TOP FAQs ON MEDISHIELD LIFE

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1. What is MediShield Life? How does it benefit me?

MediShield Life is a basic health insurance scheme that provides Singapore Citizens and Permanent Residents with universal and lifelong protection against large healthcare bills, regardless of age or health condition. While large healthcare bills are rare, the cost can be very high for the few among us who fall seriously ill. MediShield Life works by pooling financial resources from individuals in similar age cohorts, so we can each pay a smaller premium and not have to worry about a large healthcare bill.

MediShield Life helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. It is basic because it is sized for subsidised treatment in the public hospitals.

The Government provides significant help to keep premiums affordable:

·         Premium Subsidies for the lower- to middle-income

·         Additional Merdeka Generation subsidies for all Merdeka Generation seniors

·         Special Pioneer Generation Subsidies for all Pioneer Generation seniors

·         Additional Premium Support for those who need assistance with premiums even after the above subsidies and MediSave use, and have limited family support

MediShield Life premiums can be fully paid by Medisave. Family members can also help to pay premiums for their loved ones. No Singaporean will lose MediShield Life coverage due to financial difficulties.

For more details, please refer to medishieldlife.sg


2. What is the difference between MediShield Life and CareShield Life?

Both MediShield Life and CareShield Life are insurance plans, but they serve different purposes. They complement each other in providing lifetime protection against different types of healthcare expenses.

MediShield Life helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. Whereas CareShield Life provides cash payouts to help severely disabled individuals with their long-term care costs.


3. Is MediShield Life coverage only for those who use Class B2/C wards? What about those who wish to use Class A/B1 or private hospitals – will they get any MediShield Life benefits?

MediShield Life provides coverage for all ward classes including private hospitals. However, MediShield Life benefits are designed based on Class B2/C bills, so as to keep premiums affordable. If you choose to use Class A/B1 or private hospitals where bills are much higher, MediShield Life will cover a smaller portion of your bill. This ensures comparable payouts for subsidised and private patients.

You may sign up for an Integrated Shield Plan (IP), managed by a private insurer, if you want additional coverage of bills in the Class A/B1 wards or private hospitals.

IPs comprise 2 components: (i) MediShield Life and (ii) additional private insurance coverage for the additional coverage in Class A/B1 wards in the public hospitals or private hospitals. However, premiums for IPs will be higher and will increase with age, so do consider carefully your choice of ward class and the premium affordability over the lifetime, and plan your insurance coverage accordingly.


4. What are the different types of Government subsidies to help Singaporeans with their MediShield Life premiums? Who will be eligible for them?

The Government provides the following premium subsidies and support to keep premiums affordable:

Premium Subsidies (up to 50%) for lower- to middle-income Singapore Residents with household monthly income per person of $2,800 and below and living in residences with an Annual Value of $25,000 and below. Individuals who own multiple properties will not be eligible. Permanent Residents (PRs) will receive half the applicable Singapore Citizens (SCs) rate.

Additional Merdeka Generation (MG) Subsidies of up to 10% for all MGs, on top of above premium subsidies. MGs will also receive annual MediSave top-ups of $200 from 2019 to 2023, which can be used to pay premiums.

Special Pioneer Generation (PG) Subsidies of up to 60% for all PG seniors. PGs will also receive lifetime annual Medisave top-ups of $250 - $900 a year, which can be used to pay premiums. Older PGs (aged 82 years old and above in 2021) who have serious pre-existing conditions will also receive an additional one-off annual MediSave top-up of $50-$200 for five years, from 2021 to 2025. PGs aged 87 years old and above in 2021 will have premiums fully covered by the government, while younger PGs will have about two-thirds of premiums covered.

Additional Premium Support for needy Singaporeans who cannot afford their premiums even after the above subsidies and MediSave use, and have limited family support.


5. What if I do not have enough MediSave to pay for my MediShield Life premiums, or do not have a MediSave account?

You can top up your MediSave account via voluntary contributions with cash, subject to the relevant limits. Your outstanding MediShield Life premiums will be deducted from your MediSave. Family members such as parents and spouse can also help to pay for your premiums using their MediSave.

