a&h module: medishield life
TRANSCRIPT
Confidential and Proprietary Information.2Slide
Disclaimer
This presentation is prepared by Prudential Assurance Company Singapore (Pte) Limited.
The information presented is strictly confidential and for internal use only and cannot be reproduced,
amended or circulated in whole or in part to any other person without our prior written consent.
These should not be used for sales presentation.
Information presented is not exhaustive. For exact terms, conditions and specific details applicable to the
insurance products mentioned, please refer to the relevant Product Summary and Policy Document.
This presentation is for your information only and does not have regard to the specific investment
objectives, financial situation and particular needs of any persons.
The information is accurate as at 16 September 2021 unless otherwise indicated.
Confidential and Proprietary Information.3Slide
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Compliance ABC
Confidential and Proprietary Information.4Slide
What is MediShield Life?
MediShield Life Benefits
MediShield Life Premiums & Subsidies
MediShield Life & Integrated Plans (IP)
Our Solutions
Updates
Agenda
Confidential and Proprietary Information.5Slide
LaunchedNov 2015
MediShield Life (MSHL) is a national health insurance scheme that provides lifelong protection for all Singapore Citizens and
Permanent Residents against large hospital bills.
What is MediShield Life?
Confidential and Proprietary Information.6Slide
What is MediShield Life?
MediShield Life Benefits
MediShield Life Premiums & Subsidies
MediShield Life & Integrated Plans (IP)
Our Solutions
Updates
Agenda
Confidential and Proprietary Information.7Slide
For AllAll Singaporeans and PRs will be
covered for all conditions
For LifeCoverage for life
Better protectionIncreased benefits, so we pay
less for large bills
MediShield Life – What is it?
For more info: https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/what-medishield-life-benefits
Confidential and Proprietary Information.8Slide
• MediShield Life will cover all Singaporeans & PRs, including those with pre-existing conditions
• Those with serious *pre-existing conditions pay a flat Additional Premium of 30% of MediShield Life premiums for 10 years.
-Meant to be symbolic to reflect higher risk
-Does not cover full cost
For All, For Life
https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/coverage-for-pre-existing-conditions *
Confidential and Proprietary Information.9Slide
A pre-existing conditions is a medical condition that an individual already has BEFORE he/she is covered under MediShield Life/IP
Jane, insured without exclusion under MediShield Life/IP and developed a condition after insurance coverage started
Jamie, insured with exclusion on medical condition under MediShield Life/IP
Does not pay Additional Premium
May have to pay Additional Premium
YES
May not have to pay Additional Premium
Tony, uninsured with medical condition
NO
Is pre-ex condition serious?
With pre-ex conditionNo pre-ex condition
What is Pre-Existing Condition?
Confidential and Proprietary Information.10Slide
• Applicable to serious pre-ex conditions
–The Ministry has conducted an extensive review on the serious pre-existing conditions that will be subjected to Additional Premiums, with specialist advice from clinicians.Examples of serious pre-existing conditions:
• Life-threatening and may result in permanent disability
• Have high-risk of future complications or recurrence and/or may require prolonged treatment
• Stroke, cancer, kidney failure and heart diseases
Individuals will be notified individually before the start of MediShield Life if they have to pay the 30% Additional Premium
What conditions will the Additional Premiums be applied to?
Confidential and Proprietary Information.11Slide
Better Protection
• MediShield Life is targeted at Class B2/C coverage.
• MediShield Life pays out a level of benefits for private hospital or Class A/B1 bills that is pegged to the equivalent Class B2/C expenses
-If you are hospitalised in a Class B1 ward, your bill will be pro-rated by 43% (SC) and 38% (PR) before the MediShield Life payout is calculated
-If you are hospitalised in a Class A ward/private hospital, your bill will be pro-rated by 35% before the MediShield Life payout is calculated
• MediShield Life will continue to pay for a small portion of higher ward stays
Confidential and Proprietary Information.12Slide
MediShield Life Benefits
Source: https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/what-medishield-life-benefits
Note: MSHL payouts are subjected to deductible, co-insurance and respective policy & benefits limits
Confidential and Proprietary Information.13Slide
MediShield Life Benefits – Your Claim
Source: https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/how-to-make-a-medishield-life-claim
You are responsible to pay for parts A, B & C of your claim
• (A) Maximum Claim Limit: $100,000 per policy year
• (B) Deductibles: Fixed amount you have to pay per year before any claim is payable
• (C) Co-insurance: A percentage of the claimable amount that you have to pay after deductibles. Ranges from 3% to 10% (depending on bill size).
• (D) Portion covered by MSHL
Confidential and Proprietary Information.14Slide
What is MediShield Life?
