1. Eldershield
2. Medishield Premium
3. Medishield Life Copayment Login
4. Medishield Life Scheme
5. Medishield Life Singapore

By Linette Lai

Under MediShield Life, the co-insurance rate starts at 10% and goes lower as the claimable amount increases. D = The portion covered by MediShield Life - MediShield Life benefits are designed to cover subsidised bills incurred by Singapore Citizens at Class B2/C wards and subsidised outpatient treatments/day surgery at public hospitals. You may also use your MediSave to help pay for outpatient treatments for your dependents. The limit here is $500 per year per MediSave account, and a co-payment of 15% applies. Difference #6: MediSave may not be used for related expenses.

MediShield Life’s basic health insurance protection is very bare-bones. Payouts will only cover stays in Class B2 or Class C wards in public/restructured hospitals, and a lot of things are not. If You Have an Existing IP With Full Rider, Nothing Has Changed for You. We have observed some.

MediShield Life, which replaces MediShield, will take effect on November 1, 2015. The compulsory all-inclusive health insurance scheme provides lifetime coverage for all Singaporeans and permanent residents, regardless of age or pre-existing health conditions. Reporter Linette Lai, with help from the Ministry of Health, puts together a comprehensive guide to the new scheme. Here are the answers to 101 frequently asked questions.

The Basics

MediShield is the current basic Government health insurance plan. It provides coverage up to age 92. Some people are not covered because they are too old, opted out, or were excluded based on pre-existing conditions.MediShield will be replaced by MediShield Life.

These are the key differences between the two:

MediShield Life offers higher claim limits for hospital bills and outpatient cancer treatments like chemotherapy.

There is no lifetime claim limit for MediShield Life, meaning you are covered until death.

It covers pre-existing medical conditions like congenital problems or HIV.

All Singapore Citizens will receive Transitional Subsidies over four years to help with the premium increases under MediShield Life. Members of the Pioneer Generation will receive Pioneer Generation Subsidies for life. Two in three Singaporeans will also receive Premium Subsidies for lower to middle-income families. Deductibles are the amounts you must pay before you can start making claims under MediShield Life.

They range from $1,500 to $3,000, depending on your age and class of hospital ward you choose.Here's an example:
If your hospital bill is $1,400, you will not be able to claim under MediShield Life if your deductible is $1,500.
However, you only need to pay the deductible once every policy year
So, if you are warded multiple times in a year and are charged $1,500 every time, you would be able to claim from MediShield Life after that first hospital stay.

It is the money that you have to pay on top of the deductible, and is calculated as a percentage of the bill.

Under MediShield Life, the co-insurance rate is between 3 and 10 per cent, depending on the size of your bill.

This is in line with the principle of universal coverage.

But PRs won't get any 'transitional subsidies' - that is, the subsidies that Singaporeans get in the first four years of MediShield Life's implementation which will help them ease into the scheme. PRs will also get only half the permanent subsidies that Singaporeans get.

Making Claims

MediShield Life covers hospital bills and certain outpatient treatments for conditions like cancer or kidney failure. It does not cover the cost of seeing a GP or a doctor at polyclinics or specialised outpatient clinics, or the medicine they prescribe.

Generally, MediShield Life will cover more of big hospital bills - including both surgery and ward charges - than MediShield currently does.

For example, it will cover more of the cost of chemotherapy and radiotherapy. It also covers things like implants and kidney dialysis. Here goes:

You are a 60-year-old who was warded in a B2 ward for 10 days after a heart attack. Your bill is $8,100.
You will have to pay $2,000 in deductibles and a further $455 in co-insurance.
The total that you pay is $2,455.
The total that MediShield Life pays is $5,645.
Under MediShield, your co-insurance would be higher, at $605. Claim limits are also lower, so you would end up paying $4,655.
MediShield would pay $3,445.

Pre-existing conditions

Cancer, stroke, chronic conditions with serious complications (e.g. hypertensive heart disease), stroke, degenerative disorders (e.g. Parkinson's disease).

However, note that if this health condition developed after the start of your insurance cover with MediShield or an Integrated Shield Plan, you will not be considered to have a pre-existing condition.

Click here for details.

The Health Ministry says that those with serious pre-existing conditions would have to pay a lot more than 30 per cent if the Government didn’t bear most of the costs.

