Since end of 2015, MediShield Life has replaced Medishield, a low cost basic medical insurance scheme since 1990. The new scheme will offer
- Better protection and higher payouts, so that patients pay less Medisave/cash for large hospital bills
- Protection For All Singapore Citizens and Permanent Residents, including the very old and those who have pre-existing illnesses
- Protection For Life
You can use your Medisave to pay your premiums in full, but with better coverage, MediShield Life premiums will have to increase.
The guide will give you all the information you need about
- MediShield Life Benefits
- Medishield Life claim procedures and how pre-existing illnesses are covered
- MediShield Life Premiums and Subsidies and
- Medishield Life Integrated Shield Plans
MediShield Life Benefits
MediShield Life will provide better protection for life for all Singaporeans and Permanent Residents, including those who may already have a serious medical condition.
Benefits will be enhanced under MediShield Life, with higher claim limits and lower co-insurance rates, so that MediShield Life pays more and patients pay less.
How MediShield/MediShield Life Claims Work
The Claim Procedures
Just inform the staff handling your hospital admission or outpatient treatment that you wish to make a claim, and the medical institution will submit the claim for you.
If a payout is due, it will be made to the medical institution by the CPF Board on your behalf.
If you have a private Integrated Shield Plan, your private insurer will process your claim and make the total payment to the medical institution on your behalf. This will include the MediShield Life portion of the payout.
The outstanding amount on your bill, after the MediShield/MediShield Life or IP payout, can be covered by Medisave and/or cash.
Medishield Life Claim Terminologies
To better understand how to make a MediShield/MediShield Life claim, you should know these three concepts and how they work:
- Claimable limits
In the illustration below, the box below represents the bill. MediShield/MediShield Life will cover the bill up to the claim limits (A), less the deductible (B) and co-insurance component (C).
The portion covered by MediShield/MediShield Life is in green (D). The remaining portions (A – C) are payable by policyholders using Medisave and/or cash. See more information on these components below.
(A) Claimable Limits
The claimable limit is the portion of the bill eligible for MediShield/MediShield Life reimbursement. It depends on the claim limit for each type of expense, such as the daily ward charges and the type of treatment or surgery undertaken.
About 90% of all bills do not exceed the claim limits. This means that the component in blue only applies to one out of every ten bills.
Under MediShield Life, claim limits will rise further, with the maximum claim limit per policy year rising from $70,000 to $100,000. There will also be no more lifetime limit on claims.
The deductible is the fixed amount payable by the insured each policy year (the year following his policy renewal month) before the MediShield/MediShield Life payout kicks in. The deductible is payable only once every policy year. It helps to sieve out small claims, which can be paid using Medisave and/or cash, and helps to keep premiums affordable.
For those aged 80 and below, the deductible is $1,500 for stays in Class C wards, and $2,000 for stays in Class B2 and above wards. For those above age 80, the deductible is $2,000 and $3,000 for stays in Class C and B2 and above wards respectively.
The co-insurance is a percentage of the claimable amount which you have to pay, on top of the deductible. The larger the bill, the lower the co-insurance payable.
Under MediShield, the co-insurance rate ranges from 20% to 10% as the bill size increases. Under MediShield Life, the rate will range from 10% to 3% as the bill size increases.
So patients will pay less co-insurance, while MediShield Life will cover more.
How Medishield Life covers Pre-existing conditions
Pre-existing conditions are medical conditions which developed before an individual started his/her MediShield/Integrated Shield Plan coverage.
In line with the principle of universal coverage, MediShield Life will cover all Singapore Citizens and Permanent Residents, including those who have pre-existing conditions and who may be unable to obtain insurance coverage currently. Their pre-existing conditions will also be covered.
The Government will bear the bulk of the cost of this coverage.
Individuals who have a serious pre-existing condition, which developed before they started their MediShield/Integrated Shield Plan coverage, will need to co-share a portion of the cost, in reflection of their higher risk.
Those with pre-existing conditions would already have been bearing higher medical costs in the past, being unable to obtain medical insurance coverage for their conditions.