MediShield Life Benefits
MediShield Life Premiums & Subsidies
MediShield Life & Integrated Plans (IP)
Our Solutions
Updates
Agenda
Confidential and Proprietary Information.15Slide
1. MediShield Life premiums are risk-pooled to support the payouts
and benefits under MediShield Life.
2. Government provides significant support to keep premiums
affordable for Singapore Citizens and Permanent Residents
3. This includes those who need to pay Additional Premiums.
MediShield Life Premiums & Subsidies
Confidential and Proprietary Information.16Slide
Government will provide support for MediShield Life premiums, to keep them affordable
Premium Subsidies for Low to Medium Income
Transitional Subsidies
Pioneer Generation Subsidies
Additional premium
support for the needy
MediShield Life Premiums & Subsidies
Confidential and Proprietary Information.17Slide
Merdeka Generation Subsidies and MediSave top-ups
https://www.mof.gov.sg/news-publications/press-releases/pioneer-and-merdeka-generation-seniors-to-receive-278-million-in-medisave-top-ups-in-july-2021
MediShield Life Premiums & Subsidies
Confidential and Proprietary Information.18Slide
Range between 15 - 50%
+ +
You live in HDB FlatOR in Private Housing with Annual Value ≤$21,000
Your Household Monthly Income per Household member is ≤ $2,800
You do not own any property, or have only one property to your name
Premium Subsidies for Lower to Middle Income
Confidential and Proprietary Information.19Slide
Age Next BirthdaySubsidies as a percentage of premiums
(for Singapore Citizens, non Pioneer Generation)
Monthly HH income per person? $1,200 or less $1,201 to $2,000 $2,001 to $2,800
Annual value of property? < $13,000* (includes all HDB flats)
Does individual own multiple property?
No
1 – 40yo 25% 20% 15%
41 – 60yo 30% 25% 20%
61 – 75yo 35% 30% 25%
76 – 85yo 40% 35% 30%
86 – 90yo 45% 40% 35%
>90 50% 45% 40%
• If AV is higher than $13k but less than $21k, will receive 10% points less than listed subsidy rates.• PRs receive 50% subsidies to that of a similar Singaporean • https://www.moh.gov.sg/cost-financing/healthcare-schemes-subsidies/medishield-life/medishield-life-
premiums-and-subsidies/premium-subsidy-tables
Premium Subsidy Table
Confidential and Proprietary Information.20Slide
MediShield premium
MSHL premium BEFORE subsidy
MediShield Premium
MediShield premium
MediShield Life premium
Increase in Premiums
What is net premium increase?
Confidential and Proprietary Information.21Slide
MediShield Life premium payable
MediShield premium
MSHL premium BEFORE subsidy
With MSHLAFTER subsidy
MediShield Premium
Subsidy
MediShield premium
MediShield Life premium
Increase in Premiums
Net Premium Increase
What is net premium increase?
Confidential and Proprietary Information.22Slide
MediShield Life premium payable
MediShield premium
MSHL premium BEFORE subsidy
With MSHLAFTER subsidy
MediShield Premium
Subsidy
MediShield premium
MediShield Life premium
Increase in Premiums
Net Premium Increase
What is net premium increase?
Confidential and Proprietary Information.23Slide
MediShield Life premium payable
MediShield premium
With MSHLAFTER subsidy
MediShield Premium
Subsidy
What happens if subsidies are large?
Confidential and Proprietary Information.24Slide
✓ Given to all Pioneers.
✓ More generous than premium subsidies for non-pioneers.
✓ Pioneers receive special MediShield Life premium subsidies of between 40% –60%, depending on age.
✓ Pioneers will also receive $250 - $900 a year in MediSave top-ups (depending on year of birth) for life, which can be used to pay for their MediShield Life premiums
Who are they?Special generation of Singaporeans are aged 65 and older by the end of 2014.Obtained citizenship on or before 31 December 1986
Source: https://www.moh.gov.sg/medishield-life/medishield-life-premiums-and-subsidies
Pioneer Generation Subsidies and MediSave top-ups
Confidential and Proprietary Information.25Slide
• No one will drop out because of inability to afford premiums
• Meant for needy Singaporeans, who cannot afford MSHL premiums even after subsidies
• IP policyholders are not eligible for Additional Premium Support
• However, if IP policyholders fall into financial difficulty and have to drop their IP, they will retain their MSHL coverage and be eligible for Additional Premium Support if they cannot afford their MSHL premiums.
Additional Premium Support for Needy
Confidential and Proprietary Information.26Slide
✓ From 1 July 2019, Merdeka Generation seniorswill receive additional Merdeka GenerationSubsidies of 5% of their annual MediShield Lifepremiums, increasing to 10% after they turn75 years old, regardless of their householdmonthly income or the Annual Value of theirhome. This is on top of the existing PremiumSubsidies that the seniors may receive.
