Friday, 8 April 2016

Singapore’s Healthcare: MediShield Life

Medisave-approved Integrated Shield Plans

MediShield Life, which is run by the Central Provident Fund (CPF) Board, provides coverage that is sized for subsidised treatment in public hospitals.

If you plan to use Class A/B1 wards of public hospitals or go to a private hospital for your future hospitalisations, you may wish to consider purchasing Medisave-approved Integrated Shield Plans (IPs).

IPs are made up of two components – MediShield Life and additional private insurance coverage providing additional benefits and coverage (e.g. to cover the costs of private hospitals or Class A/B1 wards in the public hospitals).

Comparison of Integrated Shield Plans
Launch of Standard Integrated Shield Plan on 1 May
About MediShield Life
Find out more about Integrated Shield Plans
Check if you have an Integrated Shield Plan
Compare the premiums and benefits of Integrated Shield Plans
8 Things You Need to Know About IPs (4 lang)
How MediShield Life and Integrated Shield Plans Work (4 lang)
Do You Need An Integrated Shield Plan? (4 lang)
Medishield Life

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About Integrated Shield Plans (IPs)

Many Singaporeans have private insurance plans for hospitalisation in the form of Integrated Shield Plans (IPs). IPs comprise two components:
  • The first is a MediShield Life component run by the Central Provident Board (CPF) Board. From 1 Nov 2015, MediShield Life replaced the MediShield component of your policy, to give policyholders better coverage.
  • The second is an additional private insurance coverage component run by private insurers, typically to cover Class A/B1 wards in public hospitals or private hospitals.
If you have an IP, you are already covered by MediShield Life. MediShield Life is a component of your IP, there is no duplicate coverage. The private IP insurers act as a single point of contact for IP policyholders, even though they work with CPF Board back-end on premium collection and claims disbursement for the MediShield Life component.

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MediShield Life still focused on basic, affordable coverage

The Government’s focus is to provide basic and affordable health insurance coverage for all Singaporeans through MediShield Life, regardless of their health condition.

Therefore, MediShield Life is designed to provide sufficient coverage for subsidised Class B2/C wards.

For those who wish to enjoy higher-than-basic coverage, Integrated Shield Plans (IPs) are available as an option.

related: Why wasn’t Class B1 plan incorporated directly under MediShield Life?

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New B1 insurance plan fails to address some concerns

Medical insurance just got more confusing.

This week, the Ministry of Health (MOH) announced the introduction of a standard B1 plan for those who want basic medical insurance coverage at the B1 level. That's one class above the B2 level that MediShield Life covers. At B1, patients can choose their doctors and enjoy air-conditioned rooms.

The new B1 standard plan is one of several Integrated Plans (IPs) that people can buy to enhance their MediShield Life coverage. It is the most basic of IPs. The problem is that it is anything but standard.

5 insurers to offer standard, no-frills Integrated Shield Plan insurance from May
All you need to know about the standard B1 class Integrated Shield Plan
Is the standard B1 Integrated Plan for you?
Standard B1 health plan: A missed opportunity to bring private insurers to heel

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MediShield Life vs Integrated Shield Plans

With  the recent proposed enhancements for MediShield Life, some people may wonder:
“Does it still make sense to upgrade to private Integrated Shield plans? Will MediShield Life be sufficient?”
Integrated Shield plans are essentially made up of MediShield and a Medisave-approved enhancement plan by a private insurer, hence the name integrated. Such plans are meant to provide more comprehensive coverage than the basic Medishield plans and can be purchased using CPF Medisave.
Let’s take a look at some of the differences between Integrated Shield plans and MediShield Life:
  • Option to secure comprehensive coverage in Private Hospitals with Integrated Shield plans.
  • As-charged coverage for Integrated Shield plans instead of specific limits
  • Option to cover the co-insurance and deductible portion of the bill
  • Coverage for pre- and post hospitalisation related follow up charges
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Integrated Shield plan - what is it?

A Shield plan is designed to cover major/catastrophic events related to Hospitalisation & Surgery (H&S). It is not meant to cover minor ailments and visits to general practitioners.

CPF Board operates the CPF MediShield, which covers up to 80 per cent of your H&S bills at subsidised wards in restructured hospitals.

The private Integrated Shield Plans run by private insurers are designed to cover hospitalisation in A & B1 wards in restructured hospitals and private hospitals. You may still choose to stay in a subsidised ward if you have a private Shield plan.