If you do not have family support and are unable to pay your premiums, you can apply for Additional Premium Support.


6. What are Integrated Shield Plans and should I consider getting one?

MediShield Life is a basic scheme designed to cover Class B2/C bills. As the bills for Class B1/A wards and private hospitals are much higher, MediShield Life will cover a smaller portion of the bill.

The Integrated Shield Plans (IP) provide additional coverage beyond MediShield Life. IPs consists of 2 components – the MediShield Life component and an additional private insurance coverage component. Those covered under IPs enjoy the combined benefits of (i) MediShield Life, run by the Central Provident Fund Board; and (ii) the additional private insurance coverage for Class A/B1 and private hospital stays, run by private insurers. There is no duplicate coverage between MediShield Life and IPs.

The existing IPs in the market are:

-       AIA HealthShield Gold Max,

-       Singlife Shield

-       HSBC Life Shield,

-       Great Eastern GREAT SupremeHealth,

-       Income IncomeShield,

-       Prudential PRUShield, and,

-       Raffles Health Insurance Raffles Shield.

Please note that as IPs are private plans with additional coverage, premiums are much higher than MediShield Life premiums and will increase with age. You may also be subject to additional health checks possibly resulting in exclusions and/or risk-loading for the additional private insurance coverage component. We advise you to carefully consider your ward preferences and the affordability of premiums over the longer-term, when deciding whether to buy an IP. Please speak to your financial advisor who will be able to share more about your options.


7. I already have an Integrated Shield Plan. How is MediShield Life relevant to me?

Integrated Shield Plans (IPs) comprise 2 components – the MediShield Life component and the additional private insurance coverage. Those covered under IPs currently enjoy the combined benefits of MediShield Life, which is run by the Central Provident Fund Board, and the additional benefits of the additional private insurance coverage, which is run by private insurers.

As MediShield Life is a component of your IP coverage, you need not worry that there is duplicate coverage between MediShield Life and your IP.

MediShield Life will cover all pre-existing conditions, even if they are excluded by your private insurer from the additional private insurance coverage of your IP. Should you decide to drop your IP cover one day, you will remain covered by MediShield Life.


8. What is the Standard Integrated Shield Plan?

The Standard Integrated Shield Plan (IP) is a private insurance product targeted at covering large hospital bills and selected outpatient treatments at the Class B1 level in Singapore’s public hospitals.

The Standard IP gives Singapore Residents an option for additional coverage beyond basic MediShield Life in a standardised, easily understood package. It will also be a viable option for those who want to switch from their Class A and Private Hospital IPs to a more affordable plan.

The Standard IP benefits are regulated by the Government and are identical across all IP insurers.

Similar to all other IPs, premiums for the additional private insurance coverage component of the Standard IP are set by the private insurers. 


9. Will I be arrested if I am unable to pay my premiums?

You will not be arrested if you are unable to pay for your MediShield Life premiums. Various forms of support are available to help with the payment of your MediShield Life premiums. No Singaporean will lose MediShield coverage due an inability to pay.

However, if an insured person is informed that he is restricted from leaving the country until his premiums are paid, but still tries to leave the country, he will be arrested.


BENEFITS UNDER MEDISHIELD LIFE

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1. What is MediShield Life? How does it benefit me?

MediShield Life is a basic health insurance scheme that provides Singapore Citizens and Permanent Residents with universal and lifelong protection against large healthcare bills, regardless of age or health condition. While large healthcare bills are rare, the cost can be very high for the few among us who fall seriously ill. MediShield Life works by pooling financial resources from individuals in similar age cohorts, so we can each pay a smaller premium and not have to worry about a large healthcare bill.

MediShield Life helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. It is basic because it is sized for subsidised treatment in the public hospitals.

