Healthcare costs in Singapore can be daunting, especially when unexpected medical bills start piling up.
That’s why I’m here to guide you through MediShield Life and Integrated Shield Plans.
In this post, you’ll learn:
- What MediShield Life is and how it works
- The limitations of MediShield Life coverage
- Why you might need an Integrated Shield Plan
- A rundown of the top Integrated Shield Plans available
Curious to know more and make sure you’re fully covered?
Let’s dive in and explore your best options together.
What is MediShield Life?
MediShield Life is a fundamental health insurance scheme designed to cover significant hospital expenses and certain expensive outpatient treatments like dialysis and cancer chemotherapy.
Its design aims to reduce your out-of-pocket costs by utilising MediSave and cash for major hospital bills.
MediShield Life is an important national scheme that is available to all Singapore Citizens and Permanent Residents, providing universal coverage and ensuring that everyone has access to essential healthcare without financial burden.
It’s affordability ensures that everyone can maintain continuous health insurance coverage without undue financial strain.
The comprehensive coverage ensures that a wide range of medical needs is addressed, giving you peace of mind.
Who is eligible for MediShield Life?
Specifically, the following groups are eligible for MediShield Life:
- Singaporean Citizens
- Permanent Residents
How does MediShield Life work?
MediShield Life helps to offset costs, covering a portion of hospital bills and outpatient treatments, with the remainder paid using MediSave or cash.
This ensures that significant medical expenses do not become an insurmountable financial burden.
The new plan has significantly increased claim limits, allowing for better financial support during prolonged or intensive medical treatments.
I’ll cover more on this later.
MediShield Life’s lifelong coverage ensures continuous protection, providing peace of mind as you age.
Unlike MediShield, which excluded individuals with pre-existing conditions, MediShield Life covers conditions like HIV, congenital issues, and other medical conditions.
What does MediShield Life exclude?
MediShield Life, while comprehensive, has certain exclusions that policyholders should be aware of.
Key exclusions include ambulance fees, medical reports, and maternity charges.
Ambulance services are not covered under MediShield Life, meaning the associated costs will need to be paid out-of-pocket or through alternative means.
Additionally, fees for obtaining medical reports are not included in the coverage, so any detailed medical documentation you require must be paid for separately.
Maternity-related expenses, including both prenatal and postnatal care, are also excluded from MediShield Life coverage – a maternity insurance plan might help you with these costs though.
You will need to find alternative coverage or pay these costs directly.
What can you claim under MediShield Life?
MediShield Life Claim Limits
Under MediShield Life, the highest claimable amount per policy year is capped at $150,000.
Additionally, there are no restrictions on the total amount that can be claimed over a lifetime, providing lifelong protection and financial support for your medical needs.
Deductibles
When making claims under MediShield Life, it’s important to understand the deductible structure, which varies based on your age and the type of ward or treatment.
The deductible is the amount you need to pay out-of-pocket before the insurance coverage kicks in.
| Deductible (based on age at next birthday at the start of the policy year) | ||
| Ward Class/Treatment | 80 and below | 81 and above |
| Class C | $1,500 | $2,000 |
| Class B2 and above (including stay in private hospitals) | $2,000 | $3,000 |
| Day surgery | $1,500 | $2,000 |
| Outpatient treatments | Not applicable | |
Co-insurance component
The co-insurance component of MediShield Life requires you to pay a percentage of the claimable amount after the deductible has been met.
The co-insurance varies from 10% to 3%, decreasing as the bill amount increases.
| Inpatient/Day Surgery
Claimable amount accumulated within a policy year |
|
| First $5,000 | 10% |
| Next $5,000 | 5% |
| Above $10,000 | 3% |
| Outpatient treatment | 10% |
What does MediShield Life cover?
