Once you fall sick, what’s the very first thing you do? Complain about how costly healthcare is in Singapore? Properly, after doing that, the subsequent factor it’s best to do is to see how MediShield Life may also help you.
However what’s MediShield Life anyway? How do you profit from it? And why do you want it when a part of your CPF contributions have already got to enter your Medisave account? These questions and extra shall be answered proper right here.
Contents
- What’s MediShield Life?
- Am I eligible?
- MediShield Life Protection & Advantages
- MediShield Life Exclusions
- What’s deductible?
- What’s co-insurance?
- MediShield Life Declare
- Does MediShield cowl pre-existing situation?
- MediShield Life Premium
- MediShield Life Subsidies
- Updates to MediShield Life
- Built-in Protect Plan vs MediShield Life
1. What’s MediShield Life?
Have you ever ever been advised that you simply’ll go bankrupt in case you fall significantly ailing and don’t have medical insurance coverage?
Properly, guess what, even in case you’ve by no means spoken to an insurance coverage agent or bought a single insurance coverage coverage in your life, you truly are lined by the Ministry of Well being’s medical insurance coverage, MediShield Life.
MediShield Life is a fundamental medical insurance coverage plan which all Singaporeans and Everlasting Residents (PRs) are robotically enrolled in.
It really works in the identical method as different kinds of medical health insurance. Principally, you can also make a declare for sure kinds of medical payments, together with hospitalisation and sure kinds of outpatient therapy.
The catch is that, being a really fundamental plan, there are strict limits as to how a lot you possibly can declare and what’s lined.
As an illustration, in case you get hospitalised, your MediShield Life payouts will solely in a position to cowl the price of Class C or Class B2 wards at public hospitals.
To offer you an thought of the distinction in value, listed here are the median hospital payments from MOH for a advanced knee joint alternative surgical procedure on the numerous wards:
| Ward class | Whole hospital invoice |
| Public hospital: Ward C | $6,436 (subsidised) |
| Public hospital: Ward B2 | $7,753 (subsidised) |
| Public hospital: Ward B1 | $21,586 |
| Public hospital: Ward A | $24,899 |
| Non-public hospital | $10,220 – $14,400 |
For public hospitals alone, the second you improve from Class B2/C to Class B1/A, costs greater than triple. Massive distinction!
So if you wish to keep in a better class ward or go to a personal hospital, MediShield Life received’t be sufficient. You’ll must complement your plan with an Built-in Protect plan (extra on that beneath) for increased protection, and/or high up the rest in money or Medisave.
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2. Am I eligible for MediShield Life?
All Singapore residents and PRs are robotically granted lifetime safety by MediShield Life.
If you’re a PR, it’s necessary to notice that the quantity of subsidies you obtain at public hospitals shall be decrease than what Singapore residents obtain. That is prone to end in your having to pay increased out-of-pocket fees.
You can’t choose out of MediShield Life, and must proceed paying the premiums over your lifetime — until you reside abroad and don’t have any intention of returning. Then you possibly can apply to choose out.
You get pleasure from lifetime protection no matter any pre-existing medical circumstances.
