United World College of South East Asia 2021
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United World College of South East Asia Group Medical Insurance Handbook 2021 - 2022 Loc Group Medical Insurance 2021 2022 Contents 1. Introduction: Your Group Insurance Cover……………………..….…………. 3 2. Singapore Network……………………………………………………………………………. 4 2.1 Hospitals Network……………………………………………………………………. 4 2.2 Outpatient GP Clinic Network………………………………………………….. 6 3. Benefits Overview………………………….………………..................................... 8 3.1 Inpatient Coverage………………………………………………………………….. 9 3.2 Outpatient Coverage…….…………………………………………………………. 12 3.3 Further Benefits…….………………………………………………………………… 14 4. Policy Exclusions…………………………………………..……….............................. 15 5. Area of Coverage……..…………………………………………..………...................... 18 6. Inpatient Direct Billing Services……………..…………………………………………. 19 6.1 Pre-Authorisation……….…………….……………………………...……………… 19 6.2 Prior Approval Treatment…………………………………………………....….. 19 6.3 Scheduled & Emergency Hospital Admission………………………….... 20 7. Outpatient Direct Billing Services.……………..…………….……...................... 22 7.1 Outpatient Direct Billing Procedures……………………….................... 22 7.2 Outpatient Non-Direct Billing Network………………………….……….... 23 8. Claims Procedure (Pay & Claim)…….…………...………………………….……….….. 23 8.1 Cigna Envoy App Submission……..……………….…….………………………. 23 8.2 Cigna Envoy Online Portal Submission.……….….………………….....….. 24 8.3 Claim Form Submission……………………………………….…………………..... 24 9. Cigna Envoy…………………………………………………………………..……………………. 25 9.1 Registration Process…..………………………………………........................ 25 9.2 Cigna Envoy Mobile App…………………………………………………………… 26 10. Cigna Virtual Clinic……………………………………………………..……………………… 27 10.1 Registration Process…..………………………………………...................... 28 10.2 Teleconsultation…………………………………………………………………….. 28 10.3 How to View Documents & Purchase Medication…………………… 29 11. Contact Details…………………………………………………………………………………… 31 12. Appendix……………………………………………………………………………………….. 32 2 | P a g e Simplifying Insurance Group Medical Insurance 2021 2022 1. Introduction: Your Group Medical Insurance Coverage This booklet provides the necessary information for your international group medical insurance scheme and benefit entitlement under UWC South East Asia. This is just a summary and is not meant to replace the actual policy wording and insurance contract. Policy Period: 01 August 2021 to 31 July 2022 Policy Number: 605500 / 605501 Insurance Provider: Cigna Health Insurance Insurance Advisor: Pacific Prime Singapore Eligibility: You are covered under the Global Health Benefits Scheme plan as active and permanent employee of UWC South East Asia. Insurance Card: Each new joiner or employee will be issued with a Cigna E-Card and will receive a membership pack on the UWC South East Asia registered email address. Cigna Insurance Card (front) Cigna Insurance Card (back) NOTE: The content reflected in this handbook is correct at the time of print and are subject to changes as needed. 3 | P a g e Simplifying Insurance Group Medical Insurance 2021 2022 2. Singapore Network 2.1 Hospitals network You are entitled to a standard private room at these hospitals: • Standard private room of following Public Hospitals: Singapore General Hospital (SGH) – Bukit Merah (Rank 3rd best hospitals in the world 2019, covers all specialisms) Changi General Hospital (CGH) – Tampines (Covers all specialisms) National University Hospital (NUH) – Queenstown (Covers all specialisms) Ng Teng Fong General Hospital – Jurong East (Newest, integrated healthcare initiative in the West) KK Women and Children’s Hospital (KKH) – Bukit Timah (Best for Women & Children) Alexandra Hospital – Queenstown (Best for acute/sub-acute conditions & rehabs) Khoo Teck Puat Hospital – Yishun (Best integrated healthcare initiative in the North) Sengkang General Hospital (SGH) – Sengkang (Best integrated healthcare initiative in the North) Tan Tock Seng Hospital – Novena (Largest multi-disciplinary hospital) 4 | P a g e Simplifying Insurance Group Medical Insurance 2021 2022 • Standard private room of following Hospitals under Cigna Links where 10% co- payment applies (Please note members must visit the listed doctor at the listed facility to be classed as ‘in network’, please refer to Appendix A1): Gleneagles Hospital - Tanglin Mount Elizabeth Hospital - Orchard Mount Elizabeth Novena Hospital - Novena Parkway East Hospital - Eunos • Standard private room of following Private Hospitals outside of Cigna Links (20% co-payment applies): Raffles Hospital - Bugis Thomson Medical Centre - Novena Farrer Park Hospital - Bendemeer Mount Alvernia Hospital - Braddell Concord International Hospital – Tan Kah Kee 5 | P a g e Simplifying Insurance Group Medical Insurance 2021 2022 2.2 Outpatient