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 PruShield A and B – Summary of Revisions 2015

Refer to the attached “Summary of Revisions” for details of revisions made to the Policy. These changes will take effect from 1 November 2015.
This means if the date of admission to the Hospital or date of performance of medical treatment under Outpatient Hospital benefits is on or after
1 November 2015, the claims will be assessed based on the revised terms and conditions of the Policy.

1
 PruShield A and B – Summary of Revisions 2015

Summary of Revisions

Benefits Schedule

PruShield A PruShield B
PruShield A PruShield B
NEW NEW

Inpatient and Day Surgery Benefits

Daily Room & Board $900 $900 $550 $750

Daily Intensive Care $1,400 $1,400 $1,000 $1,250

Outpatient Hospital Benefits

Radiotherapy (per day) $450 $600 $300 $550

Chemotherapy (per year) $25,000 $42,000 $15,000 $36,500

Other Benefits

Short Stay Ward (per day) $900 $900 $550 $750

Limits of Cover

Lifetime Limit $6,000,000 Unlimited $1,000,000 Unlimited

Age Limits

Maximum Renewal Age 90 Lifetime 90 Lifetime

2
 PruShield A and B – Summary of Revisions 2015
Before 1 Nov 2015 On and after 1 Nov 2015

2.4.1 Types of plan offered 2.4.1 Types of plan offered

Footnote 3 under Benefit Schedule Footnote 3 under Benefit Schedule

3 3
This benefit provides coverage for the following Approved Immunosuppressant Drugs: This benefit provides coverage for the following Approved Immunosuppressant Drugs:
- Cyclosporin - Cyclosporin
- Tacrolimus - Tacrolimus
- Azathioprine tablets - Azathioprine tablets
- Prednisolone tablets - Prednisolone tablets
- Mycophenolate mofetil capsules and tablets - Mycophenolate mofetil capsules and tablets
- Mycophenolate sodium tablets - Mycophenolate sodium tablets
- Sirolimus tablet and oral solution - Sirolimus tablet and oral solution
- Daclizumab injection - Daclizumab injection
- Basiliximab injection - Basiliximab injection

The Approved Immunosuppressant Drugs refer to those approved under the MediShield Life
scheme and by MOH as the immunosuppressant drugs for organ transplant.

2.4.3.3 What do we pay for Daily Community Hospital Confinement 2.4.3.3 What do we pay for Daily Community Hospital Confinement

If the life assured, upon discharge from the Hospital, is immediately hospitalized in a Standard
Room of a Community Hospital to continue treatment, we pay the room and board charges up
to the limits as set out in the Benefits Schedule for his type of plan. Charges include meals,
Inpatient prescriptions, professional charges, investigations, laboratory tests, charges for high
dependency wards and other miscellaneous medical charges incurred per day.
If the life assured, upon discharge from the Hospital, is immediately hospitalized in a Standard
Room of a Community Hospital to continue treatment, we pay the room and board charges up
to the limits as set out in the Benefits Schedule for his type of plan. Charges include meals,
Inpatient prescriptions, professional charges, investigations, laboratory tests, charges for high
dependency wards and other miscellaneous medical charges incurred per day.

Currently, the Community Hospitals included under this plan are Bright Vision Hospital, St. Currently, the Community Hospitals included under this plan are Bright Vision Hospital, St.
Luke’s Hospital, St. Andrew’s Community Hospital, Ang Mo Kio Community Hospital, Luke’s Hospital, St. Andrew’s Community Hospital, Ang Mo Kio Community Hospital,
Westpoint Family Hospital, Ren Ci Community Hospital and Kwong Wai Shiu Hospital. Westpoint Family Hospital, Ren Ci Community Hospital and Kwong Wai Shiu Hospital.

Hospices and convalescent centres / hospitals / homes are not covered. Hospices and convalescent centres / hospitals / homes are not covered.
A Community Hospital is one that is registered and classified under the category of
Community Hospitals with the Ministry of Health, Singapore.

3
 PruShield A and B – Summary of Revisions 2015
Before 1 Nov 2015 On and after 1 Nov 2015

2.4.4.3 What do we pay for Approved Immunosuppressant Drugs for Organ Transplant? 2.4.4.3 What do we pay for Approved Immunosuppressant Drugs for Organ Transplant?

We reimburse you for the cost of the Medically Necessary Approved Immunosuppressant We reimburse you for the cost of the Medically Necessary Approved Immunosuppressant
Drugs prescribed as a result of an organ transplant and as part of the outpatient treatment to Drugs prescribed as a result of an organ transplant and as part of the outpatient treatment to
reduce the rate of rejection episodes up to the maximum limit set out in the Benefits Schedule reduce the rate of rejection episodes up to the maximum limit set out in the Benefits Schedule
above for your plan. above for your plan.