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3. MediShield Life Protection & Advantages
Right here’s a fast have a look at the present MediShield Life advantages (i.e. how a lot you possibly can declare). Desk taken from the Ministry of Well being:
| MediShield Life Protection (Inpatient) | Declare Limits |
| Day by day Ward and Therapy Prices | |
| Regular Ward | $800/day |
| Intensive Care Unit Ward | $2,200/day |
| Psychiatric (as much as 60 days/12 months) | $160/day |
| Neighborhood Hospital (Rehabilitative) | $350/day |
| Neighborhood Hospital (Sub-Acute) | $430/day |
| Inpatient Palliative Care Service (Common) | $250/day |
| Inpatient Palliative Care Service (Specialised) | $350/day |
In case you’re getting hospitalised for a surgical procedure, there’s a really complete desk of surgical procedures on the Ministry of Well being‘s web site you could consult with. Discover your actual surgical procedure from that desk, after which it is possible for you to to match the price of it right here:
| MediShield Life Protection (Inpatient) | Declare Limits |
| Surgical Procedures | |
| Desk 1 A/B/C (much less advanced procedures) | A $240, B $340, C $340 |
| Desk 2 A/B/C | A $580, B $760, C $760 |
| Desk 3 A/B/C | A $1,060, B $1,160, C $1,280 |
| Desk 4 A/B/C | A $1,540, B $1,580, C $1,640 |
| Desk 5 A/B/C | A $1,800, B $2,180, C $2,180 |
| Desk 6 A/B/C | A $2,360, B $2,360, C $2,360 |
| Desk 7 A/B/C (extra advanced procedures) | A $2,600, B $2,600, C $2,600 |
| Implants | $7,000/therapy |
| Radiosurgery | $10,000/therapy |
| Continuation of Autologous Bone Marrow Transplant Therapy for A number of Myeloma | $6,000/therapy |
Lastly, in case you’re going to the hospital for therapy as an outpatient (not getting hospitalised there), listed here are the advantages and declare limits:
| MediShield Life Protection (Outpatient) | Declare Limits |
| Outpatient Therapy | |
| Chemotherapy for Most cancers | $3,000/month |
| Radiotherapy for Most cancers | |
| Exterior (Besides Hemi-Physique) | $300/therapy |
| Brachytherapy | $500/therapy |
| Hemi-Physique | $900/therapy |
| Stereotactic | $1,800/therapy |
| Kidney Dialysis | $1,100/month |
| Immunosuppressants for Organ Transplant | $550/month |
| Erythropoietin for Power Kidney Failure | $200/month |
| Lengthy-term Parenteral Vitamin | $1,700/month |
Further $1,200/12 months for Most cancers Outpatient Prices from September 2022
Talking of most cancers outpatient therapies, there was a lot speak across the low MediSave withdrawal restrict ($600/12 months) for most cancers sufferers to make use of for his or her on cancer-related MRI, CT, and different scans. View MediSave withdrawal limits right here.
Whereas the MediSave withdrawal restrict received’t be elevated, most cancers sufferers will have the ability to declare an extra $1,200/12 months for scans as a part of their most cancers therapy from September 2022. Radiotherapy most cancers sufferers will have the ability to declare from the MediShield Life radiotherapy part, too.
Permitted Outpatient Most cancers Medication from September 2022
Different necessary information to notice about claiming for most cancers from MediShield Life is that this – from September 2022, the outpatient most cancers medicine that you simply use in most cancers therapy must be within the official MediShield Life Most cancers Drug Checklist to be claimable.
To see in case your most cancers drug is claimable and subsidised underneath MediShield Life, verify this Ministry of Well being Drug Subsidies Checklist.
What are the declare limits for MediShield Life? You possibly can declare as much as $150,000 per coverage 12 months, however there’s no cap on how a lot you possibly can declare in your whole lifetime.
| MediShield Life Most Declare Restrict | |
| Per Coverage 12 months | $150,000 |
| Lifetime | No Restrict |
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4. MediShield Life exclusions
There are specific stuff you can’t use MediShield Life to pay for, reminiscent of the next.
- Ambulance charges
- Beauty surgical procedure
- Dental work (besides because of unintended accidents)
- Vaccination
- Infertility, sub-fertility, assisted conception or any contraceptive operation
- Intercourse change operations, together with their associated issues
- Maternity fees (together with Caesarean operations) or abortions, together with their associated issues, besides therapies for critical issues associated to being pregnant and childbirth
- Therapy for accidents arising from the insured’s legal act
- Therapy of accidents arising straight or not directly from nuclear fallout, struggle and associated danger
- Therapy of accidents arising from direct participation in civil commotion, riot or strike
- Bills incurred after the 7th calendar day from being licensed to be medically match for discharge from inpatient therapy and assessed to have a possible discharge possibility by a medical practitioner
- Surgical interventions, together with associated issues, for the next uncommon congenital circumstances that are extreme and deadly by nature: Trisomy 13, Bilateral Renal Agenesis, Bart’s Hydrops and Anecephaly
- Non-obligatory objects that are exterior the scope of therapy
- Abroad medical therapy
- Non-public nursing fees
- Buy of kidney dialysis machines, iron-lung and different particular home equipment
- Therapy which has obtained reimbursement from Workmen’s Compensation and different types of insurance coverage protection
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5. What’s deductible in MediShield Life?