Subsidies are also applicable to the additional 30 per cent premium to be applied for those with serious pre-existing conditions. This includes the Premium Subsidies for the lower- to middle-income, Pioneer Generation Subsidies and Transitional Subsidies. For the needy, on a case by case basis, the Government will provide Additional Premium Support.

Only 6 per cent of Singaporeans are not insured under MediShield. About 23,000 people in this group will have to pay higher premiums because of serious pre-existing conditions.

Of those covered under MediShield or Integrated Plans but with exclusions on certain conditions, around 2,000 will have to pay higher premiums.

Subsidies

It is a simple and administratively practical way of assessing households’ relative means, says the Government.

Those with a home of a higher annual value would, generally speaking, be better off.For those who find it hard to afford premiums but do not qualify for subsidies due to their home’s annual value, additional help may be made available on a case-by-case basis, depending on a person’s family circumstances.

Premiums

No, they will not. No single individual will pay more than everyone else in the same age band simply because he has made more claims.

However, if everyone in your age band makes many claims, premiums may go up the next time the Health Ministry reviews this group.

In line with the principle of insurance, premiums are risk pooled and used to support payouts for policyholders who fall ill and make claims. While some members may die earlier, the contributed premiums will continue to support the rest of the pool. For those who die without making a claim, premiums that they had contributed in the past will have gone towards supporting the claims payouts and commitments for the Scheme.

If a member dies through the premium year, the premium will be pro-rated and refunded to the member’s Medisave account, according to the number of months left in the premium year. These Medisave monies will be distributed to the family members, along with other Medisave monies.

According to the Health Ministry, premiums went up that year to reflect the claims and improvements made under MediShield.

As MediShield Life provides better coverage, higher premiums are to be expected.

No. However, if you have outstanding premiums, you may be warned that you are not to leave Singapore until they are paid.

If you still leave or try to do so, you may be jailed up to a year, fined up to $5,000, or both.

Data Privacy

These are records that have already been submitted to the Government, such as details on CPF contributions.

The Government will not be looking at private or commercial data, including bank accounts or credit records.

It will ensure that as many Singaporeans as possible are able to benefit from the subsidies. This is particularly important for the vulnerable and needy who may find it more challenging to put together the necessary forms and documents that are normally needed to access government subsidies.

You may choose to deny the Government access to your information. However, you will not get any Premium Subsidies as there is insufficient information to assess your eligibility.

Integrated Shield Plans

Eldershield

More Questions

If you are a pensioner, you will continue to receive the same post-retirement medical benefits even when MediShield Life is introduced. There are no changes.

To ensure that pensioners will not be worse off with the introduction of MediShield Life, the Government will help pensioners with their MediShield Life premiums. The Government has written directly to all affected pensioners.

Healthcare coverage from employers is rarely guaranteed for life. Employees with healthcare coverage from their employers may lose such coverage when they leave employment or retire, and may not be able to re-apply for coverage thereafter if they have already developed some health conditions.

MediShield Life ensures that all Singaporeans will have assurance against large healthcare bills for life regardless of your employment status, e.g. in between jobs or after retirement.

Medishield Premium

© Provided by MoneySmart CPF MediShield Life in Singapore

When you fall sick, what’s the first thing you do? Complain about how expensive healthcare is in Singapore? Well, after doing that, the next thing you should do is to see how MediShield Life can help you.

But what the heck is MediShield Life anyway? How do you benefit from it? And why do you need it when part of your CPF contributions already have to go into your Medisave account? These questions and more will be answered right here.

Contents

• What on earth is MediShield Life?
• Who is eligible?
• What benefits do you get from MediShield Life?
• What are the exclusions?
• What is the deductible and how much must you pay?
• What is the co-insurance portion and how much must you pay?
• How do you make a MediShield Life claim?
• What happens if you have a pre-existing condition?
• How much are MediShield Life premiums?
• What subsidies will you get?
• Updates to MediShield Life
• What is an Integrated Shield Plan and how does it work with MediShield Life?

What on earth is MediShield Life?

Have you ever been told that you’ll go bankrupt if you fall seriously ill and don’t have medical insurance?

Well, guess what, even if you’ve never spoken to an insurance agent or purchased a single insurance policy in your life, you actually are covered by medical insurance, and that’s MediShield Life.