✓ Merdeka Generation members will also receive$200 a year in MediSave top-ups, every Julyfor five years from 2019 to 2023. These top-ups can be used to pay for their MediShieldLife premiums.
https://www.mof.gov.sg/news-publications/press-releases/pioneer-and-merdeka-generation-seniors-to-receive-278-million-in-medisave-top-ups-in-july-2021
Merdeka Generation Subsidies and MediSave top-ups
Confidential and Proprietary Information.27Slide
Source: https://www.merdekageneration.sg/
Merdeka Generation Subsidies and MediSave top-ups
Who are they?
You are eligible for the Merdeka Generation Package if you:
• Were born from 1 January 1950 to 31 December 1959; and• Became a Singapore citizen on or before 31 December 1996.
The Merdeka Generation Package is also given to seniors who:
• Were born on or before 31 December 1949; and• Became Singapore citizens on or before 31 December 1996; and• Do not receive the Pioneer Generation Package
Confidential and Proprietary Information.28Slide
Source: https://www.merdekageneration.sg/
COVID-19 Subsidies
Confidential and Proprietary Information.29Slide
Low to Middle Income Premium Subsidy
Pioneer Generation Subsidy
Premium Support for the needy
Merdeka Generation Subsidy
COVID-19 Subsidy
Singaporeans with Household per capita Income ≤ $2,800
Yes, subject to means testing
No Yes, subject to means testing
Yes Yes, applied on net premium increase
Pioneer Generation No Yes Yes, subject to means testing
Yes, Provided they do not receive pioneer generation subsidy
Yes, applied on net premium increase
Permanent Residents
Yes, subject to means testing. PRs receive 50% of what SG will be getting
No No No No
Summary
Confidential and Proprietary Information.30Slide
Check out the Premium Calculator at https://www.moh.gov.sg/cost-financing/healthcare-schemes-subsidies/medishield-
life/medishield-life-premiums-and-subsidies/medishield-life-premium-calculator
How to get a quick premium estimation?
Confidential and Proprietary Information.32Slide
What is MediShield Life?
MediShield Life Benefits
MediShield Life Premiums & Subsidies
MediShield Life & Integrated Plans (IP)
Our Solutions
Updates
Agenda
Confidential and Proprietary Information.33Slide
COMMON MISCONCEPTIONS“MediShield Life is duplicate coverage + double payment!”“We are not eligible for MediShield Life premium subsidies”
“We don’t benefit from MediShield Life!”
66% of
Singaporeans have IPs
Most Do not know how IPs and MediShield are related
Integrated Plans (IP) – Did you know?
Source: https://sbr.com.sg/healthcare/news/chart-day-two-thirds-singapores-population-covered-insurance-programme
Confidential and Proprietary Information.35Slide
Additional Private
Insurance Coverage
Inte
gra
ted S
hie
ld
Pla
n
• Provides basic coverage targeted at large hospital bills in Class B2/C (public hospitals)
• Administered by CPF Board
•Provides additional benefits and higher coverage in Class B1/A (public hospital) and Private Hospitals •Additional coverage administered by private insurer
MediShieldLife
Scope of Coverage Premiums
• Policyholders pay an additional premium for the additional private insurance coverage• Payable by MediSave up to a certain limit; some cash outlay may be needed
•Policyholders pay a basic MSHL premium• Fully payable by MediSave
All Integrated Shield Plan policyholders are already covered by MediShield Life.There is NO duplicate coverage, and there is NO double premium payment.
How are IPs related to MediShield/MediShield Life?
2 components
Confidential and Proprietary Information.36Slide
Premiums: first paid to IP insurer who will then pay to CPF
Claims: first paid by IP insurer who will then take from CPF
How do IP premiums and claims work?
Confidential and Proprietary Information.37Slide
With MSHL
• Jamie will be covered by MSHL for all conditions.
• The exclusion on knee-related conditions will only be applied on the addtl private insurance
Payout:
Today
Coverage: • Jamie is covered by an IP, but has an exclusion on knee-related conditions
Additional private
insurance coverage
No payout
MediShield Life
MSHL pays out
When he is hospitalised for a knee injury….
Example: Impact of MSHL on IP policyholder with an exclusion
Confidential and Proprietary Information.38Slide
• Yes, IF they meet the eligibility criteria.• The applicable subsidies will be applied on the
MediShield Life portion of their IP
Can IP policyholders receive premium subsidies?
Confidential and Proprietary Information.39Slide
Upgrading
To highlight to IP policyholder that:
• The upgraded portion of the IP benefits would be subject to additional underwriting
•New conditions that developed after he became a policyholder of the original IP would be covered up to the benefits of the original IP.