So, you may need learn that there’s a “deductible” for MediShield Life. The deductible is the sum of money you must pay earlier than you can also make your first MediShield Life declare every year, and it will depend on which ward you keep in.
| MediShield Life Deductible | ||
| Age 80 and underneath | Age 81 and over | |
| Ward Class C | $1,500 | $2,000 |
| Ward Class B2 and above | $2,000 | $3,000 |
| Day surgical procedure | $1,500 | $3,000 |
| Outpatient Therapies | – | – |
You’ll solely must pay the deductible every year, even in case you make a number of claims in that 12 months.
Instance:
You get hospitalised twice in a 12 months, and in each instances you get warded in a Class B2 ward. Your first medical invoice is $8,000 and the second is $4,000, making a complete of $12,000.
Being underneath 81 years outdated, you’d thus pay a deductible of $2,000 after your first hospital go to. As deductibles are solely payable as soon as a coverage 12 months, you wouldn’t must pay any deductible when making a declare in your second go to.
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6. What’s co-insurance?
The deductible isn’t the one cash that you must fork out with a view to make a MediShield Life declare.
Additionally, you will must pay co-insurance, which is calculated as a share of the quantity you’re attempting to assert. Whereas the deductible is charged solely as soon as a coverage 12 months, co-insurance should be paid every time you make a declare.
The quantity of co-insurance you need to pay varies in accordance with the scale of your invoice.
| Quantity being claimed | Co-insurance |
| $0 to $3,000 | 10% |
| $3,001 to $5,000 | 10% |
| $5,001 to $10,000 | 5% |
| > $10,000 | 3% |
Instance: Let’s take the instance within the earlier part, the place you incurred two hospital payments value $8,000 and $4,000 respectively, and paid a deductible of $2,000 after the primary hospital go to.
After paying your deductible, you’ve nonetheless bought $10,000 value of bills.
After the primary hospital go to, which price $8,000, you paid a deductible of $2,000. You’ll then submit a declare for $6,000. The co-insurance portion for that sum is 10% of the primary $3,000 and 5% of the subsequent $3000, so you’d pay $450 and declare the remaining $5,550.
For the second hospital go to, there isn’t a deductible, so you possibly can submit a declare for all the invoice of $4,000. The co-insurance portion is 5% for the primary $2,000 and three% for the subsequent $2,000 so you’d pay co-insurance of $160, after which obtain $3,840 value of MediShield Life payouts.
On this situation, your whole medical invoice of $12,000 is damaged down as follows:
| MediShield Life payout | $9,390 |
| Deductible (paid by you) | $2,000 |
| Co-insurance (paid by you) | $610 |
| Whole medical payments | $12,000 |
As you possibly can see, to cowl your medical payments totalling $12,000, you would need to fork out $2,610, and the remaining could be paid by MediShield.
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7. The best way to make a MediShield Life declare?
The claims course of differs relying on whether or not you might have bought an Built-in Protect Plan (ie. a personal medical health insurance coverage that works in tandem with MediShield Life), or whether or not you can be relying solely on MediShield Life.
In case you don’t have an Built-in Protect Plan…
You’re in all probability wishing you had an Built-in Protect Plan proper now. The excellent news, if we will name it that, is that the paperwork in your MediShield Life declare shall be dealt with by the employees at your hospital or different healthcare supplier.
As soon as you might be admitted, inform the employees that you simply want to make a MediShield Life declare to pay a part of your payments. The medical establishment will submit your declare in your behalf after receiving your authorisation.