The Government provides significant help to keep premiums affordable:

·         Premium Subsidies for the lower- to middle-income

·         Additional Merdeka Generation subsidies for all Merdeka Generation seniors

·         Special Pioneer Generation Subsidies for all Pioneer Generation seniors

·         Additional Premium Support for those who need assistance with premiums even after the above subsidies and MediSave use, and have limited family support

MediShield Life premiums can be fully paid by Medisave. Family members can also help to pay premiums for their loved ones. No Singaporean will lose MediShield Life coverage due to financial difficulties.

For more details, please refer to medishieldlife.sg


2. When will the enhancements to MediShield Life benefits / increased premiums take effect?

The enhancements to MediShield Life benefits take effect from 1 March 2021, i.e. for admissions on or after 1 March 2021. Premiums will be adjusted for policies renewing or commencing from 1 March 2021 onwards.


3. Is MediShield Life coverage only for those who use Class B2/C wards? What about those who wish to use Class A/B1 or private hospitals – will they get any MediShield Life benefits?

MediShield Life provides coverage for all ward classes including private hospitals. However, MediShield Life benefits are designed based on Class B2/C bills, so as to keep premiums affordable. If you choose to use Class A/B1 or private hospitals where bills are much higher, MediShield Life will cover a smaller portion of your bill. This ensures comparable payouts for subsidised and private patients.

You may sign up for an Integrated Shield Plan (IP), managed by a private insurer, if you want additional coverage of bills in the Class A/B1 wards or private hospitals.

IPs comprise 2 components: (i) MediShield Life and (ii) additional private insurance coverage for the additional coverage in Class A/B1 wards in the public hospitals or private hospitals. However, premiums for IPs will be higher and will increase with age, so do consider carefully your choice of ward class and the premium affordability over the lifetime, and plan your insurance coverage accordingly.


4. Even with the increase in benefits under MediShield Life, there remains a cap on the MediShield Life payout. Is it possible to introduce a stop-loss feature to provide greater assurance to Singapore Residents?

MediShield Life is designed to be a basic scheme, with claim limits, deductible and co-insurance features to keep premiums affordable for all Singaporeans. In particular, co-insurance helps to reduce the propensity for over-consumption, over-servicing and over-charging which can arise when there is no co-payment required for medical treatment.

The co-insurance, deductible and amount above the claim limits can be paid through Medisave and cash. Today, about 8 in 10 Singaporeans pay little or not cash for their subsidised hospitalisation bills. Needy Singaporeans who are unable to pay their share of bills can seek MediFund assistance from the public hospitals.


5. Many Singapore Residents, especially the elderly, do not receive any payout for their bills, due to the deductible. Can the deductible be further lowered for MediShield Life so that more Singapore Residents can benefit from the scheme?

Deductibles focus MediShield Life coverage on the larger bills, where protection is most critical. By not covering smaller bills, which can be adequately covered by Medisave, MediShield Life premiums can be kept more affordable. Deductibles accumulate across bills and are payable only once a policy year.

Most Singaporean families have sufficient Medisave to cover the deductibles. The Government also provides Medisave top-ups for lower-income and elderly Singaporeans through schemes such as Workfare, GST Voucher scheme, and Pioneer Generation and Merdeka Generation Packages. For those who are unable to afford the deductible, MediFund assistance is available at the public hospitals.


6. With an ageing population, healthcare costs are expected to increase significantly. Is it possible to provide incentives such as premium discounts to encourage and reward healthy living through MediShield Life? Can there be a “No-claim Bonus” for MediShield Life, to incentivise healthy living or reward those who remain healthy and have not made claims? With lower claims, there will be premium savings in the long term.

It is important to encourage Singaporeans to adopt healthy living habits, so as to reduce the likelihood and delay the onset of illnesses. However, a ‘no-claims discount’ would penalise Singaporeans, especially the elderly, for illnesses and large bills that they may inevitably face throughout their lives. It could also discourage Singaporeans from seeking early diagnosis and treatment, for fear of losing their discount. This could lead to poorer health and higher healthcare cost down the road when the condition exacerbates, and complications set in.