MediShield Life
Addtl pvtinsurance coverage
MediShield Life
Original Addtlpvt insurance coverage
No additional underwriting
Upgraded portion
Additional underwritingOriginal IP
Upgraded IP
Downgrading
To explain to IP policyholder that:
• Depending on ward preference and affordability, he has option to downgrade to a lower IP
• Downgrading is done without additional underwriting
• Even if he wants to cancel his IP, he will still be covered under basic MSHL
What should policyholders know about upgrading/ downgrading?
Confidential and Proprietary Information.40Slide
MediShield Life premiums
Additional private insurance premiums
• You are able to use your MediSave account to pay for your Integrated Shield Plan’s premiums, subject to the Additional Premium Limits (AWL).
• Cash outlay may be required for premiums above the AWL.
IP
P
rem
ium
AWL
Fully payable by Medisave
LegendAWL: Additional Withdrawal Limit
What is the withdrawal limits for Integrated Shield Plan?
Additional Withdrawal Limits for IP
• ANB 1 to 40: $300• ANB 41 to 70: $600• ANB 71 and above: $900
Confidential and Proprietary Information.41Slide
IP-equivalent plan does not have MSHL component, but premiums are payable by Medisave
MWL for full IP-equivalent premium = Standard MSHL premium +AWL
2 tier approach for IPs (ie: integrated with MSHL component)
Additional private insurance premium
Standard MSHLPremium
AWL
Payable by cash
Payable by Medisave
IP-equivalent premiumMWL
Payable by cash
Additional Premium
Standard MSHL premium
AWL
For SC/PRs For Foreigners
Approach towards Foreigners with Non-Integrated Plans
Confidential and Proprietary Information.42Slide
Example: 2 individuals in same age group
Ben, Foreigner with non-integrated plan
Jane, SC with IP (has MSHL premium loading)
Impact of Restructured MWLs for Foreigners with Non-Integrated Plans
Confidential and Proprietary Information.43Slide
The significance of 30% loading is symbolic, does not reflect actual costs of coverage. Government will cover the bulk of the costs.
Risk Loading by MediShield Life
• Period of loading: 10 years
• Affected policyholders will be notified individually.
• Conditions subject to MSHL Additional Premiums may differ from those that private insurers consider for risk-loading/exclusions
Confidential and Proprietary Information.44Slide
Standard Integrated Shield Plan
A new Standard Integrated Shield Plan (Standard IP) targeted at Class B1-level coverage has been made available from all IP-insurers from 1 May 2016. The Standard IP is a private insurance product which gives Singaporeans the option of additional coverage beyond MediShield Life, targeted at Public Hospital Class B11.
Standard IP Benefits
The benefits of the Standard IP are identical across all IP insurers. This enables Singaporeans to compare premiums across insurers easily and make an informed decision as to which plan suits their needs. Just like MediShield Life, the Standard IP will offer coverage for hospitalisation stays and selected outpatient treatments and will have co-payment features of claim limits2, deductible and co-insurance.
1. Patients hospitalised in Class B1 wards have a choice of doctor, and Class B1 wards have 4 beds, TV, and are air-conditioned.
The Government provides subsidies of 20% for Public Hospital Class B1 wards for Singapore Citizens.
2. Standard IP benefits are sized to fully cover 9 out of 10 Public Hospital Class B1 bills
Standard IP
Confidential and Proprietary Information.45Slide
MediShield Life
• https://www.moh.gov.sg/cost-financing/healthcare-schemes-subsidies/medishield-life
• https://www.cpf.gov.sg/eSvc/Web/Schemes/MedisaveCalculator/Step1
Check for MediShield/ IP Coverage
• Check at CPFB website > Login Singpass > “My Messages”- Under “Insurance”
Where to get more info?
Confidential and Proprietary Information.46Slide
What is MediShield Life?
MediShield Life Benefits
MediShield Life Premiums & Subsidies
MediShield Life & Integrated Plans (IP)
Our Solutions
Updates
Agenda
Confidential and Proprietary Information.47Slide
• PRUExtra CoPay** - Covers Deductibles and Co-insurance
**PRUExtra CoPay can only be added to PRUShield (as charged) plans^ MediShield Life is not available to Foreigners
• PRUShield Plus- Covers treatment up to Class A ward in Restructured Hospitals level
• PRUShield Premier- Covers treatment up to standard room in Private Hospitals level
• MediShield Life^
- MediShield Life is a basic health insurance plan, administered by the CPF Board that provides coverage up to Class B2/C ward level in Restructured Hospitals (limits apply)
Co-InsDeductible
Private Hospitals
Restructured Hospitals
Class C / B2
• Cash• MediSave
Main Plan
Main Plan
Optional Rider
Healthcare Financing in Singapore
• PRUShield Standard- Covers treatment up to Class B1 ward in
Restructured Hospitals level
Main Plan
Confidential and Proprietary Information.48Slide
PRUShieldPremier
PRUExtra
Premier CoPay
PRUExtra Preferred CoPay
PRUExtraPremier Lite CoPay
PRUShieldPlus
PRUExtra Plus CoPay
PRUExtra Plus Lite CoPay
~PRUShieldStandard Plan
Optional Rider
Optional Rider
No Rider
Hospitalisation Coverage
~ For Singaporeans and Permanent Residents of Singapore only.
