Medical Insurance Guide for Employees- Vinculum, Singapore by K7ebwgW

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									    Employee Group Insurance Policy-
         Quick Guide Singapore
1
                  Confidential
           Process Flow of Medical Visit
               Doctors give medicine and
                 employee comes back

                                   General
                                                                   
                                    Physician
                    Goes to                           Recommends        Specialist
    Employee                       Panel list of
                                                                         Slide 6




                                                                                     Recommendation
                                     Doctors
                                     Slide 4




                                                                                         Written
                   Admit to a                                 
                    hospital                                       Hospitalization
                    Slide 10                                          Slide 8
                 Outpatient &
                 Tests Slide 6

     2                                         Confidential
          Types of Coverage

1. General Physician(GP)
   Consultation and
   related charges

2. Hospitalization and
   surgical charges


3                 Confidential
    Panel List for General Physician
Please click the icon below to view the list of Registered Medical
Practitioner (RMP), approved by Prudential for GP visit. If you
visit any other GP outside this list , they will not accept your
member card and such receipts, if submitted for
reimbursements, will not be entertained/reimbursed.




     Back


4                          Confidential
         “Unlimited” General Practitioner
                                      (GP) visits!!!

1. So now you don’t have to worry
    about not visiting a GP!!

2. You can now visit a GP for your and
    your dear ones’ smallest medical
    worries!!

Note: Since the GP visits are unlimited, no medical leave
    will be granted without a Medical Certificate from
    any of the GPs mentioned in the Panel List

   5
                                                  Confidential
         The Plan Coverage for Specialists
       (If recommended by a Registered Medical Practitioner Slide 10 )


          Medical Expenses                    Coverage Limit (Cumulative annualized)



1. Specialist Consultation- There is no                      S$ 750
        specified Specialists list.

2. Diagnostics X-ray& Laboratory Test                        S$ 750




                 Note: This coverage will only be considered if a RMP in
                 Singapore recommends the patient with a written
     Back        recommendation letter to a Specialist and then the tests are
                 done as per this Specialists prescription. No charges will be
                 covered if there is no recommendation from a RMP in this case.
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                              Exclusions
    (All these are not covered under the policy and no exceptions will be accepted)

1. Routine physical examinations , health check-ups and tests
2. Charges which are not actual, medically necessary and required in the treatment
    of a covered sickness. Some eg. can be Acne, hairloss, pigmentation etc.
3. Related charges to self inflicted injuries
4. Cosmetic Surgery
5. Vaccinations and preventive treatments
6. Drugs (any medicines) purchased without a Registered Medical Practitioner’s
    (RMP) prescription -No exceptions will be accepted.
7. Any laboratory tests, x-ray and Specialist Doctor’s consultation fee if not
    recommended by a RMP
8. Physiotherapy except performed by member of Singapore Physiotherapy
    Association
9. Any expenses related to Pregnancy /Miscarriage/Abortion(including all medical
    tests)
10. Fixing of glasses/contact lenses/hearing aids /dental or oral care


7                                    Confidential
                       Hospitalization and Surgical
                                                                      Hospitalization in       Hospitalization in
                    Benefits                                         hospitals other than   Singapore Government
                                                                   Singapore Government     Restructured Hospitals**
                                                                        Restructured                 (S$)#
                                                                       Hospitals** (S$)#

Daily Room &Board (max 120 days per year)#                                          110                       110
Intensive Care Unit (max:30 days per year)#                                         330                       330
High Dependency Ward (max: 30 days per year)#                                       220                       220
Other hospital services                                                          5,000
Surgical Fess                                                                    8,000
                                                                                                            5,500
In Hospital Doctors visit(max 120 days)                                             100
Pre & Post Hospitalization Treatment                                                750
Emergency Out Patient (Accident only)                                            2,500                      2,500
Death Benefit                                                                    5,000                      5,000
                          # Days or $ whichever limit is utilized first
                          ** General rates for restructed hospitals
         Back             Defn of Year: 1st April to 31st March of every calendar year(Eg: If
                          the patient has stayed in the hospital for more that 120 days then
                          even if his $limit is not reached yet, he cannot claim for the 121st
   8                                               Confidential
                          day onwards)
           Important points to note

1.   A patient has to ensure that he visits the GP and gets a written recommendation from
     the RMP before getting admitted to the hospital where he has to quote his member
     number.
2.   In case of emergency, he has to call the helpline number on the backside of the
     Insurance Card , quote his member number and inform prudential about his condition. In
     a case if the insured is too unwell to make the call someone with him/her can also make
     the call on his behalf. No claims will be entertained if no prior call has been made to the
     insurance people.
3.   The patient in case of extreme emergency, has to inform Vinculum via email or written
     letter deposited at the High Street Centre office within 31 days of he/she being
     referred to a specialist/admitted to the hospital to be eligible for the claim.
4.   Only GP visit is cashless upon flashing the member card. Nothing else is cashless and will
     be reimbursed upon providing the original receipts if the same fulfills the criterion.
5.   In all cases of apart from GP visit, informing Vinculum and Prudential about the medical
     situation is a must.



9                                       Confidential
Restructured Hospital Usual Rates




            Restructured Hospital
                 usual rates




     Back

10                  Confidential
      Helpline


     Prudential
      Helpline
      Number
        In case of unavailability of the above,
                   please contact :

                  Mrigakshi Ray
        mrigakshi.ray@vinculumgroup.com


11                      Confidential

								
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