With MediShield Life, they will pay an Additional Premium of 30% for a period of 10 years. Even with the Additional Premium, the premium payable does not cover the full cost of their coverage. This is because the bulk of it will be funded by the Government, with the rest shared among all other policyholders.
After the 10-year period, they will pay the standard premium paid by others in their age group.
MediShield Life Premiums
You can use Medisave to pay for your MediShield Life premiums. As an insurance scheme, MediShield Life premiums will be risk-pooled to support the payouts and benefits under MediShield Life. Those with serious pre-existing conditions may have to pay Additional Premiums for ten years.
The Government will help Singapore Citizens and Permanent Residents with their MediShield Life premiums, including those who need to pay Additional Premiums.
No one will lose their MediShield Life coverage due to the inability to afford premiums.
You can calculate your estimated MediShield Life premiums payable after the applicable Premium Subsidies using the premium calculator or check the premium tables below
MediShield Life Subsidies
The Government will help Singapore Citizens and Permanent Residents with their MediShield Life premiums through various types of subsidies. Those requiring more support will be able to receive additional assistance.
Types of Subsidies
- For all Singapore Citizens whose net premiums (after Pioneer Generation Subsidies or Premium Subsidies) increase after the introduction of MediShield Life, regardless of their household income or the Annual Value of their home.
- Available for the first 4 years of MediShield Life.
- In the first year, the Government will pay 90% of the net increase in MediShield Life premiums (after taking into account other premium subsidies) above MediShield premiums. This means that you only need to pay 10% of the net increase in your MediShield Life premium in the first year.
- The Government will cover 70%, 40% and 20% of the net premium increase in the second, third and fourth years of MediShield Life.
- For lower- to middle-income families with household monthly income per person of $2,600 and below, and living in residences with an Annual Value of $21,000 and below.
- Those eligible can receive subsidies of up to 50% of their premiums. Permanent Residents will receive half the subsidy rate applicable to citizens.
- This is a permanent feature of the MediShield Life Scheme.
- It will benefit up to two-thirds of Singaporean households.
- Those who own more than one property will not be eligible for this subsidy.
MediShield Life Premium Subsidies for lower-and middle-income households is based on the monthly income per person in each household. This helps to ensure that bigger households remain eligible for this subsidy, even if their total household income appears to be high.
For instance, a family with five members living together and with a total household income of $13,000 is eligible for Premium Subsidies for lower- and middle-income families. This is because their household monthly income per person is $2,600, which falls within the eligibility criteria ($2,600).
* Household members refer to family members (i.e. those related by blood, marriage and/or legal adoption) living together at the same residential address. Domestic helpers, tenants, and friends are not considered as household members for the Household Check.
Pioneer Generation Subsidies and Medisave top-ups
- Pioneers will receive generous Pioneer Generation subsidies of between 40-60%, regardless of their household per capita income or the Annual Value of their home.
- Pioneers will also receive $200 – $800 a year in Medisave top-ups (depending on year of birth) for life, which can be used to pay for their MediShield Life premiums.
- After subsidies and top-ups, all Pioneers will pay lower premiums for MediShield Life than they would have paid under MediShield.
Additional Premium Support
- For families who need assistance with their premiums even after the above subsidies and Medisave use.
- No one should worry about losing their MediShield Life coverage because they are unable to afford the premiums.
How to Receive MediShield Life Premium Subsidies
The Government will make it easy for Singaporeans and Permanent Residents to receive Premium Subsidies.
Pioneer Generation Subsidies and Transitional Subsidies for Singaporeans will be extended automatically if you are eligible.
Lower- and middle-income households will receive MediShield Life Premium Subsidies to help with their MediShield Life premiums.
No application is required, as existing information in Government databases will be used to determine your subsidies.
However, as some of the information in official records may not be fully updated, you may wish to verify your household information using online Household Check tool.
This will help to ensure that you and your family members receive the correct amount of Premium Subsidies for which you are eligible. For those who need more help even after various Government subsidies, Additional Premium Support is also available.
Medishield Life Integrated Shield Plans
Many Singaporeans have private hospitalisation insurance plans in the form of Integrated Shield Plans with Medishield / Medishield Life. Click here to find out more information about Medisave-Approved Integrated Shield Plans.