Hence, introducing a “no-claims bonus” may not be the way to incentivise a healthy lifestyle. Instead, the Government will continue other efforts to encourage healthy living, and these can help manage healthcare costs over time. For example, the Health Promotion Board has been rolling out various initiatives, such as rewards and vouchers for participation in the ‘National Steps Challenge’ and ‘Eat, Drink, Shop Healthy Challenge’.


7. Other than cancer and kidney failure, there are also other costly outpatient treatments such as treatment for Systemic Lupus Erythematosus (SLE) and multiple sclerosis. Can such treatments be considered for coverage under MediShield Life?

The Ministry of Health (MOH) will regularly review whether other outpatient treatments are suitable for coverage under MediShield Life, taking into account changes in the delivery of medical care, development of new treatments, availability of information on patient outcomes and effectiveness, and impact on premiums.

Subsidies are available for Singaporeans at subsidised Specialist Outpatient Clinics (SOC) in public hospitals. Needy Singaporeans can continue to tap on MediFund for assistance if they face difficulty with their outpatient bills.


8. Does MediShield Life cover hospice care?

Yes, MediShield Life covers the Inpatient Hospice Palliative Care Service (IHPCS) at inpatient hospices and community hospitals The claim limits are:

·         General palliative care - $250/day

·         Specialised palliative care - $350/day


9. Why are maternity and fertility expenses not covered under MediShield Life?

MediShield Life is a basic health insurance scheme designed to protect Singaporeans against large hospitalisation bills. As general maternity and fertility treatments are not for illnesses, they fall outside of the scope of MediShield Life.

However, MediShield Life does cover the inpatient treatment of serious pregnancy and delivery complications, such as pre-eclampsia. The full list of complications that are covered can be found by using this link.

There is substantial support for general maternity and fertility expenses through Government subsidies at public hospitals, Medisave use and the Marriage & Parenthood Package. The Assisted Reproduction Treatment co-funding scheme is also available to help couples pay for Assisted Conception Procedures.

CLAIMS UNDER MEDISHIELD LIFE

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1. How do I claim from MediShield Life?

The medical institution will ask if you wish to make a claim and request for your authorisation to submit the claim to MediShield Life and your Integrated Shield Plan insurer (if any) on your behalf. If a payout is due, it will be made to the medical institution directly to net off your bill. The balance amount can be paid by MediSave and/or cash.

To estimate the maximum amount that you can claim from MediSave or MediShield Life, please use this link.

You can find out the list of medical institutions participating in MediShield Life by using this link.


2. What is the pro-ration factor? How does it affect my claim?

As private hospital bills and Class A/B1 bills in public hospitals are generally higher than the Class B2/C bills that MediShield Life is designed for, they are pro-rated to the equivalent level of a Class B2/C bill before MediShield Life payouts are computed. This ensures comparable payouts for subsidised and private patients.


3. Can I submit the MediShield Life claim directly to the Central Provident Fund Board after I have settled the bill at the medical institution?

All MediShield Life claims have to be e-filed by medical institutions to ensure accountability and efficiency in claims processing, due to the high volumes involved. The Central Provident Fund (CPF) Board does not accept claims submitted manually by patients.

The medical institution will seek your authorisation to submit your claim for you. If a payout is due, it will be made directly to the medical institution to net off your bill.


4. How do I view details of my MediShield Life claims from the online MediSave and/or MediShield Life Claim Statements?

You can view the details of your MediSave withdrawals and MediShield Life claim details for past 15 months online at www.cpf.gov.sg under "Latest healthcare payments and claims".

Following are the steps to take: 

(1)  Login to your Healthcare dashboard under my cpf digital services with your Singpass 

(2)  Proceed to “Latest healthcare payments and claims”

(3)  Click on “View past 15 months”

(4)  Select the hospitalisation period

(5)  Click on the amount at Medisave Payment or MediShield Life/Integrated Shield Plan Payment to view the claim details.

If you would like to view the details of claims prior to the past 15 months, please submit a request to the CPF Board via “Write to us”.