Feb 2021 Confidential and Proprietary Information.49Slide
PRUShield Suite of Base and Supplementary Plans
Private health insurance plan on top of MSHL to extend medical coverage up to Class B1 wards
in a Public Hospital
03
Not Applicable
PRUShieldStandard
Supplementary plan
As charged private health insurance plan on top of MSHL
to extend medical coverage for a Standard ward in a Private
Hospital
01PRUShield
Premier
Supplementary plan
PRUExtraPremierCoPay
PRUExtraPreferred
CoPay
PRUExtraPremier Lite
CoPay
All Singapore
Private Hospitals
All Singapore
Private Hospitals
SingaporePrivate
Hospitals under our Panel or
Non-panel providers
As charged private health insurance plan on top of MSHL to
extend medical coverage up to Class A wards in a Public
Hospital
02PRUShield
Plus
Supplementary plan
PRUExtraPlus CoPay
SingaporePublic Hospitals(Class A Ward)
PRUExtraPlus Lite CoPay
Confidential and Proprietary Information.50Slide
✓ Comprehensive as-charged cover for hospitalisation and medical treatments
✓ Covers up to 95% of the PRUShield deductible and half of the PRUShield co-insurance
✓ 180 days for pre- and 365 days for post-hospitalisation treatments for all conditions (longest in the market)
✓ Planned Overseas Medical Treatment Cover
✓ Future Insurance Option
What does PRUShield and PRUExtra offer today?
Confidential and Proprietary Information.51Slide
Private Hospital
Air-conditioned single, 2-bedded or 4-bedded room with attached bathroom and its luxury toiletries. Fully furnished with sofa bed, flat screen television, DVD player and free-wifi. Patients have freedom to choose the attending physicians.
Restructured 'A' Class Ward
Air-conditioned single or 2-bedded room with attached bathroom. Fully furnished with wardrobe, electronic safe, television and telephone. Patients have freedom to choose the attending physicians.
'B1' Class Ward
Air-conditioned 4-bedded ward with attached bathroom, television and telephone.Patients have freedom to choose the attending physicians.
'B2' Class Ward (for subsidisedpatients)
Fan-ventilated 6-bedded ward with shared bathroom facilities and amenities.
'C' Class Ward (for subsidisedpatients)
Fan-ventilated 8-bedded ward with shared bathroom facilities and amenities.
Source: www.nuh.com.sg and www.mountelizabeth.com.sg, 2016
PRUShield & PRUExtraPremier/ Premier Lite/Preferred CoPay
PRUShield & PRUExtraPlus CoPay / Plus Lite CoPay
PRUShieldStandard Plan
Choices of Hospitals, Wards and Doctors
Confidential and Proprietary Information.52Slide
Policy Year Limit $1,200,000 $600,000 $150,000
Living Organ Donor Transplant Benefits$60,000 per Policy Year
$40,000 per Policy Year
Not Covered
Overseas Medical Treatment As Charged As Charged
Pre- & Post-Hospitalisation Benefits As Charged As Charged
Final Expense Provision $5,000 $3,000
Pregnancy Complications benefit As Charged As Charged
Congenital Abnormalities As Charged As Charged
Future Insurance Option at Life Events$100,000 sum assured per life
$100,000 sum assured per life
PRUShieldPremier
PRUShieldPlus
PRUShieldStandard Plan
Hospital / Ward Type Private HospitalRestructured
Hospital(Class A Ward)
Restructured Hospital
(Class B1 Ward)
Hospitalisation Benefit As Charged As Charged Inner Limits
Surgical Benefits As Charged As Charged Inner Limits
Outpatient Hospital Benefits As Charged As Charged Inner Limits
PRUShield Plans – Benefit at a Glance
Confidential and Proprietary Information.53Slide
Important note on switching to PRUShield plans:
✓ Customers who switch their medical insurance plan (from another company) to PRUShield will have to go through medical underwriting
✓ DO NOT switch if there have been changes to customer’s health status since the inception of his/her medical insurance plan with the other company
▪ For customer who had previously bought his/her medical insurance plan (from another company at standard life and has since developed new medical conditions, by switching to PRUShield, he/she will have to go through medical underwriting and PRUShield policy may exclude his/her “pre-existing” medical conditions
▪ Customers need to serve a new waiting period when they switch to PRUShield
Note :
Before replacing an existing accident and health policy with a new one, you should consider whether the switch is detrimental, as there may be potential disadvantages with switching and the new policy may cost more or have fewer benefits at the same cost.