The MediShield Life payouts shall be computed based mostly on the related advantages and declare limits, bearing in mind the deductible. You possibly can then use your Medisave or money to make the fee for the co-payment quantity.
The MediShield Life payout shall be launched to the medical establishments by the CPF Board after the declare has been processed.
You probably have an Built-in Protect Plan (IP)…
Contact your insurer or agent instantly when you’re going to be admitted to hospital. Additionally inform hospital employees that you simply want to pay your invoice utilizing your IP.
MediShield Life is included in all IPs. IPs comprise of two elements, the place the MediShield Life elements are run by CPF board and the extra non-public insurance coverage protection part is run by the insurance coverage firm.
Your insurer will course of your declare and ship fee to the hospital or different medical establishment in your behalf. They may even deal with the documentation in your MediShield Life declare, and the portion of your invoice being paid by MediShield Life will robotically be despatched to the medical establishment.
Clearly, whether or not you might have an IP or not, any sums in your invoice that can not be lined by MediShield Life or your IP shall be dutifully billed to you.
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8. Does MediShield Life cowl pre-existing situation?
Not like most sorts of medical health insurance, MediShield Life covers all pre-existing medical circumstances.
In case you joined MediShield Life with one of many beneath pre-existing circumstances (e.g. within the case of PRs) you will want to pay 30% further premiums for 10 years.
| Pre-Current Circumstances | Some Examples… |
| Most cancers | Lung most cancers, colorectal most cancers, breast most cancers, abdomen most cancers |
| Blood issues | Aplastic anaemia, thalassemia main |
| Degenerative illnesses | Parkinson’s illness, muscular dystrophy, amyotrophic lateral sclerosis (ALS) |
| Coronary heart or different circulatory system illnesses | Coronary heart assault, coronary artery illness, persistent ischaemic coronary heart illness |
| Cerebrovascular illnesses | Stroke |
| Respiratory illnesses | Power obstructive pulmonary illness |
| Liver illnesses | Alcoholic liver illness, persistent hepatitis, fibrosis or cirrhosis of liver |
| Autoimmune / Immune System illnesses | Systemic lupus erythematosus, HIV, AIDS |
| Renal illnesses | Power renal illness, persistent renal failure, persistent nephritic syndrome |
| Critical congenital circumstances | Congenital coronary heart illness, congenital renal illness biliary atresia |
| Psychiatric circumstances | Schizophrenia |
| Power circumstances with critical issues | Hypertensive coronary heart illness, hypertensive kidney illness, diabetes with kidney issues, diabetes with eye issues |
After 10 years, your premiums return to regular. Further premiums are Medisave-payable.
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9. MediShield Life Premiums
In fact, anyone’s bought to pay for MediShield Life. You’ll have to pay MediShield Life premiums yearly, and these premiums will rise as you age.
| Age Subsequent Birthday | Annual MediShield Life Premiums |
| 1-20 | $145 |
| 21-30 | $350 |
| 31-40 | $390 |
| 41-50 | $525 |
| 51-60 | $800 |
| 61-65 | $1,020 |
| 66-70 | $1,100 |
| 71-73 | $1,195 |
| 74-75 | $1,320 |
| 76-78 | $1,530 |
| 79-80 | $1,590 |
| 81-83 | $1,675 |
| 84-85 | $1,935 |
| 86-88 | $2,025 |
| 89-90 | $2,025 |
| >90 | $2,025 |
The excellent news is you could pay 100% of your MediShield Life premiums utilizing Medisave.
Your premiums shall be robotically deducted out of your Medisave account when you’ve got sufficient. Or, your instant relations could pay your premium utilizing their Medisave.
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10. Can I get MediShield Life premium subsidies?
Sure, there are MediShield Life premium subsidies for decrease, center, and higher earnings teams. You may get discounted premiums starting from 15% to 50%, relying in your earnings degree.