Here are the coverage details for MediShield Life:
Inpatient/Day Surgery
| Inpatient/Day Surgery | Claim Limits |
| Daily Ward and Treatment Charges | |
| Normal ward | $800 per day* |
| Intensive care unit ward | $2,200 per day* |
| * An additional claim limit of $200 per day applies for the first 2 inpatient days | |
| Psychiatric (up to 60 days per policy year) | $160 per day |
| Community hospital (Rehabilitative) | $350 per day |
| Community hospital (Sub-acute) | $430 per day |
| Inpatient palliative care service (general) | $250 per day |
| Inpatient palliative care service (specialised) | $350 per day |
Surgical Procedure
|
Surgical Procedure |
Claim Limits | ||
| A | B | C | |
| Table 1 A/B/C (less complex procedures) | $240 | $340 | $340 |
| Table 2 A/B/C | $580 | $760 | $760 |
| Table 3 A/B/C | $1,060 | $1,160 | $1,280 |
| Table 4 A/B/C | $1,540 | $1,580 | $1,640 |
| Table 5 A/B/C | $1,800 | $2,180 | $2,180 |
| Table 6 A/B/C | $2,360 | $2,360 | $2,360 |
| Table 7 A/B/C | $2,600 | $2,600 | $2,600 |
Outpatient Treatment
| Outpatient Treatment | Claim Limits |
| Cancer drug treatment | $200 to $9,600 per month, depending on the cancer drug treatment
Or
Sum of highest cancer drug treatment amongst claimable treatments for each primary cancer per month |
| Cancer drug services | $3,600 per year
Or
$7,200 per year for multiple primary cancer treatments |
| Radiotherapy for cancer – External (except Hemi-body) | $300 per treatment |
| Radiotherapy for cancer – Brachytherapy | $500 per treatment |
| Radiotherapy for cancer – Hemi-body | $900 per treatment |
| Radiotherapy for cancer – Stereotactic | $1,800 per treatment |
| Radiotherapy for cancer – Proton Beam Therapy – Category 1 | $300 per treatment |
| Radiotherapy for cancer – Proton Beam Therapy – Category 2 | $500 per treatment |
| Radiotherapy for cancer – Proton Beam Therapy – Category 3 | $1,800 per treatment |
| Kidney dialysis | $1,100 per month |
| Immunosuppressants for organ transplant | $550 per month |
| Erythropoietin for chronic kidney failure | $200 per month |
| Long-term parenteral nutrition | $1,700 per month |
Does MediShield Life cover pre-existing conditions?
Yes, MediShield Life covers pre-existing conditions.
Unlike many other insurance plans, MediShield Life includes coverage for conditions you had before your insurance started.
This means that if you have chronic illnesses or any other medical conditions prior to getting covered, you will still receive the benefits of MediShield Life.
Medishield Life Premiums
Government Support and Subsidies
MediShield Life Premium Schedule for Singapore Citizens and Permanent Residents
| Premiums (before subsidies)
Applicable for policy start/renewal date on after 1 January 2024 |
|||
| Age Next Birthday | Annual Premiums (Inclusive of 9% GST) | Age Next Birthday | Annual Premiums (Inclusive of 9% GST) |
| 1 to 20 | $147.71 | 74 to 75 | $1,344.67 |
| 21 to 30 | $254.67 | 76 to 78 | $1,558.60 |
| 31 to 40 | $397.29 | 79 to 80 | $1,619.72 |
| 41 to 50 | $534.81 | 81 to 83 | $1,706.31 |
| 51 to 60 | $814.95 | 84 to 85 | $1,971.17 |
| 61 to 65 | $1,039.07 | 86 to 88 | $2,062.85 |
| 66 to 70 | $1,120.56 | 89 to 90 | $2,062.85 |
| 71 to 73 | $1,217.34 | >90 | $2,093.41 |
Premium Subsidy for the Lower- to Middle-Income
| Premium Subsidies
(For those living in residences with Annual Value of $21,000 or less) |
|||
| Age Next Birthday | Subsidy Rates for Singapore Citizens based on Household Monthly Income Per Person | ||
| Lower-Income
$0 to $1,200 |
Lower-Middle-Income
$1,201 to $2,000 |
Upper-Middle-Income
$2,001 to $2,800 |
|
| 1 to 40 | 25% | 20% | 15% |
| 41 to 60 | 30% | 25% | 20% |
| 61 to 75 | 35% | 30% | 25% |
| 76 to 85 | 40% | 35% | 30% |
| 86 to 90 | 45% | 40% | 35% |
| >90 | 50% | 45% | 40% |
| Note: Those living in residences with an Annual Value of between $21,001 and $25,000 will receive 10 percentage points less than the subsidy rates shown above. Those living in residences with an Annual Value of above $25,000 will not receive these subsidies.