The Approved Immunosuppressant Drugs are as follow: The Approved Immunosuppressant Drugs are as follow:
- Cyclosporin - Cyclosporin
- Tacrolimus - Tacrolimus
- Azathioprine tablets - Azathioprine tablets
- Prednisolone tablets - Prednisolone tablets
- Mycophenolate mofetil capsules and tablets - Mycophenolate mofetil capsules and tablets
- Mycophenolate sodium tablets - Mycophenolate sodium tablets
- Sirolimus tablet and oral solution - Sirolimus tablet and oral solution
- Daclizumab injection - Daclizumab injection
- Basiliximab injection - Basiliximab injection

The Approved Immunosuppressant Drugs refer to those approved under the MediShield Life
scheme and by MOH as the immunosuppressant drugs for organ transplant.

2.9.7 Termination of Benefit 2.9.7 Termination of Benefit

All of the benefits under your policy shall terminate when:
- you cancel your policy, after the expiry of the Review Period, by giving us 30 days’ written
notice.
- you renounce your Singapore citizenship or Singapore Permanent Residence status.
- your premium is not received after the Grace Period.
- the life assured has attained age 91 years next birthday on the Premium Due Date.
- the total claims paid to you reaches the Lifetime Limit (as set out in the Benefits
Schedule).
All of the benefits under your policy shall terminate when:
- you cancel your policy, after the expiry of the Review Period, by giving us 30 days’ written
notice.
- you renounce your Singapore citizenship or Singapore Permanent Residence status.
- your premium is not received after the Grace Period.
- the life assured has attained age 91 years next birthday on the Premium Due Date.
- the total claims paid to you reaches the Lifetime Limit (as set out in the Benefits
Schedule).

4

Before 1 Nov 2015
2.9.9 Changes to Policy Benefits / Conditions / Plan
We reserve the right to vary the policy benefits and conditions at any time. Also, if PruShield is
not available when your policy is due for renewal, we reserve the right to renew your policy to
a similar medical product that is available at the time of renewal.
However, we will give you 30 days’ written notice before doing so.
Any such changes will be subject to compliance with the ‘Guidelines for Medisave-Approved
Medical Enhancement Schemes to MediShield’ issued by MOH.
5
PruShield A and B – Summary of Revisions 2015
On and after 1 Nov 2015
2.9.9 Changes to Policy Benefits / Conditions / Plan
We reserve the right to vary the policy benefits and conditions at any time. This includes
mandatory changes to the policy benefits, features, guidelines and/or conditions as may be
introduced by MOH, the Central Provident Fund Board or any other regulatory authority on
MediShield Life.
Also, if PruShield is not available when your policy is due for renewal, we reserve the right to
renew your policy to a similar medical product that is available at the time of renewal.
However, wWe will give you 30 days’ written notice before doing so. However, such
mandatory changes to the policy benefits, features, guidelines and/or conditions stipulated by
the relevant regulatory authority will immediately apply to your policy without written notice
given to you.
Any such changes will be subject to compliance with the conditions for Medisave-approved
medical insurance plan issued by MOH.
 PruShield A and B – Summary of Revisions 2015
Before 1 Nov 2015 On and after 1 Nov 2015

2.11.2 Example to illustrate Pro-ration 2.11.2 Example to illustrate Pro-ration

PruShield B Policyholder - Male, Age 34 PruShield B Policyholder - Male, Age 34

Diagnosis: Recurrent Left shoulder dislocation Diagnosis: Recurrent Left shoulder dislocation
Hospital Ward Class A Hospital Ward Class A
Class: Class:
Hospitalisation: 04 July to 07 July Hospitalisation: 04 July to 07 July

Benefits PruShield B Incurred Pro- No. of Payable Benefits PruShield B Incurred Pro- No. of Payable
Benefit ration Days Benefit ration Days
Limits Limits
(85% pro-ration) (85% pro-ration)
Inpatient and Day Surgery Benefits Inpatient and Day Surgery Benefits

Daily Room & $ 550 per $ 1,400 $ 1,190 3 Days $1,190 Daily Room & $ 750 per $ 1,400 $ 1,190 3 Days $1,190
Board day Board day
Surgical $ 4,500 per $ 4,500 $ 3,825 $3,825 Surgical $ 4,500 per $ 4,500 $ 3,825 $3,825
Procedure treatment Procedure treatment
(Based on Table 5) (Based on Table 5)
Surgical $ 8,000 per $ 900 $ 765 $ 765 Surgical $ 8,000 per $ 900 $ 765 $ 765
Implants/ treatment Implants/ treatment
Approved Approved
Medical Medical
Consumables Consumables
$ 6,800 $5,780 $ 6,800 $ 5,780
Less: Deductible $3,500 (Class A Less: Deductible $3,500 (Class A
Deductible) Deductible)
Balance After Deductible $2,280 Balance After Deductible $2,280
Less: Co-insurance $ 228 (10% of Less: Co-insurance $ 228 (10% of
$2,280) $2,280)
PruShield Eligible Amount $2,052 PruShield Eligible Amount $2,052
(inclusive of MediShield Life payout, if any)^

Prudential issues cheque to Hospital $2,052 Prudential issues cheque to Hospital $2,052
^ No change in intent. This amount may be inclusive of MediShield/MediShield Life payout.

