Congratulations on your promotion/confirmation and embarking on this new journey with your company! As part of your new role, your company is providing medical benefits. This page will brief you on some important details about the medical coverage you are entitled to.
Prudential’s hospitalization benefits are managed by PMCare. For hospitalization, please proceed to Prudential’s panel hospitals. If your employer provides outpatient general practitioner (GP) or specialist visit benefits, please refer to PMCare’s panel clinics.
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Antony Lim
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Frequently Asked Questions (FAQ)
What do I need to inform the hospital during admission?
As Prudential group benefits are managed by PMcare, please inform the hospital to search for your IC in the PMcare system. Ensure the hospital is within Prudential’s panel.
How much do I need to pay if I use company’s group insurance?
There are no co-payments (you pay a portion of the bill while the insurance covers the rest). You will need to pay any amount exceeding the entitled daily room & board, annual limit, hospital admin charges, or any non-claimable items.
What if I stay in a room that costs more than I am entitled to?
You will need to pay the difference, which you can claim from your personal medical insurance.
Can I claim receipts for follow-up visits?
If you were previously hospitalized, you can claim receipts for follow-up visits that occur within 90 days after discharge. However, this will be on a reimbursement basis (you pay first and submit a claim afterward).
I visited a few doctors before hospitalization. Can I claim these visits?
Yes, you can claim receipts for visits that occur within 60 days before hospitalization. However, this will be on a reimbursement basis (you pay first and submit a claim afterward).
What if I am admitted to a non-Prudential panel hospital?
You will need to pay the bill first and then submit a claim request. Claiming directly with Prudential ensures you are not being charged unreasonably. The insurance company has the right to only pay the reasonable amount, leaving you responsible for any overcharged amount. Sometimes, panel hospitals offer discounts, so it is advisable to admit to Prudential’s panel.
Can I claim consultation bills from clinics or specialists?
Medical benefits are only for hospitalization. If hospitalized, you can claim consultation fees that occur within 60 days before hospitalization and follow-up fees within 90 days after discharge. Except for accidents, if there is no hospitalization or outpatient procedure, consultation or physiotherapy is not claimable.
Except for PMCare outpatient benefits, consultations with specialists without hospitalization are claimable. Please check with your employer if you are eligible for this benefit.
Can I claim consultation bills due to an accident from clinics or hospital’s emergency department?
Yes, you must seek treatment within 24 hours after the accident. Receipts for follow-up visits within 60 days after the accident date are claimable. Receipts for follow-up emergency dental treatment within 14 days after the accident date are also claimable. Please get the doctor to write a simple note behind the receipt with the following information:
- What, when, and how the accident happened?
- What type of scan or treatment was done?
- Describe the injury or diagnosis.
- What is the suggested treatment?
- Doctor’s stamp and signature.
What is Specific Illnesses?
Specified Illnesses means the following illnesses/diseases and its related conditions and
complications:
- Hypertension, diabetes mellitus and cardiovascular disease;
- All tumours, cancers, cysts, nodules, polyps, stones of the urinary system and biliary system;
- All ear, nose (including sinuses) and throat conditions;
- Hernias, haemorrhoids, fistulae, hydrocele, varicocele;
- Endometriosis including disease of the reproduction system；or
- Vertebro-spinal disorders (including disc) and knee conditions.