MediShield Life is a basic medical insurance plan which all Singaporeans and PRs are automatically enrolled in.

It works in the same way as other types of health insurance. Basically, you can make a claim for certain types of medical bills, including hospitalisation and certain types of outpatient treatment.

The catch is that, being a very basic plan, there are strict limits as to how much you can claim and what is covered.

For instance, if you get hospitalised, your MediShield Life payouts will only able to cover the cost of Class C or Class B2 wards at public hospitals.

To give you an idea of the difference in price, here are the median hospital bills from MOH for a knee joint replacement surgery at the various wards:

Ward class	Total hospital bill
Public hospital — C	$5,329
Public hospital — B2	$6,432
Public hospital — B1	$19,772
Public hospital — A	$22,389
Private hospital	$34,531

For public hospitals alone, the moment you upgrade from Class B2/C to Class B1/A, prices more than triple. Big difference!

So if you want to stay in a higher class ward or go to a private hospital, MediShield Life won't be enough. You'll need to supplement your plan with an Integrated Shield plan (more on that below) for higher coverage, and/or top up the remainder in cash or Medisave.

Who is eligible for MediShield Life?

All Singapore citizens and PRs are automatically granted lifetime protection by MediShield Life.

If you are a PR, it’s important to note that the amount of subsidies you receive at public hospitals will be lower than what Singapore citizens receive. This is likely to result in your having to pay higher out-of-pocket charges.

You cannot opt out of MediShield Life, and have to continue paying the premiums over your lifetime — unless you live overseas and have no intention of returning. Then you can apply to opt out.

Medishield Life Copayment Login

You enjoy lifetime coverage regardless of any pre-existing medical conditions.

What are the MediShield Life exclusions?

There are certain things you can’t use MediShield Life to pay for, such as the following.

• Ambulance fees
• Cosmetic surgery
• Maternity charges (including Caesarean operations) or abortions, except treatments for serious complications related to pregnancy and childbirth.
• Dental work (except due to accidental injuries)
• Infertility, sub-fertility, assisted conception or any contraceptive operation
• Sex change operations
• Optional items which are outside the scope of treatment
• Overseas medical treatment
• Private nursing charges
• Purchase of kidney dialysis machines, iron-lung and other special appliances
• Treatment which has received reimbursement from Workmen’s Compensation and other forms of insurance coverage
• Treatment for drug addiction or alcoholism
• Treatment of injuries arising directly or indirectly from nuclear fallout, war and related risk
• Treatment of injuries arising from direct participation in civil commotion, riot or strike
• Expenses incurred after the 7^th calendar day from being certified to be medically fit for discharge from inpatient treatment and assessed to have a feasible discharge option by a medical practitioner
• Treatment of self-inflicted injuries or injuries resulting from attempted suicide
• Vaccination
• Surgical interventions for the following rare congenital conditions which are severe and fatal by nature: Trisomy 13, Bilateral Renal Agenesis, Bart's Hydrops and Anecephaly

Here's the MOH page with an up-to-date list of exclusions.

What is the deductible and how much must you pay?

So, you might have read that there is a 'deductible' for MediShield Life. The deductible is the amount of money you have to pay before you can make your first MediShield Life claim each year, and it depends on which ward you stay in.

Deductible in the policy year
Age 80 and under	Age 81 and over
Class C	$1,500	$2,000
Class B2 and above	$2,000	$3,000
Day surgery	$1,500	$3,000

You will only have to pay the deductible once a year, even if you make multiple claims in that year. Example:

You get hospitalised twice in a year, and in both cases you get warded in a Class B2 ward. Your first medical bill is $8,000 and the second is $4,000, making a total of $12,000.

Being under 81 years old, you would thus pay a deductible of $2,000 after your first hospital visit. As deductibles are only payable once a policy year, you would not have to pay any deductible when making a claim for your second visit.

What is the co-insurance portion and how much must you pay?

The deductible isn’t the only money you need to fork out in order to make a MediShield Life claim.

You will also have to pay co-insurance, which is calculated as a percentage of the amount you’re trying to claim. While the deductible is charged only once a policy year, co-insurance must be paid each time you make a claim.

The amount of co-insurance you must pay varies according to the size of your bill.