6
 PruShield A and B – Summary of Revisions 2015
Before 1 Nov 2015 On and after 1 Nov 2015

2.11.3 Example to illustrate Final Expenses 2.11.3 Example to illustrate Final Expenses

PruShield B Policyholder – Female, Age 57 PruShield B Policyholder – Female, Age 57

Diagnosis: Heart Bypass Diagnosis: Heart Bypass
Hospital Ward Class B1 Hospital Ward Class B1
Class: Class:
Hospitalisation: 13 Jul to 20 Jul Hospitalisation: 13 Jul to 20 Jul
Passed away 2 days after discharge due to post surgery complications Passed away 2 days after discharge due to post surgery complications
Benefits PruShield B Incurred No. of Payable Benefits PruShield B Incurred No. of Payable
Benefit Days Benefit Days
Limits Limits

Inpatient and Day Surgery Benefits Inpatient and Day Surgery Benefits

Daily Room & $ 550 per $ 4,900 5 Days $ 2,750 Daily Room & $ 750 per $ 4,900 5 Days $ 3,750
Board day Board day
Daily ICU $1,000 per $ 2,500 2 Days $ 2,000 Daily ICU $ 1,250 per $ 2,500 2 Days $ 2,500
Charges day Charges day
Surgical $ 5,500 per $ 5,400 $ 5,400 Surgical $ 5,500 per $ 5,400 $ 5,400
Procedure treatment Procedure treatment
(Based on Table 6) (Based on Table 6)
Surgical $ 8,000 per $ 5,000 $ 5,000 Surgical $ 8,000 per $ 5,000 $ 5,000
Implants/ treatment Implants/ treatment
Approved Approved
Medical Medical
Consumables Consumables
$17,800 $15,150 $17,800 $16,650
Less: Deductible $ 2,500 (B1 Class Less: Deductible $ 2,500 (B1 Class
Deductible) Deductible)
Balance After Deductible $12,650 Balance After Deductible $14,150
Less: Co-insurance $ 1,265 Less: Co-insurance $ 1,415
Sub-total $11,385 Sub-total $12,735
Add: Final Expense Provision Benefit $ 3,000 Add: Final Expense Provision Benefit $ 3,000
(Lower of deductible plus Co-insurance or the max limit of (Lower of deductible plus Co-insurance or the max limit of
the Benefits = lower of [($2,500 + $1,265) or $3,000] the Benefits = lower of [($2,500 + $1,415) or $3,000]

PruShield Eligible Amount $14,385 PruShield Eligible Amount $15,735

(inclusive of MediShield Life payout, if any)^

Prudential issues cheque to Hospital $14,385 Prudential issues cheque to Hospital $15,735
^ No change in intent. This amount may be inclusive of MediShield/MediShield Life payout.

7
 PruShield A and B – Summary of Revisions 2015
Before 1 Nov 2015 On and after 1 Nov 2015

2.11.4 Example to illustrate payout for Outpatient Hospital Benefits 2.11.4 Example to illustrate payout for Outpatient Hospital Benefits

PruShield B Policyholder – Male, Age 50 PruShield B Policyholder – Male, Age 50

Diagnosis: Stomach Cancer Diagnosis: Stomach Cancer

Benefits PruShield B Amount Claimed Incurred Payable Benefits PruShield B Amount Claimed Incurred Payable
Benefit Limits for the Policy Benefit Limits for the Policy
Year till date Year till date

Outpatient Hospital Benefits Outpatient Hospital Benefits

Chemotherapy $ 15,000 per year $10,800 $4,000 $4,000 Chemotherapy $ 36,500 per year $10,800 $4,000 $4,000

Less: Co-insurance $ 400 Less: Co-insurance $ 400

Sub-total $3,600 Sub-total $3,600

PruShield Eligible Amount $3,600 PruShield Eligible Amount $3,600

(inclusive of MediShield Life payout, if any)^

Prudential issues cheque to Hospital $3,600 Prudential issues cheque to Hospital $3,600
^ No change in intent. This amount may be inclusive of MediShield/MediShield Life payout.