Dear Sir / Madam,
Please be informed that all PruBSN medical plans cover for hospitalizations due to complication/side effects arising after our customers receiving the government approved COVID-19 vaccination. The coverage** is subject to each of our customers’ medical benefit limits and terms and conditions of the certificate.
This coverage** starts immediately (subject to any existing waiting period under the medical plan) and will continue until the World Health Organisation or our Malaysian government declares that COVID-19 is no longer characterised as a pandemic. All existing and future PruBSN customers with medical plans are eligible for the coverage up to the point that this declaration is made.
Please note that all the coverage** provided for hospitalizations due to post COVID-19 vaccination complication is available on reimbursement basis (HAS facility is not available), subject to reasonable & customary charges. Hence, please assist our customers to prepare necessary documents for reimbursement submission (e.g. original receipts, summary invoice, detail breakdown invoice, all lab and imaging reports, discharge summary, and any other supporting documents).
We have also attached FAQ on this memorandum for more details.
Kindly inform all relevant departments (business office, front office, patient administration, Accident & Emergency Department, admission & discharge counter, insurance counter, finance & billing department etc.)
Thank you for your understanding and cooperation.
-------------------------------------------------------------------------------------------------------------------------------------------------------
FAQ: Post Covid-19 Vaccination Complication Coverage for PruBSN Customers
1. Is hospitalisation or death resulting from complications or side effects due to COVID-19 vaccination covered?
For hospitalization due to complication or side effects from COVID-19 vaccination
PruBSN covers all our customers who have a medical plan with us for the medical expenses incurred for in-hospitalisation treatment received to treat the complications and side effect(s) after taking a COVID-19 vaccine that has been approved by the Malaysian government and administered by the appointed parties accordingly. The claim will be subject to the benefit limits and terms & conditions of the policy or certificate. This coverage will continue until the World Health Organisation or our Malaysian government no longer characterized COVID-19 as a pandemic.
For death after receiving COVID-19 vaccination
Death due to COVID-19 vaccination is covered under the Death Benefit under the certificate. Our customer may refer to their certificate for exclusions, terms and conditions that apply to Death Benefit.
2. Is COVID-19 vaccination covered under the medical plan?
No, cost of taking vaccines (including COVID-19 vaccine) is not covered under medical plans because medical plans only cover for reasonably and customary charges incurred for a Medically Necessary treatment for a disability.
3. Customer just bought a new medical plan. Is there a waiting period for COVID-19 vaccination side effects coverage?
Waiting period of 30 days will be applied for complications arising due to Covid-19 vaccinations.
4. Will PruBSN issue pre-authorisation of medical claims (Guarantee Letter) if our customer hospitalized in panel hospitals for any complications or side effect(s) arising from COVID-19 vaccination?
COVID-19 related vaccination will be covered on reimbursement basis. Customers can pay the hospitalisation charges and subsequently file for reimbursement.
5. Can our customer claim for Hospital Income Benefit if he/she is hospitalized due to complications or side effect(s) from COVID-19 vaccine?
Our customers can claim for the Hospital Income Benefit, if he/she owns an eligible hospital income benefit plan. His/her claim will be assessed based on the terms and conditions of his/her hospital income benefit plan.
6. If the vaccine was administered overseas, will PruBSN cover for treatment received in a hospital outside Malaysia due to complications or side effects arising from COVID-19 vaccination?
Yes, so long the COVID-19 vaccine obtained falls within the list of vaccines approved by the Malaysian government, we will process and administer the claim based on the terms and conditions of the medical plan, such as terms related to Reasonable and Customary Charges and the Overseas Residence clause.
?@
**Terms & conditions apply; you may refer to our corporate website for more details:
https://www.prubsn.com.my/en/campaigns-announcements/covid-19-vaccination-side-effect-coverage/
**HAS facility is NOT available for this coverage.