Household Per Person Monthly Income = Total Gross Household Monthly Income / No. of Family Members in the Household |
|||
Pioneer Generation Subsidy
| Pioneer Generation Subsidies | |
| Age Next Birthday | Pioneer Generation Subsidies as Percentage of Premiums |
| 66 to 70 | 40% |
| 71 to 80 | 44%-54% |
| 81 to 90 | 54%-59% |
| >90 | 60% |
Merdeka Generation Subsidy
| Merdeka Generation Subsidies (Applicable for policy start/renewal date on or after 1 July 2019 | |
| Age Next Birthday | Additional Merdeka Generation Subsidies as Percentage of Premiums |
| 60 to 75 | 5% |
| 76 and above | 10% |
What if I don’t pay my MediShield Life premiums?
MediShield Life coverage is mandatory for all Singapore Citizens and Permanent Residents.
To ensure compliance, the government has established several penalties and enforcement actions for those who choose not to pay their premiums.
Persistent non-payment of MediShield Life premiums can result in legal enforcement actions.
The government has the authority to initiate legal proceedings to recover the unpaid amounts, which could lead to further legal costs and complications.
Furthermore, having outstanding MediShield Life premiums may place restrictions on withdrawals from your CPF accounts, limiting your ability to use CPF savings for other purposes, such as housing or retirement.
Failing to pay your MediShield Life premiums may also result in the loss of government subsidies that help make the premiums more affordable. Without these subsidies, your financial burden may increase, making it even more challenging to maintain your coverage.
Late payment of MediShield Life premiums
Late payment of MediShield Life premiums can lead to several consequences.
First, you may incur late payment penalties and interest, which accumulate on the unpaid amount, increasing your total debt over time.
To address unpaid premiums, the government employs premium recovery measures.
This includes deducting the owed amount from your CPF accounts, such as the Ordinary Account, Special Account, or Retirement Account.
If these accounts lack sufficient funds, the outstanding premiums might be deducted from future CPF contributions.
Fortunately, most people will not have to worry about these penalties, as premiums are automatically deducted from their CPF accounts.
However, it is still important to periodically check your CPF statements to ensure that payments are being made correctly and on time.
How to claim MediShield Life?
Claiming MediShield Life is a straightforward process designed to minimise hassle and ensure you receive the coverage you need.
Here’s a step-by-step guide on how to make a claim:
- Inform the Healthcare Staff: When you are admitted to a hospital or undergoing outpatient treatment, let the staff managing your admission or treatment know that you intend to file a MediShield Life claim.
- Healthcare Facility Submission: The healthcare facility will handle the submission of your claim on your behalf.
- CPF Board Processing: Once the claim is submitted, the CPF Board will process it.The MediShield Life payout will be applied directly to your bill, reducing a significant portion of the costs covered under the scheme.
- Covering the Remaining Amount: After the MediShield Life payout has been applied, there may still be a remaining amount on your bill. You can use MediSave (up to certain limits) and/or cash to cover this remaining amount.
Is MediShield Life enough?
In any case you are hospitalised, it is evident that you’ll still have to fork out a significant amount of money from your pockets such as the deductible, co-insurance, or anything above the claim limit – despite having MediShield Life.
