Chronic diseases are a significant cause of illness and death in Singapore. This is a phenomenon common to all developed countries.
Four common chronic diseases affect about 1 million Singaporeans: diabetes mellitus, hypertension, lipid disorders (e.g. high cholesterol) and stroke.
If not properly managed, these diseases often lead to more serious complications. Many patients begin treatment late and only when severe complications arise. They end up going to multiple specialists for treatment of their many problems and may have to be hospitalized. Not only do they suffer significant pain, they will have to pay high medical costs as well.
However, with early detection and good management of these chronic diseases, complications can be avoided or delayed for many years.
The level of care will be raised through the promotion and extensive use of systematic, evidence-based chronic disease management programmes (DMPs). Patients with such chronic diseases are encouraged to work with their doctors, particularly their Family Physicians, to actively manage their diseases, through regular monitoring, appropriate medical treatment and lifestyle changes.
As disease management programmes can largely be affected at the outpatient level, MOH has allowed the use of Medisave to help pay part of the outpatient cost, and reduce out of pocket payment for patients.
The Medisave for Chronic Disease Management Programme was launched in Oct 2006. Diabetes Mellitus was the first chronic disease covered under the scheme. From 1 Jan 2007, the programme was extended to 3 other chronic diseases - hypertension, lipid disorders and stroke. From 1 Apr 2008, the programme was further extended to asthma and chronic obstructive pulmonary disease (COPD). Two more diseases, Schizophrenia and Major Depression, were added from 1 Oct 2009. There are now a total of 8 chronic diseases under CDMP.
- Details on Medisave Use
Your doctor (whose clinic has to be participating in this programme) will need to certify in the Medisave Authorisation form that you suffer from one of the four chronic diseases in the above list.
For each bill, patients will only need to pay the first $30 of the bill (as the deductible) as well as 15 per cent of the balance of the bill. Medisave can be used to pay for the remaining amount. This is regardless of whether the bill is for a one-off visit or a package.
- Deductible:
A deductible of $30 will be set on each outpatient bill. Bills below $30 will continue to be paid in cash; - Co-payment:
A co-payment (in cash) of 15% on each outpatient bill in excess of the deductible will be set; and - Annual withdrawal limit:
Withdrawals will be subject to an annual outpatient withdrawal limit of $300 per Medisave account. Patients can also use the Medisave of their immediate family member(s)* to pay for their treatment, up to a limit of $300 per year per account. A maximum of up to 10 accounts may be used.
| Table 1: Billing example |
|
| $100 | Deductible = $30.00 | $100 - $30 - $10.50 = $59.50 |
| 15% of balance ($100 - $30) = $10.50 |
| Total = $40.50 | Total = $59.50 |
| |
- Signup
Patients can sign up for this programme at any participating clinics directly. Clinics participating in the programme will be identified with a decal/sticker which will be displayed at the clinic.
We aim to help patients and their families better understand these diseases and what they can do to manage their conditions, so that they can achieve better health. Empowering the patients and motivating them to take responsibility for their own health and making relevant changes to their lifestyles, (e.g. changing their diets and exercising) are important success factors. The Ministry, together with HPB, will provide patients with patient education folders, containing background information on chronic diseases, patient booklets for recording of vital clinical indicators to aid self-monitoring, and answers to patients' frequently asked questions.
We have developed educational tool-kits and other support materials to assist doctors in providing more effective treatment to their patients under this Programme.
GPs/Clinics who wish to participate in this programme can register with the Ministry of Health.
Please download and submit the e-application forms to the address stated.
More information on chronic disease management can be found on HPB’s website. Patients may search for a CDMP clinic in their neighbourhood here. If your usual clinics are not participating in this programme, you may invite them to participate in the programme by clicking here.
To find out more about how CDMP fares in term of the quality of care since the Programme started in October 2006, click here for the First Year Report and here for the Second Year Report.