1.98mil

Plan 100: RM50,000

Plan 150: RM62,500

Plan 200: RM75,000

Plan 300: RM100,000

Plan 400: RM150,000

Lifetime Limit

None

Plan 100: RM520,000

Plan 150: RM650,000

Plan 200: RM780,000

Plan 300: RM1.04 mil

Plan 400: RM1.56 mil

Med Value Point Bonus

Med Value Point increases at 2% of the initial Med Value Point at the end of every 2 policy years provided no claim has been incurred during the 2 policy years. Applicable to plans with Hospital Daily Room & Board of RM300 and above

NA

Annual No Claims Bonus

NA

Plan 100: RM100

Plan 150: RM150

Plan 200: RM300

Plan 300: RM400

Plan 400: RM500

Emergency Medical Assistance4

Yes

Expert Medical Opinion4,5

Yes

NA

Notes:

  1. We shall only reimburse Reasonable and Customary charges on eligible expenses which are deemed Medically Necessary.
  2. If you choose a medical rider with Med Saver, you must first pay a fixed amount equivalent to the Med Saver selected out of the total Reasonable and Customary Charges of eligible benefits, which are Hospital & Surgical Benefits, Outpatient Treatment Benefits, Maternity Complications Benefits and Emergency Treatment For Accidental Injury (excluding the cost of Hospital Daily Room & Board and Intraocular Lens) for any one disability. Otherwise, if Deductible is chosen, you must first pay a fixed amount equivalent to the Deductible selected out of the total Reasonable and Customary Charges of accumulated eligible benefits, which are Hospital Daily Room & Board, Hospital & Surgical Benefits, Outpatient Treatment Benefits and Other Benefits within an annexure year.
    If Med Saver and Deductible are not chosen, the fixed amount shall not apply.
  3. If you choose a medical rider with coinsurance,you must pay 10% of the cost of an eligible benefit, subject to a minimum coinsurance amount of RM300 and a maximum coinsurance amount of RM1,000 for Hospital & Surgical Benefit, and a maximum coinsurance amount of RM2,000 for the Outpatient Treatment Benefit. The remaining balance is paid by us up to the annual limit or lifetime limit (if applicable).
  4.  Emergency Medical Assistance and Expert Medical Opinion are services provided from third party providers which are non-contractual in nature and do not form part of the policy. We have the right to terminate this service by giving a 90 days written notice.
  5. Expert Medical Opinion is a value added service that provides second medical opinion from medical experts in various areas of specialization. This service is to assist you to learn more about your medical conditions and make an informed decision on the treatment plans.

 

 

Critical Illness Riders

Ease your mind and focus on your recovery with Crisis Care rider and Crisis Guard rider which offer additional and accelerated lump sum payment benefits respectively upon the diagnosis of any of the covered 36 Critical Illnesses as stated below.

    1. Stroke
    2. Heart Attack
    3. Kidney Failure
    4. Cancer
    5. Coronary Artery By-Pass Surgery
    6. Serious Coronary Artery Disease
    7. Angioplasty And Other Invasive Treatments For Coronary Artery Disease
    8. End-Stage Liver Failure
    9. Fulminant Viral Hepatitis
    10. Coma
    11. Benign Brain Tumor
    12. Paralysis Of Limbs
    13. Blindness
    14. Deafness
    15. Third Degree Burns
    16. HIV Infection Due To Blood Transfusion
    17. Full-Blown AIDS
    18. End-Stage Lung Disease
    19. Encephalitis
    20. Major Organ / Bone Marrow Transplant
    21. Loss Of Speech
    22. Brain Surgery
    23. Heart Valve Surgery
    24. Loss Of Independent Existence
    25. Bacterial Meningitis
    26. Major Head Trauma
    27. Chronic Aplastic Anemia
    28. Motor Neuron Disease
    29. Parkinson’s Disease
    30. Alzheimer’s Disease / Severe Dementia
    31. Surgery To Aorta
    32. Multiple Sclerosis
    33. Primary Pulmonary Arterial Hypertension
    34. Medullary Cystic Disease
    35. Cardiomyopathy
    36. Systemic Lupus Erythematosus With Severe Kidney Complications

 

*For Angioplasty and Other Invasive Treatments for Coronary Artery Disease, only 10% of the Rider Sum Assured or RM25,000.00, whichever is lesser, is payable.

** Only 50% of the Rider Sum Assured is payable under Full-Blown AIDS.

 

Accidental Riders

Obtain accidental coverage with Acci Guard Plus, Acci Med Plus, and Acci Income Plus which provide lump sum benefits, medical reimbursement and income respectively for disabilities due to accidental causes.

 

Payor Riders

Concerned about your policy when the unspeakable happens? Our Payor riders will pay for your plan in the event of death (if applicable), TPD¹, or Critical Illness of yourself or your covered family members. This will be made possible using our Payor, Parent Payor, 2Parent Payor, and Spouse Payor riders.

