PRUShield Review

Ward-class scope

PRUShield Plus

Singapore Restructured Hospital – Class A Ward and below; also covers B1, B2, C wards of restructured hospitals (with pro-ration applied when ward class is higher-class ward, private hospital, or private clinic/medical institution)

PRUShield Premier

Singapore Private Hospitals; also covers Class A, B1, B2, C wards of restructured hospitals (with pro-ration applied when ward class is lower than private hospital entitlement)

Claim limits (SGD)

PRUShield Plus

Policy Year Limit: $1,000,000; Lifetime Limit: Unlimited; Refresh Benefit: $1,000,000

PRUShield Premier

Policy Year Limit: $1,200,000 (or $2,000,000 if admitted to and treated by Panel Providers); Lifetime Limit: Unlimited; Refresh Benefit: $1,200,000

Co-payment & deductible

Panel hospitals & in/out-of-panel rules

PRUShield Premier offers an elevated Policy Year Limit of $2,000,000 (versus the standard $1,200,000) if the life assured is admitted to and treated by Prudential's Panel Providers. No explicit list of panel hospital names is printed in this wording. For PRUShield Plus, the higher Panel Provider limit does not apply.

Pre-existing conditions

The policy may be void if any information provided in the proposal form, supplementary proposal form and any correspondence is incomplete or inaccurate. An Offer of Conditional Acceptance may be issued with special terms and conditions (e.g. exclusions or loadings) for specific health conditions. The Future Insurance Option at life events is only available if the policy was purchased on standard terms (i.e. no Offer of Conditional Acceptance was issued). No further explicit verbatim statement on general pre-existing condition handling (excluded, loaded or accepted at standard rates) is set out in this portion of the wording beyond the underwriting references above.

Cancer treatment

Outpatient Cancer Treatment: reimburses Reasonable and Customary Expenses incurred for approved outpatient cancer treatment at MediSave/MediShield Life accredited cancer treatment centres. Treatment refers to chemotherapy, immunotherapy and radiotherapy (external except hemi-body, brachytherapy, hemi-body and stereotactic). Consultation fees, diagnostic and laboratory tests ordered by the Registered Medical Practitioner before such treatment are also covered. Cancer Drug Treatment must be on the Cancer Drug List (CDL); treatments not listed or not administered exactly as described in the CDL are non-CDL and will not be claimable under PRUShield unless otherwise stated. The CDL currently covers most cancer drug treatments approved by the Health Sciences Authority (HSA). The cancer drug treatment claim limit is based on a multiple (5x) of the MediShield Life limit for the specific cancer drug treatment. For patients receiving treatment for Multiple Primary Cancers, higher claim limits are given on an application basis; doctors are to send the application form to MOH and to Prudential for assessment. Cancer Drug Services (consultations, scans, laboratory investigations, treatment preparation and administration, supportive care drugs and blood transfusions) are payable as part of a cancer drug treatment up to 5x the MediShield Life limit per Policy Year. Proton Beam Therapy is covered up to $100,000 per Policy Year (inpatient, day surgery or outpatient) and must be an approved indication as stated on MOH's website. Cell Tissue and Gene Therapy Treatment is covered up to $250,000 per Policy Year for inpatient or day surgery procedures approved by MOH and HSA and recommended in writing as Medically Necessary by the attending Registered Medical Practitioner. Proton Beam Therapy and Cell Tissue & Gene Therapy Treatment are excluded from the Outpatient Cancer Treatment benefit and the Stem Cell Transplant Treatment benefit.

MediShield Life integration

PRUShield is the enhancement plan offered on top of the MediShield Life tier operated by the CPF Board. It provides additional benefits above MediShield Life for hospitalisation in B2 or C wards and above of restructured Hospitals or private Hospitals. We will pay the claims according to the benefits under this enhancement plan or MediShield Life, whichever is higher. The life assured, if insured under MediShield Life, shall enjoy all benefits of MediShield Life as provided under the Act and Regulations. If the life assured is a foreigner who is not a Singapore Permanent Resident, then the PRUShield plan does not cover the MediShield Life tier operated by the CPF Board and we will pay claims according to the benefits under the PRUShield plan. Premiums may be paid using MediSave up to a maximum withdrawal limit per life assured per Policy Year as stipulated by the CPF Board; if the premium due exceeds the maximum withdrawal limit or there are insufficient funds, the balance premium can be paid by cash within the Grace Period.

Mental health cover

Psychiatric Treatment: pays for medical expenses incurred, up to $8,000 per Policy Year (PRUShield Premier) or $7,000 per Policy Year (PRUShield Plus), if the life assured receives inpatient psychiatric treatments. Also includes Pre- and Post-hospitalisation expenses incurred for Psychiatric Treatment. Payment for all eligible expenses incurred under the Psychiatric Treatment, including Short Stay Ward, shall be accumulated and paid up to the respective limit. This benefit is subject to the Deductible, Co-insurance and Pro-ration.