Upgrading medical coverage is subject to underwriting. Customers are advised to purchase sufficient coverage based on their needs.
PRUShield and supplementary plans do not have surrender value
PRUShield (Plus and Premier) Specific risks to customer
Confidential and Proprietary Information.54Slide
▪ Premiums are not guaranteed and may be adjusted based on future claims experience
▪ Premiums are determined based on the age next birthday of the life assured at the time of renewal
▪ For standard life customers who have made a claim, they will not be able to exercise their FIO at Life Events
▪ PRUShield and supplementary plans do not have surrender value
▪ Subject to Underwriting for upgrading of medical coverage
PRUShield (Plus and Premier) Specific risks to customer
Note: Customer are advised to purchase sufficient coverage based on their needs.
Confidential and Proprietary Information.55Slide
Benefits Limitations
Cover hospitalisation benefits
▪ Policy Year limit applies to the total claims paid out each policy year
▪ Deductible and co-insurance apply which are the amounts to be borne by the customers
▪ For PRUShield Plus: Pro-ration factor apply for medical treatments sought in ward higher than the entitled ward
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document
▪ Premiums are non-guaranteed
PRUShield (Plus and Premier) Benefits & Limitations
Note:PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.56Slide
PRUShield (Plus and Premier) Benefits & Limitations
Benefits Limitations
Cover surgical benefits (Including day surgery)
▪ Policy Year limit applies to the total claims paid out each policy year
▪ Deductible and co-insurance apply which are the amounts to be borne by the customers
▪ For PRUShield Plus: Pro-ration factor apply for medical treatments sought in ward higher than the entitled ward
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document
Note:PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.57Slide
PRUShield (Plus and Premier) Benefits & Limitations
Benefits Limitations
Cover Living Organ Donor Transplant benefits
▪ Benefit limits apply
▪ This benefit only cover kidney and liver
▪ The organ failure leading to the transplant must have been first diagnosed after 24 months from the cover start date of the policy or date of reinstatement , whichever is later.
▪ Deductible and co-insurance apply which are the amounts to be borne by the customers.
▪ For PRUShield Plus: Pro-ration factor apply for medical treatments sought in ward higher than the entitled ward.
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document
Note:PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.58Slide
PRUShield (Plus and Premier) Benefits & Limitations
Benefits Limitations
Cover pre- and post-hospitalisation benefits incurred 180 days before and 365 days after confinement or day surgery
▪ Policy Year limit applies to the total claims paid out each policy year
▪ Deductible and co-insurance apply which are the amounts to be borne by the customers
▪ For PRUShield Plus: Pro-ration factor apply for medical treatments sought in ward higher than the entitled ward
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document
Note:PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.59Slide
PRUShield (Plus and Premier) Benefits & Limitations
Benefits Limitations
Cover emergency and planned overseas medical treatments
▪ Referrals from appointed medical centers will be required prior to planned overseas medical treatments
▪ We will pay up to the reasonable and customary level of charges in Singapore
▪ Policy Year limit applies to the total claims paid out each policy year.