If more than one Payor rider triggers at once, not only will the premiums of the policy be borne by Prudential, but an amount equal to the Rider Sum Assured of the subsequent payor rider(s) will be allocated into the policy’s Account Value with 100% allocation, allowing for more funds for the policy owner.

 

1TPD coverage is available prior to the Policy Anniversary Date of age 70.

 

Savings/Investment Riders

Cultivate the habit of saving and investing regularly with PRUsaver or PRUsaver kid rider which improves your money’s worth with potentially higher returns and increased cash value.

 

 

For further details and the full list of benefits regarding the basic plan and these riders, please refer to the Sales Illustration and Policy Document.

Note: Jeremy chooses to purchase PRUvalue med (R&B 200, MVP RM1 million with Med Saver) under PRUmy medical plus and pay RM250 per month. However, he also has another two medical benefit options to choose from to suit his medical needs and financial affordability:

1. What is PRUwith you?

PRUwith you is a regular premium investment-linked insurance plan which pays the Basic Sum Assured upon the diagnosis of Total and Permanent Disability (TPD) before the Policy Anniversary Date of age 70 or death of the Life Assured, whichever occurs first. Rest assured that the Basic Sum Assured will be paid out because we will pay the amount upon survival of the Life Assured to policy maturity.

Being a basic plan, different riders (as stated in the table under product features) are attachable to be tailored to meet individual financial and protection needs.

2. Who can take up this package?

PRUmy medical plus is available to anyone between 14 weeks into pregnancy and 70 years old.

3. What is Med Saver?

If you choose a medical rider with Med Saver, you must first pay a fixed amount equivalent to Med Saver amount out of the eligible benefits before Prudential pays for any expenses (excluding the cost of Hospital Daily Room & Board and Intraocular Lens) for any one disability.

Med Saver applies to Hospital & Surgical Benefits, Outpatient Treatment Benefits, Maternity Complications Benefit (if any) and Emergency Treatment for Accidental Injury Benefit.

4. What is Deductible?

If you choose a medical rider with Deductible, you must first pay a fixed amount equivalent to Deductible selected out of the total accumulated eligible benefits within an annexure year, before Prudential pays the rest of the expenses. The costs of the eligible benefit accumulated for that annexure year will not be carried forward to the next annexure year.

If you already have a medical plan with an annual limit equivalent to (or higher than) the deductible amount, the eligible expenses in excess of the Deductible selected will be covered by the medical plan with Deductible.

Deductible applies to Hospital Daily Room & Board Benefit, Hospital & Surgical Benefits, Outpatient Treatment Benefits, and Other Benefits.

5. What is coinsurance?

Coinsurance is a cost-sharing arrangement under which you pay a specified percentage of the cost of an eligible benefit. If coinsurance is selected, you will have to pay 10% of the cost of an eligible benefit, subject to a minimum coinsurance amount of RM300 and a maximum coinsurance amount of RM1,000 for Hospital & Surgical Benefit, and a maximum coinsurance amount of RM2,000 for the Outpatient Treatment Benefit. The remaining balance is paid by Prudential up to the annual limit and lifetime limit, if applicable.

6. What is Med Value Point (MVP) in PRUvalue med?

Claims on eligible benefits will be payable in full (subject to Med Saver or Deductible, if applicable) up to the initial Med Value Point plus any accumulated Med Value Point Bonus. If the total accumulated eligible claims paid exceed the initial Med Value Point plus any accumulated Med Value Point Bonus, we will still provide continuous coverage up to the expiry age by paying 80% of the excess eligible benefit cost as long as the medical plan remains in force.

Outpatient Cancer Treatment and Outpatient Kidney Dialysis Benefits will be up to 1.5 times of the initial Med Value Point. Claims paid out for Outpatient Cancer Treatment and Outpatient Kidney Dialysis Benefits will be counted as part of Med Value Point.

7. What is Med Value Point Bonus in PRUvalue med?

For plans with Hospital Daily Room & Board (R&B) of RM300 and above, we will reward you with Med Value Point Bonus which increases your Med Value Point (MVP) by 2% of the initial MVP for every two policy years where you do not incur claims.

When total claims paid exceed the initial MVP plus any accumulated Med Value Point Bonus, no further Med Value Point Bonus shall be provided even if there are no further claims.

8. What is Annual No Claims Bonus (NCB) in PRUhealth?

If we do not pay you any claims under PRUhealth for the year, you will receive No Claims Bonus (NCB), where additional units are purchased for your investment in the following year. The amount of bonus paid depends on the plan that you have chosen.

If we have paid you any claim under PRUhealth, you will not receive any bonus in the following year. However, you will receive the bonus for subsequent years as long as we do not pay you any claims under PRUhealth in preceding year.

An example of the bonus mechanism, for a 25-year old male Life Assured with a PRUhealth 150 plan, expiring at age 100 and pays an annual premium of RM2,400:

Policy Years

Annual Premium (RM)

Any PRUhealth Claims Paid?