Maternity

Serious Pregnancy and Delivery-related Complications: reimburses medical expenses incurred when any of the listed complications (ectopic pregnancy, pre-eclampsia and eclampsia, disseminated intravascular coagulation, miscarriage after 13 weeks, fatty liver during pregnancy, amniotic fluid embolism, abruptio placentae, postpartum haemorrhage requiring hysterectomy, gestational diabetes mellitus, placental insufficiency and intrauterine growth restriction, antepartum/intrapartum/postpartum haemorrhage, placenta praevia, cervical incompetency, accreta placenta, obstetric cholestasis, twin to twin transfusion syndrome, infection of amniotic sac and membranes, fourth degree perineal laceration, uterine rupture, postpartum inversion of uterus, obstetric injury or damage to pelvic organs, complications resulting in a caesarean hysterectomy, retained placenta and membranes, abscess of breast, hydatidiform mole and subsequent complications including choriocarcinoma, medically necessary abortions, still-birth, maternal death) is first diagnosed by an obstetrician after 10 months from the Cover Start Date of the policy or the date of reinstatement (if any), whichever is later. We do not pay for delivery charges except in the event of a Caesarean Section arising from one of the listed Serious Pregnancy and Delivery-related Complications. Congenital Abnormalities of a female life assured's biological child: pays hospitalisation expenses (up to $20,000 per lifetime limited to $5,000 per child for Premier; up to $16,000 per lifetime limited to $4,000 per child for Plus) for Medically Necessary treatment relating to birth defects, hereditary conditions and congenital sickness or abnormalities of the child during the first 24 months from the date of birth, provided conditions are first diagnosed or symptoms first appear after 10 months from the Cover Start Date or reinstatement date. This benefit is subject to the Deductible, Co-insurance and Pro-ration.

Exclusions

• We do not pay under the Inpatient and Day Surgery benefits and Outpatient Hospital benefits if the medical expenses are incurred at non-MediShield Life accredited Hospitals or treatment centres.
• We do not pay for claims where the medical expenses have been paid by other medical insurance or you have received reimbursement from any other source.
• We do not pay for the expense of acquiring an organ from a living donor under the Organ Transplant benefit.
• We do not pay if an organ transplantation is illegal or arises from any illegal transaction or practice.
• The Organ Transplant benefit does not cover organ transplant surgery if the life assured is the donor of the organ.
• We do not pay for Inpatient and Outpatient Proton Beam Therapy and Cell Tissue & Gene Therapy Treatment under the Outpatient Cancer Treatment benefit.
• We do not pay for Inpatient and Outpatient Proton Beam Therapy and Cell Tissue & Gene Therapy Treatment under the Stem Cell Transplant Treatment benefit and Radiosurgery benefit.
• We do not pay for Day surgery, Outpatient Hospital benefits, Stem Cell Transplant treatment, Organ Transplant, Living Organ Donor Transplant, Psychiatric Treatment, Continuation of the Autologous Bone Marrow Transplant Treatment for Multiple Myeloma, Inpatient and Outpatient Proton Beam Therapy, and Cell Tissue and Gene Therapy Treatment under Emergency Medical Treatment outside Singapore.
• We do not pay for Outpatient Hospital benefits, Living Organ Donor Transplant, Continuation of the Autologous Bone Marrow Transplant Treatment for Multiple Myeloma, Inpatient and Outpatient Proton Beam Therapy, Cell Tissue and Gene Therapy Treatment, and Serious Pregnancy and Delivery-related Complications under Planned Overseas Medical Treatment.
• Hospice and convalescent centres/hospitals/homes are not covered under the Community Hospital benefit.
• We do not pay pre-hospitalisation expenses incurred prior to the diagnosis of Serious Pregnancy and Delivery-related Complications.
• All alternative and traditional treatments are excluded from Post-hospitalisation Follow-up Treatment and Services. Examples of alternative and traditional treatments are, but not limited to, Traditional Chinese Medicine treatment, Chiropractic treatment and Osteopathic treatment.
• We will not pay for the cost of delivery or courier of medication for outpatient telemedicine consultations.
• We do not pay for any counselling service charges under the Living Organ Donor Transplant benefit.
• We do not pay for any pre- or post-hospitalisation and any counselling service expenses incurred by the organ donor under the Living Organ Donor Transplant benefit (when life assured is the organ recipient).
• Cancer drug treatments not listed in the Cancer Drug List (CDL) or not administered exactly as described in the CDL are non-CDL and will not be claimable under PRUShield unless otherwise stated.
• Cancer drug services incurred before the cancer is diagnosed, after the cancer has gone into remission, or once the course of treatment has ceased, will not be covered.
• We do not pay for Cell Tissue and Gene Therapy Treatment relating to congenital abnormalities of the life assured under the Congenital Abnormalities benefit.
• We will not apply Proton Beam Therapy coverage unless it is an approved proton beam therapy indication as stated on the MOH's website.
• Cell Tissue and Gene Therapy Treatment must be approved by MOH and the Health Sciences Authority (HSA) and satisfy all other guidelines; if not, it will not be covered.
• We will not pay for any pre- or post-hospitalisation expenses incurred in relation to Outpatient Proton Beam Therapy.
• We will not pay for any pre or post-hospitalisation expenses incurred in relation to the Autologous Bone Marrow Transplant Treatment for Multiple Myeloma.
• The Refresh benefit is only applicable for inpatient hospitalisation; we will not pay for any outpatient, day surgery, pre- or post-hospitalisation expenses or for any other inpatient treatment related to a previously known condition under the Refresh benefit.
• We do not pay for delivery charges under Serious Pregnancy and Delivery-related Complications except in the event of a Caesarean Section arising from one of the listed complications.
• Medically necessary abortions due to a miscarriage that does not meet the definition of miscarriage under the miscarriage sub-benefit will not be covered under the medically necessary abortions sub-benefit.
• Your policy may be void if any information you give us is incomplete or inaccurate or you do not comply with the conditions of your policy.
• If you fail to pay your premium within the Grace Period, your policy automatically terminates and claims for Illness or Injury incurred within the Grace Period will not be considered.

Available riders