Pru Med Frequently Asked questions

What is the meaning of full cover?

This means that the benefit is covered up to your overall In patient or Outpatient cover.

What is the process of changing a dependent on the scheme?

One has to write officially to the HR giving reasons as to why they wish to change and the one being replaced should have zero utilization otherwise premiums will be applicable.

For kids below 5 years without fingerprints, how do we treat these?

These children below 5 years have developing fingerprints hence inconsistent so the parents have to register for the child on the card as at 6years the system will automatically request the child to register a finger print after it is fully formed

If I have a sick child that doesn’t possess a medical card and I don’t have money, how can I get him/her to be treated?

You have to first register the child on the medical scheme through your HR manager so that Prudential can organize for a card to your child.

Can someone else use my medical card?

No , Only the person named on the card is allowed to obtain medical treatment. Any misuse or fraudulent use of the medical card will lead to disciplinary action against the employee.

 What do I do if I lose my medical card?

You need to report the loss of your card to the police, obtain a police letter and submit to your Human Resources Manager. A replacement fee of UGX 20,000 will be chargeable for every replacement card.

In case herbal preparation/ drug has been prescribed by a doctor, do you still fail to cover that? We only cover recognized conventional drugs and medically tested and approved by the National Drugs Authority.

In case of treatment outside the country, for instance Kenya, India, SA, do you cater for the transport expenses too?

Not as yet, Prudential only covers your medical related bills.

Can I self-prescribe drugs, tests or procedures?

No, a member is supposed to seek consultation from a general practitioner or consultant who will diagnose the condition and recommend suitable medication, tests and procedures if any is to be done.

If the hospital attended doesn’t have a specific drug to treat my illness, am I allowed to go to another hospital?

Yes, you will need to acquire a prescription form signed and stamped by the hospital attaching a copy of the claim form to which you will present to another hospital or pharmacy.

What do i do when there is an emergency admission?

• Call the emergency numbers at the front, bottom area of your medical card.
• Use your Medical Card to identify yourself at any of the approved hospitals (see enclosed list)
• At discharge, please complete and sign the Pre-authorization form together with the hospital bill.

What happens if Out or In-Patient services are obtained outside the network?

It is recommended that you always obtain services at the designated service providers; however, in the event that you obtain services outside the appointed network, you will be required to do the following;

• Always notify us of any intended out of pocket expense by telephone or any other available means before paying out of pocket
• Submit a duly filled and signed reimbursement Form (to be provided by HR)
• Attach Original receipts of payment
• Submit copies of Treatment notes
• Submit any other supporting documents that would be required for claim processing

These documents should be submitted through the Human Resources Office.