In Singapore, basic health insurance needs are covered under the CPF Medishield scheme, you can upgrade your basic Medishield Life to private insurers for better coverage. These plans are called private Integrated Shield Plans (IPs).
In this article, I will explain what Medishield Life is and how the integrated shield plans work.
What is Medishield Life
It was called MediShield, which was a basic medical insurance scheme designed to help with large hospitalisation bills as well as certain outpatient treatments at approved medical institutions. It targets Class B2 and C wards and subsidised treatment in public hospitals.
In 2013, Medishield was revamped and renamed as Medishield Life. It is now a compulsory healthcare insurance scheme which covers all Singapore citizens and permanent residents for life.
You can find out the improvement of Medishield Life here, but the coverage is still targetted by government B2 wards and below.
What if you want better treatment in a private hospital or single bedded ward in a government hospital? You can upgrade your plan to Medisave-approved Integrated Shield plans offered by private insurers.
What is Medisave-Approved Integrated Shield Plan
The Integrated Shield Plans provide you with additional benefits and coverage when you opt for Class A and B1 wards in the restructured or private hospitals. Currently, there are 7 insurers approved now.
If you are not sure if you have an Integrated Shield Plan, follow the steps below to find out. Remember to have your SingPass ready!
- Go to www.cpf.gov.sg
- Log on to my cpf Online Services (You will need your SingPass)
- Go to “My Messages”
- See “Insurance” section
How Integrated Shield Plan works
Integrated Shield Plans comprise two components:
- A MediShield Life portion run by the CPF Board.
- An additional private insurance coverage portion run by private insurers, typically to cover Class A/B1 wards in public hospitals or private hospitals.
In the event of a claim, you will be either compensated by MediShield Life or your private integrated plan, there is no duplicate coverage. Behind the scene, a patient submits claims directly to their private insurer through the hospital. Their private insurer will then sort out all arrangements with MediShield Life.
Note MediShield Life will cover you for life, including your pre-existing conditions. This is the case even if your pre-existing conditions are not covered under the additional coverage from your private insurer.
Integrated Shield Plan Premium
The private IP insurers act as a single point of contact for IP policyholders, even though they work with CPF Board back-end for premium collection.
Medisave can also be used to pay for premiums of these private Medisave-approved Integrated Shield plans. From 1 Nov 2013, the Medisave withdrawal limits for Integrated Shield plan are:
- $800 per policy, per year, for those aged 65 and below next birthday;
- $1,000 per policy, per year, for those aged 66 to 75 next birthday;
- $1,200 per policy, per year, for those aged 76 to 80 next birthday; and
- $1,400 per policy, per year, for those aged 81 and above next birthday.
You will also receive subsidies for the MediShield Life portion of your integrated plan if you are eligible.
There are 8 things you need to know about Integrated Shield Plans
Below are the Medisave-approved Integrated Shield Plans:
- AIA Healthshield Gold
- AXA Shield
- Aviva MyShield
- Great Eastern SupremeHealth
- NTUC Incomeshield
- Prudential PRUShield
What are Deductible and Co-Insurance
To better understand how to make a Shield Plan claim, you should know these two terminologies.
The deductible is the fixed amount payable by the insured each policy year (the year following his policy renewal month) before the 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.
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.
You used to be able to purchase a rider from the private insurers to cover the full amount of deductible and co-insurance. But under the new rule from March 8, 2018, you have to pay at least 5% co-insurance for any new integrated shield plan.
How to compare the services between the private insurers
Claims Processing Duration
Ministry of Health periodically updates the claims return rate table which shows how long it takes each insurer to process Integrated Shield Plan (IP) claims with positive payouts.
With modern technology and integration, nearly all insurers can settle the claim within a day. Please note you must inform the hospital that you have a private shield plan when you register.
Letter of guarantee and medical records costs
When you are hospitalised, if your hospital can obtain a letter of guarantee from your insurer, you can reduce the amount of your upfront payment to the hospital. A letter of guarantee is an assurance of payment offered by insurers to hospitals, on behalf of a patient, for the portion of the hospital bill covered by insurance.
To process claims, insurers may require your medical records. Either you as a claimant, or your insurer can request medical records from medical institutions. This request, however, usually comes at a cost from $75 to $250. Note your insurer may not absorb the cost of obtaining medical records.
How to compare the Private Integrated Shield Plans
With 7 insurers providing integrated shield products, it may be difficult to compare. you can check the benefit and premium comparison from the MOH website and do a side by side comparison.
Amendment to the definition of dependant in the Private Medical Insurance Scheme
In October 2021, the Ministry of Health (MOH) has updated the definition of dependants in the MediShield Life (Private Medical Insurance Scheme) Regulations (“PMIS Regs”), to align with the definition of dependants in the CPF (MediSave Account Withdrawal) Regulations, CPF (Withdrawals for ElderShield Scheme) Regulations, and CareShield Life and Long-Term Care (Supplement Scheme) Regulations.
Due to the change in definition, if the Insured is NOT a Singapore Citizen/Permanent Resident and want to use Medisave to pay for premium for Shield plan, only the following relationships to Proposer are allowed:
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