Amount being claimed	Co-insurance
$0 to $3,000	10%
$3,001 to $5,000	10%
$5,001 to $10,000	5%
> $10,000	3%

Example: Let’s take the example in the previous section, where you incurred two hospital bills worth $8,000 and $4,000 respectively, and paid a deductible of $2,000 after the first hospital visit.

After paying your deductible, you’ve still got $10,000 worth of expenses.

After the first hospital visit, which cost $8,000, you paid a deductible of $2,000. You would then submit a claim for $6,000. The co-insurance portion for that sum is 10% of the first $3,000 and 5% of the next $3000, so you would pay $450 and claim the remaining $5,550.

For the second hospital visit, there is no deductible, so you can submit a claim for the entire bill of $4,000. The co-insurance portion is 5% for the first $2,000 and 3% for the next $2,000 so you would pay co-insurance of $160, and then receive $3,840 worth of MediShield Life payouts.

In this scenario, your total medical bill of $12,000 is broken down as follows:

MediShield Life payout	$9,390
Deductible (paid by you)	$2,000
Co-insurance (paid by you)	$610
Total medical bills	$12,000

Medishield Life Scheme

As you can see, to cover your medical bills totalling $12,000, you would have to fork out $2,610, and the rest would be paid by MediShield.

How do you make a MediShield Life claim?

The claims process differs depending on whether you have purchased an Integrated Shield Plan (ie. a private health insurance policy that works in tandem with MediShield Life), or whether you will be relying solely on MediShield Life.

If you don’t have an Integrated Shield Plan

You’re probably wishing you had an Integrated Shield Plan right now. The good news, if we can call it that, is that the paperwork for your MediShield Life claim will be handled by the staff at your hospital or other healthcare provider.

Once you are admitted, inform the staff that you wish to make a MediShield Life claim to pay part of your bills. The medical institution will submit your claim on your behalf after receiving your authorisation.

The MediShield Life payouts will be computed based on the relevant benefits and claim limits, taking into account the deductible. You can then use your Medisave or cash to make the payment for the co-payment amount.

The MediShield Life payout will be released to the medical institutions by the CPF Board after the claim has been processed.

If you have an Integrated Shield Plan (IP)

Contact your insurer or agent immediately when you know you’re going to be admitted to hospital. Also inform hospital staff that you wish to pay your bill using your IP.

Medishield Life Singapore

MediShield Life is included in all IPs. IPs comprise of 2 components, where the MediShield Life components are run by CPF board and the additional private insurance coverage component is run by the insurance company.

Your insurer will process your claim and send payment to the hospital or other medical institution on your behalf. They will also handle the documentation for your MediShield Life claim, and the portion of your bill being paid by MediShield Life will automatically be sent to the medical institution.

Obviously, whether you have an IP or not, any sums on your bill that cannot be covered by MediShield Life or your IP will be dutifully billed to you.

What happens if you have a pre-existing condition?

Unlike most kinds of insurance, MediShield Life covers all pre-existing medical conditions. If you joined MediShield Life with one of the below pre-existing conditions (e.g. in the case of PRs) you will need to pay 30% additional premiums for 10 years.

Broad categories	Examples
Cancer	Lung cancer, colorectal cancer, breast cancer, stomach cancer
Blood disorders	Aplastic anaemia, thalassemia major
Degenerative diseases	Parkinson’s disease, muscular dystrophy, amyotrophic lateral sclerosis (ALS)
Heart or other circulatory system diseases	Heart attack, coronary artery disease, chronic ischaemic heart disease
Cerebrovascular diseases	Stroke
Respiratory diseases	Chronic obstructive pulmonary disease
Liver diseases	Alcoholic liver disease, chronic hepatitis, fibrosis or cirrhosis of liver
Autoimmune / Immune System diseases	Systemic lupus erythematosus, HIV, AIDS
Renal diseases	Chronic renal disease, chronic renal failure, chronic nephritic syndrome
Serious congenital conditions	Congenital heart disease, congenital renal disease biliary atresia
Psychiatric conditions	Schizophrenia
Chronic conditions with serious complications	Hypertensive heart disease, hypertensive kidney disease, diabetes with kidney complications, diabetes with eye complications

After 10 years, your premiums go back to normal. Additional premiums are Medisave-payable.

How much are MediShield Life premiums?