▪ Deductible and co-insurance apply which are the amounts to be borne by the customers
▪ For PRUShield Plus: Pro-ration factor apply for medical treatments sought in ward higher than the entitled ward
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document
Note:PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.60Slide
PRUShield (Plus and Premier) Benefits & Limitations
Benefits Limitations
Cover selected outpatient treatments (cancer treatments, renal failure treatment and approved immunosuppressant drugs for organ transplant)
▪ Policy Year limit applies to the total claims paid out each policy year
▪ Co-insurance apply which are the amounts to be borne by the customers
▪ For PRUShield Plus: Pro-ration factor apply for medical treatments sought in ward higher than the entitled ward
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document
Note:PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.61Slide
PRUShield (Plus and Premier) Benefits & Limitations
Benefits Limitations
Provide other benefits
(Final Expense Provision, Pregnancy Complications benefit, Congenital Abnormalities, Inpatient Psychiatric Treatment benefit, Short Stay Ward and Future Insurance Option at Life Events)
▪ Waiting period of 10 months apply for pregnancy complications and 24 months for congenital abnormalities benefits
▪ Benefit limits apply for some benefits
▪ Policy Year limit applies to the total claims paid out each policy year
▪ Deductible and co-insurance apply which are the amounts to be borne by the customers
▪ For PRUShield Plus: Pro-ration factor apply for medical treatments sought in ward higher than the entitled ward
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document
▪ The “Future Insurance Option” at life event is capped at $100,000 sum assured in PRUShield (As Charged – Premier & Plus)
Note:PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.62Slide
• Customers age 1 to 75 next birthday
• Customers who are not expecting “returns” from a Non-Participating policy
• Customers who can afford to fund the premiums using MediSave (for PRUShield as charged) and/or Cash
• Customers who are looking for more comprehensive coverage than MediShield Life to cover their medical bills
• Customers who are looking for coverage up to A Ward in Restructured Hospitals
• Customers who are not expecting surrender value from their policy
PRUShield Plus Appropriate Customer Segments
Confidential and Proprietary Information.63Slide
PRUShield Plus Inappropriate Customer Segments
Customers who want returns from their policy
Customers who want level and guaranteed premiums throughout the premium payment period
Customers who want coverage up to standard room in Private Hospitals
Customers who want surrender value from their policy
Confidential and Proprietary Information.64Slide
PRUShield Premier Appropriate Customer Segments
• Customers age 1 to 75 next birthday
• Customers who are not expecting “returns” from a Non-Participating policy
• Customers who can afford to fund the premiums using MediSave (for PRUShield as charged) and/or Cash
• Customers who are looking for more comprehensive coverage than MediShield Life to cover their medical bills
• Customers who are looking for coverage up to standard room in Private Hospitals
• Customers who are not expecting surrender value from their policy
Confidential and Proprietary Information.65Slide
PRUShield Premier Inappropriate Customer Segments
Customers who want returns from their policy
Customers who want level and guaranteed premiums throughout the premium payment period
Customers who want coverage only in Restructured Hospitals
Customers who want surrender value from their policy
Confidential and Proprietary Information.66Slide
Benefits Risks and Limitations
Inpatient and Day Surgery Benefits ▪ Premiums are non-guaranteed and increase with age.▪ Policy Year limit applies to the total claims paid out each policy
year.▪ Deductible and co-insurance apply which are the amounts to be
borne by the customers. ▪ Pro-ration factors apply for medical treatments sought in ward
higher than the entitled ward. ▪ There are certain conditions under which no benefit is payable.
These exclusions are stated in the policy document.▪ The cover will terminate upon cessation of Singapore
Citizen/PR status
Outpatient Treatments Benefits ▪ Policy Year limit applies to the total claims paid out each policy year.
▪ Co-insurance applies which is the amount to be borne by the customers.
▪ Pro-ration factors apply for medical treatments sought in ward higher than the entitled ward.
▪ There are certain conditions under which no benefit is payable. These exclusions are stated in the policy document.
▪ The cover will terminate upon cessation of Singapore Citizen/PR status
Benefits Risks and Limitations – PRUShield Standard Plan
Note: PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.67Slide
Appropriate
• Customers who are looking for basic medical and hospitalisation cover that is higher than MediShield Life
• Customers who mainly need local medical cover in Singapore
Inappropriate
• Customers who are looking for medical and hospitalisation cover in higher ward class (e.g. A class ward in restructured hospitals or standard room in private hospitals)
• Customers who wish to get comprehensive medical coverage.
• Customers who need overseas medical coverage
Customer Segment – PRUShield Standard Plan
Note: PRUShield and supplementary plans do not have surrender value
Confidential and Proprietary Information.68Slide
What is MediShield Life?
MediShield Life Benefits
MediShield Life Premiums & Subsidies
MediShield Life & Integrated Plans (IP)
Our Solutions
Updates
Agenda
Nov 2020 Confidential and Proprietary Information.69Slide
Changes to MSHL: With effect from 1st March 2021
MSHL PremiumsAdjustment
MSHL Changes to Benefits
Nov 2020 Confidential and Proprietary Information.70Slide
Changes to PRUShield:
With immediate effect on
1st April 2021Benefits update
for PRUShield Plans
Nov 2020 Confidential and Proprietary Information.71Slide
1Alignments
What PRUShield changes to expect with immediate effect on 1 April 2021?
5Changes to
Benefits
4New
Benefits
Nov 2020 Confidential and Proprietary Information.72Slide
1
What PRUShield changes to expect with immediate effect on 1 April 2021?