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Integrated Shield Plan: making private healthcare affordable
MediShield Life
  • When MediShield Life kicks into gear at the end of 2015, all Singaporeans and Permanent Residents will get better medical insurance coverage.
  • A larger portion of their bills for treatments and stays in B2 or C class wards will be taken care of. However, the deductible and co-insurance would have to be borne by the patient.
  • As MediShield Life is designed to benefit patients up to B2 class ward level, should you choose to be treated in a ward class higher than B2, your out-of-pocket expense is going to be higher.
Integrated Shield Plan
  • You can reduce that expense significantly by taking an Integrated Shield Plan, which consists of a MediShield Life portion AND an addition component by a private insurer*. By subscribing to additional riders, the Integrated Shield Plan will even cover the deductibles and co-insurance portions of the bill.
  • An Integrated Shield Plan will only set you back between $1.25 and $2.40 a day—that's the price of a bottle of mineral water!
  • With it, you may not need to fork out a single cent in out-of-pocket expense for numerous procedures in a private hospital such as Mount Elizabeth Novena Hospital.**
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Insurers to offer new integrated shield plan from May 1 

A new private medical insurance plan that offers identical benefits across insurers for stays in Class B1 wards in public hospitals will be available from May 1.

This Standard Integrated Shield Plan (IP), set up by the Ministry of Health (MOH) together with private insurers, comes nearly two years after a committee that worked out the details of MediShield Life pushed for it.

IPs are offered by private insurers, providing benefits over and above the coverage offered by MediShield Life, which provides coverage for large hospital bills in Class B2 or C wards in public hospitals. Insurers hitherto offered their own plans that came with varying benefits, causing some confusion.

MediShield Life ‘will also benefit Integrated Shield Plan holders’
Suggestions on MediShield Life premiums unveiled
Standard Integrated Shield plan to start in first half of 2016
MediShield Life to account for bigger chunk of Integrated Shield payouts

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New no-frills insurance plan for higher hospital class

Singaporeans wanting insurance coverage for a higher hospital class than that provided by the basic MediShield Life can opt for a new standardised package from five private insurers from May 1.

This new Integrated Shield Plan (IP) will cover nine out of 10 Class B1 public hospital bills, and will give people the option for coverage beyond Class B2/C at affordable premiums.

The Ministry of Health (MOH) worked with the five private insurers to develop the key features of the new Standard IP, following public feedback to the MediShield Life Review Committee that there was demand for such coverage.

related: All you need to know about the standard B1 class Integrated Shield Plan

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5Cs and 10 questions to ask about that new B1 IP

PUBLIC feedback for a mid-priced insurance plan has been heard. The new Standard B1 Integrated Shield Plan (IP) was announced this week, after recommendations were made to the MediShield Life Review Committee in 2014. Five private insurers – AIA, Aviva, Great Eastern, Prudential, and NTUC Income – will start offering the new plan from May this year.

If you’re currently only on MediShield Life, or on one of the IPs, you may be thinking of switching to this new Standard B1 IP, whose coverage and premium costs fall somewhere between the two types of policies.

But is the new plan right for you? Here are the 5Cs about that new B1 plan you can ask your insurance provider:
  • Comfort
  • Coverage
  • Costs
  • Claims
  • Care
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Thinking of switching to the new Standard IP? Read this first

IT’S finally here, after about two years in the making: A new insurance policy that lets you be just a bit more comfortable if you’re packing an overnight bag for the hospital. Called the Standard Integrated Shield Plan (IP), the policy which starts on May 1 builds on the national MediShield Life (MSHL) by letting patients choose to stay in Class B1 wards rather than B2 or C wards. Class B1 wards have air-conditioning, B2/C wards do not.

Concerns over rising premiums with the new and compulsory MSHL have led to calls for a more “budget” IP targeted at consumers who don’t really care for private facilities. In 2014, the MediShield Life Review Committee recommended that the G work with private insurers to offer such an option. Most IPs currently on the market cover costs up to Class A wards and stays in private hospitals.

If you’re thinking of making a switch, be sure to talk to all six insurers (AIA, Aviva, AXA, Great Eastern Life, Prudential and NTUC Income) who offer the plan. Although the benefits are the same, the premiums may vary. Premiums for the Standard IP will be more expensive than the basic MSHL plan, but cheaper than those covering Class A and private hospital stays.


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Medishield Life: What is clear and not so clear

The MediShield Life scheme, the details of which were announced on Thursday, is to give Singaporeans peace of mind, a phrase that is being used often by the government.

How far will it go in assuring Singaporeans, especially older Singaporeans, that it is better to die than fall sick? Here we try to break down the scheme to itemise the clear and not-so-clear aspects.
  • MediShield Life pays more for large medical bills
  • In return, premiums will increase
Not so clear:
  • Lower income group with pre-existing conditions
  • Claim limits may pose a problem to more people
  • Premiums are increasing, but outpatient costs are not addressed

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Why Singaporeans should get an integrated shield Plan

Every Singaporean is covered by MediShield Life and will need to pay annual premiums that are slightly higher that the old MediShield though for the next four years, the Singapore government will be subsidizing the cost of MediShield Life for most of us. The amount of subsidy you get is based on the value of your home and also depends on whether you are a Singapore Citizen or Permanent Resident.