5. Will the claim details on the online MediSave and/or MediShield Life Claim Statements be changed if the hospital adjusts my bill size?

Yes, the online statements will take into account any adjustments made to the hospital bills, if the hospital has informed the Central Provident Fund Board about the change before the date of enquiry.


6. What are the claim details that can be viewed from the online MediSave and/or MediShield Life Claim Statements?

Claim details will be reflected on the online MediSave and/or MediShield Life Claim Statements whenever there is a MediSave deduction and/ or MediShield Life payout.

You will also be able to view the claim details for MediShield Life claims, even if the claimable amounts are below the deductible.

If you are covered under an Integrated Shield Plan (IP), you will be able to view the claim details for claims under the MediShield Life component of your IP on the ’Summary of Healthcare Payment’ page. IPs consists of 2 components – MediShield Life component administered by the Central Provident Fund Board and the additional private insurance coverage administered by private IP insurers. You will have to contact your private insurer if you want to find out more about the total claim computation under your IP.


7. Why am I unable to view claim details of my hospitalisation from the online MediSave and/or MediShield Life Claim Statements?

Claim details displayed online are accurate as at the date of enquiry. They will be reflected only after the medical institution submits your claim and the MediSave and/or MediShield Life claim is processed.

Please note that the medical institution can only submit your claim after the medical bill has been finalised. Claim details of your hospitalisation will only be available after your MediSave and/or MediShield Life claim is processed.

You can check the status of your MediShield Life claim via 'My Activities' after you log onto "my cpf Online Services" with your SingPass.


8. Will I be informed of how much I have claimed to date from the online MediSave and/or MediShield Life Claim Statements?

You will be able to view the total amount that you have claimed for the current policy year, as at the date of enquiry.


9. With the availability of the online MediSave and/or MediShield Life Claim Statements, will I still receive hardcopy statements?

You will not receive a hardcopy statement when deductions are made from your MediSave Account to pay for your dependents or your own medical bills. Instead, you will be informed of any deductions via one of the following mobile notifications:

a. If you have the Singpass Mobile App, you will be notified via the Singpass Mobile App Inbox;

b. If you do not have the Singpass Mobile App, but have registered your mobile number with Singpass, you will be notified via SMS.

If you still prefer to receive a hardcopy of your MediSave transaction statement, you may submit an online application to opt out from the mobile notification service. If you do not have a Singpass account and or a registered mobile number, you will continue to receive the hardcopy MediSave transaction statement. No further action is required.

If your claim was only for MediShield Life and there was no deduction made from your MediSave account for the claim, you will not receive a hardcopy statement. For these cases, you will be able to access the claim details from the online MediSave and/or MediShield Life Claim Statements.

If you would like to have the claim statements but are unable to log in online, you may approach our customer service officers over the counter or contact us at 1800-222-3399 for assistance.


10. Will I be able to view claim details of my dependant(s) from the online MediSave and/or MediShield Life Claim Statements?

You will be able to view claim details of your dependant(s) if:

(i) You are the MediSave payer for your dependant’s hospitalisation; or

(ii) You are the MediShield Life premium payer for the dependant who is less than 16 years old.

If your dependants are 16 years old and above, they may apply for SingPass by using this link and login to view their own healthcare payment details.


11. Will my hospitalisation claims still be processed after renouncement or citizenship or permanent resident status?

If you are insured by MediShield Life only, only claims that were submitted prior to the renouncement date of your citizenship or permanent resident status will be processed.

Please inform your private insurer if you have plans to renounce your citizenship or permanent resident status so that your insurer can advise you on the available coverage options, and on the processing of your claims under your IP.


12. I am covered by employer medical benefits or a non-Integrated Shield Plan. Can I claim from MediShield Life as well? Who pays first?