Qualify for Bonus?

Amount of Bonus Received (RM)

1

2,400

No

Yes

-

2

2,400

Yes

No

150

3

2,400

No

Yes

-

4

2,400

No

Yes

150

5

2,400

No

Yes

150

 

9. 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. The premiums are payable throughout the duration of the plan up to its maturity. Premiums can be paid yearly, half-yearly, quarterly, or monthly via Auto Debit, Credit/Debit Card, or Cash/Cheque.

Please refer here for details on cost of insurance for the medical riders, critical illness riders and payor riders.

Note: The insurance charge for basic benefits is guaranteed, whereas the insurance charges for the riders are not guaranteed and may be varied from time to time by giving you 3 months notice except for medical and critical illness benefit where 30 days notice will be provided).

10. How will my regular premiums be invested?

We will allocate a portion of the premium to purchase units in the investment-linked fund(s).

Any unallocated 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.

Through our PRUlink and PRUlink global funds that can cater to the financial risk appetite of a wide range of customers, you can have your premium invested in both local and even global markets. This way, you would have control not only over the amount of risk you are exposing your investments to but can also widen your investment scope internationally.

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

The eligibility for the benefits under the policy will start only after the waiting periods below from the effective date of the policy. Where Life Assureds of PRUwith you are unborn children, a

waiting period of 30 days from birth will be applicable for the death and TPD coverage. Otherwise, there is no waiting period for the death and TPD coverage under PRUwith you.

Benefit

Conditions

Waiting Period

Critical Illness & Payor Benefit

Heart attack, coronary artery bypass surgery, serious coronary artery disease, angioplasty and other invasive treatments for coronary artery disease and cancer

60 days

All other covered illnesses

30 days

Medical Benefit

Specified covered illnesses         

120 days

All other covered illnesses

30 days

Maternity Complications

365 days

Hospitalisation due to accidents

No waiting period

The waiting periods for other riders are detailed in the Product Disclosure Sheet and Sales Illustration.

 

 12. What are the exclusions of PRUmy medical plus?

Please click on the product/riders for the exclusion list:

PRUwith you

PRUvalue med

PRUhealth

PRUmillion med

Payor Basic

Crisis Care

  • This content contains only a brief description of the product and is not exhaustive. You are advised to refer to Prudential’s Product Disclosure Sheet, Sales Illustration, and the consumer education booklet on Life Insurance, Investment-Linked Insurance, Child Education Plan, and Medical and Health Insurance before purchasing the plan, and to refer to the terms and conditions in the policy document for details of the important features of the plan.
  • Please note that the package here consists of components that can be bought separately and you are not obligated to select all components of this package.
  • You should satisfy yourself that this product will best serve your needs. You should also satisfy yourself that the premium payable under the policy is an amount that you can afford. To achieve this, 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 may also contact the insurance company directly for more information.
  • The insurance charge for basic benefits is guaranteed, whereas other charges and the insurance charges for the riders are not guaranteed and may be varied from time to time by giving 3 months’ notice to policy owners (except for medical and critical illness benefit where 30 days’ notice will be provided). If we increase the insurance charge rates after the premium payment term, you may need to pay an additional premium or top-ups. Premiums for this plan are payable throughout the entire term of this policy.
  • If you cancel the policy in the early years, you may not be able to obtain the full value from the amount you have paid to us. When you surrender the policy, all benefits in the policy will be terminated.
  • Details of the fees and charges charged for providing the insurance coverage and its optional riders are detailed in the Product Disclosure Sheet and Sales Illustration.
  • There is a free-look period of 15 days after the delivery of your policy to allow you to review it if it meets your needs. If the policy is cancelled within this period, we will refund you the value of units (at the next pricing date) plus the premiums that are not invested, insurance charges, policy fees and taxes (if any) that we have deducted, less medical expenses that we may have already paid or agreed to pay.
  • It is important that any receipt that you receive should be kept as proof of payment of premiums.
  • PRUwith you and its attachable riders are not Shariah-compliant products.
  • Non-payment of premiums may cause this policy to lapse. Should you stop paying premiums, the policy may continue for as long as there are sufficient units in the respective accounts and will lapse when the value of investment units is insufficient to pay for the insurance and other charges.
  • For more information on the funds, please refer to their respective Fund Fact Sheet available on our website at www.prudential.com.my. You may also track the performance of your funds by checking the unit prices published daily on our website.
  • If you switch your current medical plan with another or from one provider to another, you may be subject to new underwriting requirements and waiting periods for the new plan.
  • You must inform us of any change in your occupation, avocation or sports activities because it may affect the premiums, terms, conditions and benefits.
  • Any age reference shall be on the basis of Age Next Birthday.
  • Prudential Assurance Malaysia Berhad (PAMB) is an insurance company licensed under the Financial Services Act 2013 and is regulated by Bank Negara Malaysia.

 

Prudential Assurance Malaysia Berhad
Member 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).

 

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.

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