4 New Benefits
Outpatient Hospital Benefit
Long-Term Parenteral Nutrition
Other BenefitPregnancy Complication Conditions
(28 conditions)
Congenital Abnormalities
Other Benefit
Autologous Bone-Marrow Transplant
Inpatient and Outpatient Proton Beam Therapy
Cell Tissue and Gene Therapy Treatment
Hospitalisation Benefit
Direct admissions from Restructured Hospitals’ A&E to
Community Hospital
HIV definition
Alignment with LIA 2019 Critical Illness definition
5 Changes to Benefits
Pre & Post-Hospitalisation TreatmentBenefit
Pre-Hospitalisation Consultation & Services. Post-Hospitalisation
Follow-up Treatment & Services
Coverage for Vaccinations
To cover for inpatient hospitalisation due to adverse
effects resulting from vaccinations
Alignment
Nov 2020 Confidential and Proprietary Information.73Slide
Overview of Changes to PRUShield Suite from 1 March 2021 & 1 April 2021
PRUShieldPremier
PRUShieldPlus
PRUShieldStandard,A & B Plan
1 March
2021
Premiums
Overall adjustment for SG and/or PR due to MSHL adjustment(No change in IP premiums)
• Reprice of FR (type 1 & 2) premium due to MSHL premium adjustment• FR (type 1) premiums to be aligned with SC/PR/FR (type 2) for PRUShield &
PRUExtra
NA
Age of entryExtending of maximum age of entry for foreigner from 55 ANB to 75 ANB for PRUShield & PRUExtra
1 April
2021
Changes in PRUShield
Benefits
• Pregnancy Complication Conditions• Congenital Abnormalities benefit• Direct admission from Restructured hospitals’ A&E to Community hospitals• Outpatient Telemedicine Consultation for Pre & Post-hospitalisation
Treatment benefit• Coverage for adverse effects for all vaccinations
New Benefits
• Long Term Parenteral Nutrition• Autologous Bone Marrow Transplants• Inpatient and Outpatient Proton Beam Therapy• Cell Tissue and Gene Therapy Treatment
Please note that PRUShield A & B plans had been withdrawn from new business
Nov 2020 Confidential and Proprietary Information.74Slide
TRANSITION
PLAN
PRUExtra
For policiespurchased between
8th Mar 2018 – 31st Mar 2019
Integrated Shield Plan (IP) Rider: Transition to IP With Co-Payment Feature
Nov 2020 Confidential and Proprietary Information.75Slide
Who are the impacted customers for this transition?
8 Mar 2018to
31 Mar 2019
TRANSITION COHORT
PRUExtra policies upgraded between 8th March 2018 to 31st March 2019 (based on upgrade request submission date)
2PRUExtra policies submitted and incepted between 8th
March 2018 to 31st March 2019 (including MTA)
1
Transition Cohort: Overview of PRUExtra Transition
Nov 2020 Confidential and Proprietary Information.76Slide
Customers who purchased* (including upgrades) the IP rider between 8th
March 2018 to 31st March 2019 will be transitioning to the new IP riders with co-payment features upon their policy renewal from 1st April 2021 onwards.
Purchased between(8th Mar 2018 to 31st Mar 2019)
Transition to(From 1st Apr 2021)
PRUExtra Premier PRUExtra Premier CoPay
PRUExtra Premier Saver^ PRUExtra Premier Lite CoPay (NEW for FR)
PRUExtra Premier Lite PRUExtra Premier Lite CoPay
PRUExtra Plus PRUExtra Plus CoPay
PRUExtra Plus Lite PRUExtra Plus Lite CoPay (NEW)
*Based on proposal submission date^PRUExtra Premier Saver will be withdrawn from downgrade from 9th Feb 2021 onwards
Note: For new business, upgrade/downgrade and MTA of PRUExtra Premier Lite CoPay (FR) and PRUExtra Plus Lite CoPay (SC/PR/FR), it will only be available from 8 June 2021 onwards
Transition Cohort: Overview of PRUExtra Transition
Nov 2020 Confidential and Proprietary Information.77Slide
*PRUExtra Premier Lite CoPay (SC/PR) continues to be available under new business, upgrade/downgrade, MTA and renewal;^Details of the newly transition rider will be attached together with the PNL and issue out to customer 50 days prior to policy renewal
Customer will receiveTransition Notification Letter
(50 days before renewal)
Commencement of PRUExtra Transition Exercise (upon renewal)
From 10 Feb 2021
From
1 April 2021
Open for new business on
8 June 2021(including upgrades, downgrades & MTA)
PRUExtra Plus Lite CoPay*
(SC/SPR/FR)
PRUExtra PremierLite CoPay
NEW
(FR)
Transition Cohort: Transition of PRUExtra Premier Saver to PRUExtra Premier Lite CoPay
Confidential and Proprietary Information.78Slide
Keeping healthcare affordable for everyone
Health Insurance Task Force observed that full cover riders encourage:
This increases healthcare costs and insurance premiums for all Singaporeans.
78
Over-consumption by consumers
Over-servicing by some medical professionals
Over-charging by some medical professionals
As a leading insurer, healthcare accessible and insurance premiums affordable for all in the long run.