For members who are covered under multiple schemes, the Ministry of Health has set out the following claims protocol to avoid duplicative payouts:

1. Employer, private insurance, other third party pays first

2. Followed by MediShield Life (MSHL)/Integrated Shield Plan (IP)

3. Then MediSave

4. Then Cash

MSHL will pay for the portion of the bill that is not covered by employer, private insurance and other third party payers, subject to claim limits, deductible and co-insurance. If you have filed a claim against MSHL/IP first and subsequently with a third party payer, you or the third party payer must reimburse the relevant amount to MSHL/IP, in line with the claims protocol. The public/private healthcare institutions and the insurance industry have been informed of this claims protocol.


PREMIUMS AND SUBSIDIES

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1. What are the different types of Government subsidies to help Singaporeans with their MediShield Life premiums? Who will be eligible for them?

The Government provides the following premium subsidies and support to keep premiums affordable:

Premium Subsidies (up to 50%) for lower- to middle-income Singapore Residents with household monthly income per person of $2,800 and below and living in residences with an Annual Value of $25,000 and below. Individuals who own multiple properties will not be eligible. Permanent Residents (PRs) will receive half the applicable Singapore Citizens (SCs) rate.

Additional Merdeka Generation (MG) Subsidies of up to 10% for all MGs, on top of above premium subsidies. MGs will also receive annual MediSave top-ups of $200 from 2019 to 2023, which can be used to pay premiums.

Special Pioneer Generation (PG) Subsidies of up to 60% for all PG seniors. PGs will also receive lifetime annual Medisave top-ups of $250 - $900 a year, which can be used to pay premiums. Older PGs (aged 82 years old and above in 2021) who have serious pre-existing conditions will also receive an additional one-off annual MediSave top-up of $50-$200 for five years, from 2021 to 2025. PGs aged 87 years old and above in 2021 will have premiums fully covered by the government, while younger PGs will have about two-thirds of premiums covered.

Additional Premium Support for needy Singaporeans who cannot afford their premiums even after the above subsidies and MediSave use, and have limited family support.


2. The majority of Singapore Residents are covered under Integrated Shield Plans. Are they eligible for subsidies?

Yes, Singapore Residents covered under Integrated Shield Plans (IPs) will also receive the applicable subsidies for MediShield Life premiums if they meet the eligibility criteria.

IPs are made up of 2 components: (i) MediShield Life and (ii) additional private insurance coverage providing additional benefits and/or coverage (in private or public hospitals).

Subsidies for those who are insured under IPs will be applied only on the MediShield Life component of the IP premiums.


3. Will I receive premium subsidies if my child / payer is paying for my MediShield Life premium?

You will be able to receive subsides if you meet the eligibility criteria, regardless of who is paying for your premiums.


4. I am a Pioneer Generation member. How much subsidies will I receive for my MediShield Life premium?

All Pioneer Generation (PG)) seniors receive special Pioneer Generation Subsidies of 40% to 60%. PGs will also receive lifetime annual Medisave top-ups of $250 - $900 a year, which can be used to pay premiums. Older PGs (aged 82 years old and above in 2021) who have serious pre-existing conditions will also receive an additional one-off annual MediSave top-up of $50-$200 for five years, from 2021 to 2025. PGs aged 87 years old and above in 2021 will have premiums fully covered by the government, while younger PGs will have about two-thirds of premiums covered.

To calculate your estimated MediShield Life premiums after the applicable Pioneer Generation Subsidies, please click here.  

PGs who are unable to pay their remaining share of premiums even after the Pioneer Generation Subsidies and Medisave top-ups can apply for Additional Premium Support. No one will lose MediShield Life coverage because of an inability to pay.


5. How will the Government help those who cannot afford their MediShield Life premiums?

All Singapore Residents will remain covered under MediShield Life and no one will lose coverage due to an inability to pay. The Government provides Singaporeans with premium subsidies and support, such as Premium Subsidies for the lower- to middle-income, special Pioneer Generation Subsidies, additional Merdeka Generation subsidies, Medisave top-ups.

Those who continue to face difficulties with their premiums even after the various subsidies can apply for Additional Premium Support. No one will lose their MediShield Life coverage due to an inability to pay.