You can see why a basic MediShield Life is certainly not enough because it can easily wipe out your savings just like that.
Retrospectively, the average hospitalisation bill in Singapore for B2 and C wards in public hospitals ranges from about $1,178 to $3,380 and $1,012 to $2,558 respectively – according to MOH.
There have been instances where 5% of patients have paid way more than that range, with about $3,434 to $10,389 (for Class B2) and $2,973 to $8,466 (for Class C).
Plus, looking at the benefits provided by MediShield Life, there are relatively few and not sufficient.
Thus, there are many insurers that offer Integrated Shield Plans (IPs) that provide additional financial support on top of your MediShield Life.
Especially if you seek a higher comfort level (i.e., Class B1 or A wards) or wish to get treated at private hospitals, IPs can also provide you with the ability to do so.
So, for your convenience, I have compiled a comprehensive guide to IPs and identified the best based on a few select criteria.
These plans are offered by private insurers and are designed to cover more expensive treatments, higher-class wards, and even private hospital stays, which MediShield Life alone might not fully cover.
Here are some of the 7 policies and insurers available for Integrated Shield Plans in Singapore:
- AIA HealthShield Gold Max
- Singlife Shield
- HSBC Life Shield
- Great Eastern SupremeHealth
- NTUC Income Enhanced IncomeShield
- Prudential PruShield
- Raffles Health Insurance Raffles Shield
Frequently Asked Questions
How do I make payment for my outstanding premiums?
Payments can be made directly from your CPF MediSave account, ensuring that the premiums are automatically deducted.
If there are insufficient funds in your MediSave account, you can pay the outstanding amount using cash, which can be done through AXS stations, SingPost branches, or via internet banking.
Keeping your premiums up to date ensures continuous coverage under MediShield Life.
Does MediShield Life cover all medical expenses?
No, MediShield Life does not cover all medical expenses.
While it provides significant coverage for major hospital bills and certain costly outpatient treatments like dialysis and cancer chemotherapy, it does not cover all costs.
Standard exclusions include ambulance fees, medical reports, and maternity charges.
Additionally, there are limits on the amounts claimable for various treatments and services.
Conclusion
In a nutshell, MediShield Life is a crucial part of Singapore’s healthcare system, offering essential coverage for significant hospital expenses and certain costly outpatient treatments.
However, as we’ve discussed, there are limits to what it covers.
You might still face substantial out-of-pocket costs for deductibles, co-insurance, and treatments exceeding the claim limits.
Considering the average hospitalisation costs, especially in higher-class wards or private hospitals, relying solely on MediShield Life might not be sufficient.
This is where Integrated Shield Plans come in, providing enhanced coverage and additional benefits to ensure you’re well-protected against hefty medical bills.
We’ve highlighted several Integrated Shield Plans from trusted insurers like AIA, Singlife, HSBC, Great Eastern, NTUC Income, Prudential, and Raffles Health Insurance.
Each offers unique benefits that can complement your MediShield Life coverage.
If all this sounds a bit overwhelming or if you’re unsure which plan is right for you, don’t worry.
Our financial advisor partners are here to help.
Feel free to reach out for a free consultation to get personalised advice tailored to your needs.
Taking the time to understand and choose the right plan can make a significant difference in your financial peace of mind.
References
- https://www.iras.gov.sg/schemes/disbursement-schemes/medishield-life-(mshl)
- https://www.moh.gov.sg/healthcare-schemes-subsidies/medishield-life
- https://www.cpf.gov.sg/member/infohub/educational-resources/what-can-you-claim-under-medishieldlife
- https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/how-to-make-a-medishield-life-claim
- https://www.moh.gov.sg/healthcare-schemes-subsidies/medishield-life/medishield-life-faqs
- https://www.cpf.gov.sg/member/healthcare-financing/medishield-life
