Understanding Medical Revision

To ensure you are always adequately protected, Prudential regularly reviews our medical plans against the current healthcare costs. Due to escalating healthcare costs and medical inflation that has resulted in higher claims for the medical portfolio, Prudential may undertake this revision every year, if necessary, to help ensure your long-term medical protection will be there for you when you need it.

The additional premium/ top-up is required to cover the increased insurance charges. With the increase in insurance charges, more units will be deducted from your policy account value to pay for the higher insurance charges. If you continue to pay the same amount of premium after the new premium effective date or do not top-up your policy after this revision, it is possible that your policy’s sustainability may be impacted and the policy may lapse earlier than expected. As for a Universal Life policy, No-Lapse Guarantees will be affected if a customer continues to pay the same amount of premium after the new premium effective date.

How insurance works and is calculated, is by pooling and spreading the risks among all those who are insured in the portfolio. Health/medical insurance is no different. When you purchase health insurance, you join a group of other customers who have similar risk characteristics (such as age group, plan type, gender etc.). We (the insurance company) cover the entire group rather than individuals. Similarly, when we review our medical portfolio, it is conducted across the board.

The insurance charges and/or premium rates of our medical plans are not guaranteed, as shown in our product materials and product illustrations, as well as the policy. They can be revised provided that prior notice is given to customers (according to the notice period stated in the policy document).

All coverage and benefits remain the same.

The impact on the policy's overall account value should be minimal because the additional premium is utilised to cover the increased insurance charges.

The revision of premium and insurance charges take effect from the policy anniversary date. Customers will receive their Revision Notification Letter at least 30 days before their policy anniversary date, depending on the type of medical plan.

There are a variety of options that may apply to your specific situation. Listed below are some of the options you may wish to consider in reviewing your current policy coverage and affordability: -

If you would like to review your existing coverage or consider the above options that may better meet your protection and financial needs, please do not hesitate to reach out to your Prudential Wealth Planner or Bank Representative.

Deductible or Med Saver is usually a fixed amount you pay out of your pocket for medical expenses before your medical plan starts to pay out. In the case of a RM300 Deductible or Med Saver amount, you will have to pay a fixed amount of RM300 of total expenses covered under your policy for a disability (excluding the cost of daily room & board). The remaining balance of eligible benefits will be paid by Prudential up to the annual and lifetime limits, subject to reasonable and customary charges. Please refer to your policy document for more details.

We continuously engage and work with our healthcare providers to maintain high quality care and preferred rates. We also have on-going discussions with the Life Insurance Association of Malaysia (LIAM), Ministry of Health (MOH) and Association of Private Hospitals, Malaysia (APHM) to address escalating healthcare costs.

Every year, we evaluate our medical portfolio to align with current healthcare costs so we can ensure ongoing protection for you and your loved ones. However, the trend of rising medical inflation and claims utilisation has negatively impacted the long-term sustainability of the medical portfolio.

Therefore, it is necessary to review the insurance charges and/or premium rates of your medical plan this year. This ensures that your long-term medical protection remains reliable and available when you need it.

Waiver riders are optional riders under which the future premium of your policy (in whole or in part) will be waived by Prudential when any of the claimable event(s) defined in your policy document occurs.

Medical rider premiums are not guaranteed and therefore not covered by waiver rider. There is no impact to waiver rider due to this revision. 

If there is a waiver claim on your policy, Prudential will waive part of the annualised premium. The medical rider premium will be revised as the medical rider premium is not guaranteed and not covered by waiver rider. You are still required to continue paying the premium amount that is not waived by us to ensure continuous insurance coverage.

You are required to pay the revised premium to enjoy long term protection. In the event of non-payment of premium and if your policy has acquired surrender value, the premium due will be automatically covered under the Automatic Premium Loan scheme, with interest charged. You will continue to enjoy the benefits until the surrender value is fully exhausted.

There is no change to your current payment arrangement and the new premium will be deducted upon the new revision date. 

For policies currently under the Waiver status, the above applies as the medical rider premium is revised.

For policies under minor claim, the premium for the medical plan will still increase. The premium will increase from the Next Premium Due Date (NPDD) onwards.

For policies under discounted advance premium scheme, you will need to pay the difference in premium after the revision. You will receive a notification letter from us detailing the additional premiums that you are required to top-up. Please pay the additional premiums required to ensure your discounted advance premium scheme remains applicable and to continue enjoying your policy coverage until policy maturity.

With the premiums you pay every month, you get in return long-term financial protection, in which the insurance company will pay a portion of your medical expenses if you get hospitalised or a sum of money to your loved ones in the event of death and permanent disability.

There are mainly two types of insurance, namely life insurance and general insurance which cover different aspects in your life.

Medical and Health Insurance (MHI) is designed to reimburse the cost of private medical treatment, which can be very expensive, especially with hospitalisation and surgery.

There are different types of medical plans available in the market, such as hospitalisation and surgical plans or critical illness plans: –

• Hospitalisation and surgical insurance plan generally covers your room and board in the hospital, laboratory fees, use of special facilities, nursing care, and certain medicines and supplies.

• Critical illness plan is typically where the insurance company makes a lump sum cash payment to the policyholder if he or she is diagnosed with one of the critical illnesses listed in the policy.

Our Hospital Alliance Services (HAS) is a value-added service to facilitate insurance claims for our medical policyholders, at no extra charge.

For more information, click here.

The Supplementary Schedule that you receive contains details of the revision and a summary of the projected insurance charges / premium rates for your medical plan. It forms part of your existing Policy upon the respective effective date(s) indicated and supersedes the provisions in the existing schedule(s).

It is important for you to note that if any part of your Policy in connection with the provisions in the Supplementary Schedule varies after the date of the Supplementary Schedule but before your policy anniversary date, the provisions in this Supplementary Schedule will not apply.

Deductible is usually a fixed amount you pay out of your pocket for medical expenses before your medical and health Insurance plan starts to pay out. In the case of a RM300 Deductible amount, you will have to pay a fixed amount of RM300 of total expenses covered under your policy for a disability (excluding the cost of daily room & board). The remaining balance of eligible benefits will be paid by Prudential up to the annual and lifetime limits, subject to reasonable and customary charges. Please refer to your policy document for more details.

We encourage you to review your insurance coverage at least once a year. This is because as you progress in life, your needs and priorities may change over time; and with healthcare costs consistently outpacing inflation, it is all the more important to ensure that you are always adequately insured.