Listed here are the MediShield Life subsidy for lower-income households ($0 to $1,200 family month-to-month earnings per particular person):
| Age Subsequent Birthday | MediShield Life Subsidy |
| 1 – 40 | 25% |
| 41 – 60 | 30% |
| 61 – 75 | 35% |
| 76 – 85 | 40% |
| 86 – 90 | 45% |
| > 90 | 50% |
Listed here are the MediShield Life subsidy for decrease to middle-income households ($1,201 to $2,000 family month-to-month earnings per particular person):
| Age Subsequent Birthday | MediShield Life Subsidy |
| 1 – 40 | 20% |
| 41 – 60 | 25% |
| 61 – 75 | 30% |
| 76 – 85 | 35% |
| 86 – 90 | 40% |
| > 90 | 45% |
Listed here are the MediShield Life subsidy for center to upper-income households ($2,001 – $2,800 family month-to-month earnings per particular person):
| Age Subsequent Birthday | MediShield Life Subsidy |
| 1 – 40 | 15% |
| 41 – 60 | 20% |
| 61 – 75 | 25% |
| 76 – 85 | 30% |
| 86 – 90 | 35% |
| > 90 | 40% |
As well as, to obtain any subsidies in any respect, you need to dwell in a residence with an annual worth of $13,000 or much less. In case you dwell in a residence with an annual worth of between $13,001 and $21,000, your subsidy charges shall be reduce by 10%.
What’s a property’s annual worth? In layman phrases, it’s the fundamental rental value and earnings your home can fetch in case you rented it out.
Oh sure, and people who are a part of the Pioneer Technology get 40% to 60% in MediShield Life premium subsidies from age 66 onwards.
In the meantime, the Merdeka Technology will get 5% premium subsidy from age 60 to 75, and 10% subsidy from age 76 onwards.
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11. MediShield Life Updates (2021)
Healthcare being a significant authorities precedence, MediShield Life does bear a specific amount of scrutiny by the higher-ups, and does get tweaked every so often to fulfill protection gaps.
However in 2021, there shall be a significant evaluate of the MediShield Life scheme. Because of healthcare inflation, the present advantages at the moment are lagging behind the precise price of healthcare and have to be revised upwards.
The proposed adjustments embody:
- Revising the annual declare restrict from $100,000 to $150,000
- Larger declare limits for the primary 2 days of hospitalisation, which is when most diagnostics and exams occur
- Larger declare limits for intensive care, dialysis, and psychiatric care
- Larger protection for sub-acute care at neighborhood hospitals
- Protection for tried suicide, self-harm, substance abuse and alcoholism
- Extra reasonably priced day surgical procedure for the aged — so they don’t have to be warded to assert
- Non-public hospital claims shall be capped at 25% down from 35%
Nevertheless, these enhancements would additionally imply as much as 35% improve in MediShield Life premiums. Yikes.
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12. What’s an Built-in Protect Plan? Distinction between IP Plan vs MediShield Life
You’ve already heard you could’t rely solely on MediShield Life due to how fundamental it’s.
However the resolution is fairly straightforward: Improve your protection is to go for an Built-in Protect Plan (IP), which may be paid for with Medisave. There are 7 insurers that present IPs in Singapore.
Built-in Protect plans comprise the MediShield Life base plan + further non-public insurance coverage offered by the insurance coverage firm. So there’s no duplicate right here.
One of many greatest advantages to getting an IP is that you’ve the choice of staying in non-public hospitals or upgrading to Class B1 and A wards and get lined. This additionally offers you the prospect to decide on your personal physician, with the potential for shorter queues and wait occasions. You may as well purchase riders in your IP to obtain even larger protection.
The draw back is clearly that you simply’ll be paying increased premiums when you’ve got an IP, and there could also be a money portion that can not be paid utilizing Medisave. These premiums could also be reasonably priced while you’re younger, however they’ll rise as you age and may ultimately get fairly hefty.
For extra particulars, try our Built-in Protect plan comparability.
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