Of course, somebody’s got to pay for MediShield Life. You will have to pay MediShield Life premiums annually, and these premiums will rise as you age.

Age on next birthday	Annual MediShield Life premium
1-20	$130
21-30	$195
31-40	$310
41-50	$435
51-60	$630
61-65	$755
66-70	$815
71-73	$885
74-75	$975
76-78	$1,130
79-80	$1,175
81-83	$1,250
84-85	$1,430
86-88	$1,500
89-90	$1,500
>90	$1,530

The good news is that you can pay 100% of your MediShield Life premiums using Medisave. Your premiums will be automatically deducted from your Medisave account if you have enough. Or, your immediate family members may pay your premium using their Medisave.

Can you get MediShield Life premium subsidies?

Yes, if you're in the lower income group. You can get discounted premiums ranging from 15% to 50%, depending on your income level. Here are the 2019 MediShield Life premiums after subsidy:

Age on next birthday	Lower income	Lower-middle income	Upper-middle income	No subsidy
1-20	$98	$104	$111	$130
21-30	$146	$156	$166	$195
31-40	$233	$248	$264	$310
41-50	$305	$326	$348	$435
51-60	$441	$473	$504	$630
61-65	$491	$529	$566	$755
66-70	$530	$571	$611	$815
71-73	$575	$620	$664	$885
74-75	$634	$683	$731	$975
76-78	$678	$735	$791	$1,130
79-80	$705	$764	$823	$1,175
81-83	$750	$813	$875	$1,250
84-85	$858	$930	$1,001	$1,430
86-88	$825	$900	$975	$1,500
89-90	$825	$900	$975	$1,500
$90	$765	$842	$918	$1,530

To figure out which group you belong to,

• Lower income: Household monthly income of $1,200 or less per person.
• Lower-middle income: Household monthly income of $1,201 to $2,000 per person.
• Upper-middle income: Household monthly income of $2,001 to $2,800 per person.

In addition, to receive any subsidies at all, you must live in a residence with an annual value of $13,000 or less. If you live in a residence with an annual value of between $13,001 and $21,000, your subsidy rates will be cut by 10%.

Oh yes, and those who are part of the Pioneer Generation get 40% to 60% in MediShield Life premium subsidies from age 66 onwards. Meanwhile, the Merdeka Generation gets 5% premium subsidy from age 60 to 75, and 10% subsidy from age 76 onwards.

Updates to MediShield Life in 2021

Healthcare being a major government priority, MediShield Life does undergo a certain amount of scrutiny by the higher-ups, and does get tweaked from time to time to meet coverage gaps. But in 2021, there will be a major review of the MediShield Life scheme. Due to healthcare inflation, the current benefits are now lagging behind the actual cost of healthcare and need to be revised upwards. The proposed changes include:

• Revising the annual claim limit from $100,000 to $150,000
• Higher claim limits for the first 2 days of hospitalisation, which is when most diagnostics and tests happen
• Higher claim limits for intensive care, dialysis, and psychiatric care
• Higher coverage for sub-acute care at community hospitals
• Coverage for attempted suicide, self-harm, substance abuse and alcoholism
• More affordable day surgery for the elderly — so they do not need to be warded to claim
• Private hospital claims will be capped at 25% down from 35%

However, these enhancements would also mean up to 35% increase in MediShield Life premiums. Yikes.

What is an Integrated Shield Plan and how does it work with MediShield Life?

You’ve already heard that you can’t rely solely on MediShield Life because of how basic it is.

But the solution is pretty easy: Upgrade your coverage is to opt for an Integrated Shield Plan (IP), which can be paid for with Medisave. There are 7 insurers that provide IPs in Singapore.

Integrated Shield plans comprise the MediShield Life base plan + additional private insurance provided by the insurance company. So there's no duplicate here.

One of the biggest benefits to getting an IP is that you have the option of staying in private hospitals or upgrading to Class B1 and A wards and get covered. This also gives you the chance to choose your own doctor, with the possibility of shorter queues and wait times. You can also buy riders for your IP to receive even greater coverage.

The downside is obviously that you’ll be paying higher premiums if you have an IP, and there may be a cash portion that cannot be paid using Medisave. These premiums may be affordable when you’re young, but they’ll rise as you age and can eventually get quite hefty.

For more details, check out our Integrated Shield plan comparison.

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