MediShield Life covers you for hospitalisation and treatment regardless of which ward class you choose. However, the coverage is based on the costs of Class B2/C wards. That means it will not cover most of your costs if you choose to go with a Class B1/A ward in public hospitals, or private hospitals. Integrated Shield Plans provide that additional coverage.

You may already have an Integrated Shield Plan without realising it. According to the Ministry of Health, 60 per cent of Singaporeans are already paying the premiums for an Integrated Shield Plan. This means that you may already be eligible for additional coverage at private hospitals or Class A and Class B1 wards in public hospitals without realizing it. In fact, many Singaporeans are unknowingly paying annual premiums for an Integrated Shield Plan.

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Singapore’s Healthcare System: The Best Of Both Worlds

Over the past few days, we have heard from various parties about how they believe Singapore’s healthcare system can be improved. In particular, the SDP has called for the 3M model to be scrapped, in favour of a single-payer system that makes healthcare virtually free for some, and our healthcare financing system far less progressive.

The government recognises that there are few things more distressing than struggling to pay for medical expenses while worrying about a family member’s medical condition. Our promise is that all Singaporeans will have access to good healthcare regardless of their circumstances.

Part of how we’ve been able to achieve this while keeping overall expenditure on healthcare manageable is our MediSave and MediShield scheme. They go a long way in protecting Singaporeans against large medical bills. We also introduced Medifund as a safety net for those who were unable to pay despite our first 2Ms.

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Shielded For Life

MediShield, Singapore’s mandatory low-cost basic medical insurance scheme was introduced in 1990 in order to help Singaporeans pay for hospitalisation bills. On 1 Nov 2015, it will be replaced by MediShield Life, which according to the Ministry of Health (MOH) is an upgraded version that will provide better protection and higher payouts for all Singaporeans.

For example, patients can currently claim up to $450 per day for each night’s stay for Normal Wards at subsidised public hospitals and $900 per day for treatment at Intensive Care Unit (ICU) Wards. Under Medishield Life, this will increase to $700 per day for Normal Wards and $1,200 per day for ICU wards. Other differences include a lower co-payment percentage reducing individual treatment fees and coverage for life, unlike MediShield’s previous age limit of 90.

However, these benefits come with increased premiums, and certain individuals with serious pre-existing conditions like cancer or heart disease will have to pay an extra 30% in Additional Premiums for 10 years. According to the MOH, 25,000 individuals, or less than 1% of all residents will be affected. Health Minister Gan Kim Yong noted that they adopted a “fair and compassionate approach in identifying Singaporeans who will be subject to the Additional Premiums”, specifically for people that “would not be able to purchase insurance and would have been bearing high medical costs without any insurance protection over the past years.”

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No more A Class ward for me

Still reminiscing the good old days when life was good, when many things were free. Dental and medical treatments were free for children. And as adults working in the civil service, hospitalization entitlement was free even for the wife, and in A Class ward. Many retired civil servants that opted out from the old medical schemes are kicking themselves silly today when the cost of A Class ward today is like paying for a Presidential Suite in a 5 star hotel.

Just a few decades ago, practically every Singaporeans, technicians and taxi drivers, would opt for A Class wards on admission to a hospital. A Class was affordable to the average Singaporeans with their large savings in their CPF.

Today, you no longer hear the average Singaporeans asking for A or even B1 wards in privatized public hospitals. They know that one admission would make them a bankrupt or in debt forever. I have made up my mind that C Class is what I could afford should I ‘sway sway’ get admitted to a private public govt hospitals. And I am not even sure if I could afford to pay the medical bills even with subsidies and with the MediShield Life Scheme.

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SSISS: MediShield Life premiums kept affordable, HPB’s sexuality FAQ welcomed

Health Minister Gan Kim Yong said that premiums for the MediShield Life scheme will be kept within MediSave annual contributions levels to keep premiums affordable. He added that premiums paid by the younger generation will not be used to subsidise the older generation, rather, it will be used to pre-fund each age cohort’s future premiums when they get older.

Healthcare costs in Singapore without insurance coverage is hefty. Public knowledge of what can or cannot be funded by MediSave or covered by MediShield is confusing, mired with jargon and still a long way from ideal.

Pre-funding one’s own insurance premiums is a prudent way of ensuring that everyone has at least minimal insurance coverage when they are older and without income. The Health Ministry has to ensure that adequate coverage is given to seniors in the future even if they can no longer no longer fund MediShield since they have been paying premiums when they were younger to pre-fund their later years.

