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ElderShield Review Committee Interim Update (30 Jan 2018)


The ElderShield Review Committee (ESRC) heard a wide representation of views from over 800 Singaporeans, across 26 focus group discussions. These include long-term care service providers, financial advisors, academics, industry professionals, community partners such as unions and self-help groups, and youths. Public feedback, suggestions submitted to the ElderShield website’s online feedback form and email recommendations have also been taken into consideration.

Need to strengthen ElderShield as a social safety net

2.    With a rapidly ageing population and shrinking family sizes, there is a need to plan ahead for our future long term care needs. The demand for long-term care is set to increase. About one in two Singaporeans who is healthy at the age of 65 is at risk of having a severe disability over their lifetime.

3.    ElderShield, as a long term care insurance scheme, allows us to pool our risks, and be protected against the uncertainty and variability in the length and cost of disability later on. It complements other forms of long-term care financing, such as personal savings and Government assistance schemes.

4.    To strengthen the effectiveness of the scheme, the Committee has a number of key interim recommendations and is working to finalise the full set of recommendations by the middle of 2018.   

Recommendation: ElderShield to be a universal and inclusive scheme for future cohorts

5.    The ESRC recommends that ElderShield should be made a universal and inclusive scheme for future cohorts of Singaporeans.  Universal coverage for future cohorts is aligned with our principle of collective responsibility and supports our aim to be a caring and inclusive society.

6.    Universal coverage will provide assurance for the lower-income who may find it challenging to save for their long-term care needs.

7.    With universal coverage, Singaporeans in future cohorts with pre-existing severe disabilities would be included in the enhanced ElderShield scheme. This supports our aim to be a caring and inclusive society, and the low prevalence of severe disability at younger ages means that this can be achieved without significant impact on premiums.

Recommendation: Inclusion age to be lowered to 30 to ensure more affordable premiums

8.    By lowering the starting age for enrolment into the scheme from age 40 to age 30, policyholders will be able to start contributions to the scheme earlier, and in turn ensure that annual premiums are more affordable. With this, coverage will start from age 30, which will allow Singaporeans to enjoy peace of mind earlier. By age 30, most Singaporeans would have started working and contributing to their Medisave accounts, and should be able to cover their ElderShield premiums without out-of-pocket expenses.  

9.    With the lowering of the inclusion age, the ESRC recommends that those aged between 31 and 40 should be included into the enhanced scheme when it is implemented.

10.    The ESRC recommends that the Government provide premium support for lower-income Singaporeans and those in financial difficulties, so that no Singaporean will lose ElderShield coverage due to financial difficulties.

Recommendation: ElderShield should be administered by the Government as a key pillar of our social safety net

11.    Today, ElderShield is administered by three private insurers on behalf of MOH. Singaporeans who are auto-enrolled onto ElderShield at 40 years old are randomly assigned to one of the three private insurers, and allowed to switch insurers at the point of enrolment.  A Government Administration Sub-Committee was formed within the ESRC to study the pros and cons of various administration models.  In their review, the Sub-Committee took feedback from the public on the current scheme and studied examples from other jurisdictions.

12.    The Sub-Committee is of the view that enhanced ElderShield should be administered by the Government as a key pillar of our social safety net.  This will allow the Government greater flexibility to provide subsidies for premiums. Government administration would also offer more flexibility for future scheme enhancements, while still ensuring that the scheme remains sustainable over the long-term.

13.    Having a single administrator would also make it more consistent and easier for policyholders to navigate claims processes.

Recommendation: The ElderShield claims process should be made more accessible and convenient for policyholders and their caregivers

14.    Within the ESRC, a Claims Assessment Sub-Committee studied the full claims journey to identify potential gaps and areas for improvement. The Sub-Committee has identified some improvements to the claims process, so as to make the process more accessible and convenient for policyholders and their caregivers. These include:

  • To equip frontline staff or social workers at key touchpoints (e.g. long-term care providers) to help policyholders or their caregivers access information on ElderShield and the claims application process.
  • To expand the assessor pool (e.g. allow certified Occupational Therapists, Physiotherapists), and consider whether other functional assessment tools used for disability care planning can also be used for ElderShield assessment.
  • To make better use of existing information on claimants’ care settings and medical or disability conditions to determine how often a claimant should undergo periodic reviews.


Full recommendations to be ready in mid-2018

15.    The Committee’s full recommendations for the enhanced ElderShield scheme will be ready by mid-2018.


ElderShield Review Committee
30 January 2018