Clinic Network ▪ General Practitioners: o Public Facilities - 18 Polyclinics across Singapore (strictly on Pay-and-Claim basis) Map of Singapore Polyclinics Location o Cigna has aligned with ParkwayHealth (Cigna Links) and Doctor Anywhere to provide seamless medical services, where you can obtain access to an extensive network of local health professionals and facilities through Cigna direct billing (cashless) services. - Parkway facilities strategically located throughout Singapore more than 400 general practitioners - Doctor Anywhere Clinic (Onsite Campus) ▪ Specialist Practitioners: o Public Facilities - Out-Patient Specialists in Public Hospitals (strictly on Pay-and- Claim basis) o Public Facilities - 7 specialised national medical centres (strictly on Pay-and-Claim basis): - National Heart Centre (specialised in Heart conditions) - Singapore National Eye Centre (specialised in Eye conditions) - National Cancer Centre (specialised in Cancer conditions) 6 | P a g e Simplifying Insurance Group Medical Insurance 2021 2022 - National Skin Centre (specialised in Skin conditions) - National Neuroscience Institute (specialised in Neuro conditions) - Communicable Disease Centre (specialised in Infectious Diseases) - Institute of Mental Health and Jurong Medical Centre (specialised in mental conditions) Map of Singapore Specialised National Medical Centre Location The list of Singapore Public Facilities available near your location can be found easily on the Health Buddy Mobile App developed by the SingHealth Group. Alternatively, you can also refer to the Appendix A2 for full listing of Singapore public facilities. We would strongly advise you to download the app since it also provides you with the access to health information and including the ability to make appointments at SingHealth providers. Do kindly refer to Appendix B for the “MiniGuide on Health Buddy App”. o Cigna has aligned with ParkwayHealth (Cigna Links) to provide seamless medical services, where you can obtain access to an extensive network of local health professionals and facilities through Cigna direct billing (cashless) services. Parkway facilities strategically located throughout Singapore; - more than 780 Specialist practitioners 7 | P a g e Simplifying Insurance Group Medical Insurance 2021 2022 3. Benefits Overview Insurer: Cigna Health Insurance Plan Name : Global Health Benefits Area of Cover : Worldwide excluding the USA Underwriting Terms : Medical History Disregarded Overall Plan Limit : SGD 2,250,000 New Co-payment Applies: Inpatient Outpatient Cigna Out-of- Cigna Out-of- Govt Network Govt Network Network Network Network Network SG Government All other Providers + All other SG Treatment private Cigna Virtual private Government CignaLinks CignaLinks Location providers in SG Clinic + Doctor providers in Providers + Raffles Anywhere SG + Raffles Campus Clinic Co- 0% 10% 20% 0% 20% 20% payment Out of Pocket SGD $5,000 maximum out of pocket per member per year Maximum Inpatient In Network: All Government Restructured Hospitals, CignaLinks Singapore Outpatient In Network: All Government Restructured Clinics and Cigna Virtual Clinic, CignaLinks Singapore For a detailed summary of your benefits under your Cigna plan, please refer to the Table of Benefits available on your Cigna Envoy Online Portal or Mobile App: www.cignaenvoy.com NOTES: 8 | P a g e Simplifying Insurance Group Medical Insurance 2021 2022 • Within CignaLinks members must visit the listed Doctor at the listed facility to be classed as ‘In-Network’. • Cigna Virtual Clinic refers to general practitioner video consultation, medication prescription and its delivery, as well as treatment at the affiliated physical clinics in Singapore, under Doctor Anywhere (DA) Group upon presenting CIGNA Card or DA Card link to their Cigna membership. 2.1 Inpatient Coverage In the following sections, some benefits are indicated as paid in full but please note that the total value of claims paid by the insurer cannot exceed the overall plan limit. Govt In Network: All Government Restructured Hospitals CignaLinks In Network: CignaLinks Hospitals CignaLinks Govt In-Network Out of Network In-Network Inpatient and Daycare Paid in full 90% Refund 80% Refund treatment (Private Room) (Private Room) (Private Room) Parental accommodation Paid in full 90% Refund 80% Refund Pre-Hospitalisation (up to 30 days before procedure) Paid in full 90% Refund 80% Refund Post Hospitalisation (up to 90 days after procedure) includes Rehabilitation as well which is Paid in full 90% Refund 80% Refund subject to maximum of 120 days after procedure Specialist Physician’ Fee include stays in hospital and Paid in full 90% Refund 80% Refund intensive care as long as is required by medical necessity Radiotherapy, Chemotherapy, Paid in full 90% Refund 80% Refund Oncology Radiology