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Medishield Life: 8 Things Our Caring Singapore Government Wants You to Know

Medishield Life is a universal form of health insurance, which means all of us will be covered by it, and also be hit by higher premiums. But the government says that the benefits of this new health scheme outweighs the higher costs, and that it will give you subsidies to ease into the new policy. Is the scheme as good as it sounds?

Take a look:
  • Covers everyone - All Singapore Citizens and Permanent Residents. Even if you have pre-existing conditions including cancer, stroke, heart disease. Even if you were previously rejected by insurers.
  • Protects you for life.
  • Has better benefits - MediShield Life pays more of your bill. You pay less.
Medishield Life: Taking Care of Our Healthcare by Taking from Our Medisave?
25,000 Singaporeans and PRs to Pay Additional MediShield Life Premiums
Overseas S'poreans Against ML: “Unfair to Pay for Something We Don’t Use”
S$100,000 Hospital Bill, Man Paid S$0 Thks to MediSave, Medishield Subsidies
High Interest, Harsh Penalties, Claims Restrictions: Frightful Facts of MediShield
A Lifetime Living Tax: The Sinister Side of Medishield Life

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Medishield Life commences today, overseas Singaporeans complain mandatory payment

Singapore’s first universal health insurance Medishield Life has taken effect today (Nov 1) and will cover Singapore citizens and Permanent Residents for large hospital bills and expensive outpatient treatments. Those with pre-existing conditions will also be covered but their insurance premiums will be adjusted upwards on a case-by-case basis.

Health insurance is nationalised for the first time in Singapore after years of failure by the private insurance model to provide affordable healthcare for the masses. Medishield Life is mandatory and payment is automatically deducted from CPF’s Medisave account. Penalty for deliberately defaulting Medishield Life premiums payment will result in a fine and a jail sentence. Those who do not pay Medishield Life will not be allowed to leave Singapore and the government will take legal actions by suing the defaulter.

Singaporeans and Permanent Residents who permanently resides overseas are not spared from the charge. According to the Health Minister Gan Kim Yong, this group of people will enjoy the benefits when they returned to Singapore. However, this arrangement has met with severe opposition from overseas Singaporeans. Overseas Singaporeans who are PRs of another country reasoned that they are already permanently living in another country and that paying for health insurance in Singapore alongside their overseas coverage is akin to double taxation. The Singapore Government however refused to budge.


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How to get the max out of Medisave / Use Medisave to buy health insurance
"You can die in Singapore, but you can’t afford to fall sick here" is a common refrain heard on the street

A recent survey by research company GfK found that 42 per cent of respondents expressed concern about the cost of healthcare in Singapore.

September 2013's inflation data released by the Department of Statistics showed that healthcare costs went up by 4 per cent compared to the same period a year ago, higher than the 1.6 per cent increase in the overall consumer price index.

But healthcare in Singapore can be affordable. The system has multiple tiers of protection to ensure that no Singaporean is denied access to basic healthcare because of affordability issues.

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ADHD not covered by Medisave as it is less common among population

Under the Chronic Disease Management Programme (CDMP), which was introduced in 2006 to improve outpatient chronic disease management, Singaporeans can use up to S$400 per year from their Medisave account to pay for their treatment.

Immediate family members can also use up to S$400 from their Medisave account for the patient’s bills.

The CDMP has been expanded over the years and now covers 19 chronic conditions, which were included based on various considerations, such as how common the disease is among the population and the effectiveness of early treatment in reducing complications.

AXA's Integrated Shield Plan (AXA Shield) will be offered from 1 May 2016

MEDISHIELD LIFE: This is the national health insurance that covers all Singaporeans and permanent residents for life. The coverage is enough for most treatments in the subsidised C and B2 class wards in a public hospital.

INTEGRATED SHIELD PLAN (IP): This provides coverage additional to MediShield Life. There are three categories of IP pegged to treatments at public hospital Class A and B and at private hospitals. The premiums for IPs include that for MediShield Life.

UNDERWRITING: While MediShield Life will cover everyone, including those who are already very sick, private insurers are not obliged to do the same. They can refuse coverage, or exclude cover for medical conditions that exist at the time the person buys the insurance.

STANDARD B1 IP: This is the new plan starting on May 1 that all six IP insurers must offer. It is meant to provide coverage higher than subsidised care, at affordable prices in an easily understood package.

Singapore’s Healthcare: MediShield Life
National health insurance scheme MediShield Life
Medishield Life Review
The MediShield Life Conundrum
Return Our CPF – MediShield Life
Tweaks in Our SG Healthcare
Health Cost