6. Will I be eligible for MediShield Life Premium Subsidies for the lower- to middle-income for the rest of my life?

Yes, for as long as you meet the eligibility criteria. Premium Subsidies are provided to help the lower- to middle-income households with their MediShield Life premiums. Pioneer Generation Subsidies and Merdeka Generation subsidies are applicable for life, regardless of income or place of residence.


7. To receive Premium Subsidies, why is the household monthly income per person criteria set at $2,800 (applicable for renewals from 1 September 2019)? Does this mean if I earn above $2,800, I am considered high income and cannot receive any Premium Subsidies?

The $2,800 figure refers to the household monthly income per person, which is based on the total income earned by a family staying in the same residential address, divided by the number of members of that family.

So, if the total income earned by family members is $10,000, and there are four members in the family, then the household monthly income per person is $2,500, and the family would qualify for subsidies. 

This is a fairer way of calculating the need for subsidies, because a family with more members may need more support, even if the total income they make is quite high.

Families in a lower household income category will get a higher subsidy rate. In this way, we give more help to those who have less resources and need more help.  This is part of being a compassionate and inclusive society.


8. The use of Annual Value / Multiple Property Ownership as an assessment criterion for MediShield Life premium subsidies will overlook ‘asset-rich, cash-poor’ citizens. Will there be any flexibility that can be extended to these citizens if they face difficulty with their premiums?

In general, Government subsidies should be targeted at those in greater need. The assessment approach for MediShield Life Premium Subsidies uses the household monthly income per person and Annual Value (AV) of homes as a way to assess the household’s means and better target these subsidies. In addition, those who own multiple properties will not be eligible for Premium Subsidies.

The household assessment process strikes a balance between being more precise in assessing applicants’ means and keeping the process simpler for applicants and administratively practical. While the approach is not perfect, it provides us with a fair and objective basis to take a person's income and wealth into consideration.

Singaporeans with difficulties affording their premiums even after government subsidies, MediSave and family support can apply for Additional Premium Support. We will take into account any extenuating circumstances when assessing the application.


9. Do the Premium Subsidies differ for Singapore Citizens and Permanent Residents?

Premium subsidies are extended to all lower and middle income households. Permanent Residents receive half of the subsidy rates applicable to Singapore Citizens.


10. Are my premiums increasing because of the ageing population?

MediShield Life premiums are actuarially priced by independent and external actuarial experts based on health risks and expected healthcare utilisation of each age group. Each age group’s payouts are broadly supported by their own premiums to ensure that MediShield Life remains sustainable even as our population ages.

Since its launch, MediShield Life has been providing more payouts and greater protection for more Singaporeans. Annual payouts have increased by close to 40% and the number of Singaporeans who have made claims has increased by about 30% between 2016 and 2019. For the scheme to continue to be able to provide these payouts to Singaporeans, premiums will have to increase. About two-third of the premium increases are due to the growth in utilisation and payout.

One-quarter of the premium increases is to support the recommendations to refresh and refine the claim limits to ensure that Singaporeans continue to be adequately covered for the vast majority of subsidised bills.

The remaining 8% of premium increases support new benefits including those which were previously implemented without any premium adjustment. This includes the extension of coverage to inpatient hospices and inpatient treatment of serious pregnancy complications.


PREMIUM NOTICE LETTER

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1. Where can I check my MediShield Life/ Integrated Shield Plan premium and subsidies?

Information on your MediShield Life premium and applicable subsidies will be sent in writing to the payer of your premium about 1-2 months before your policy renewal date, by the Central Provident Fund Board or your Integrated Shield Plan (IP) insurer (if you are insured under an IP).

If you would like to obtain an estimate of your MediShield Life premium and applicable subsidies, you may wish to use the MediShield Life premium e-service available, please use this link.


2. How were the MediShield Life premium subsidies in my Premium Notice Letter (PNL) determined?

The different types of subsidies are as follows:

(a) Premium Subsidies for lower- to middle-income Singapore Residents. Eligibility for this subsidy will be subject to criteria such as household monthly income per person, Annual Value of residence and multiple property ownership.

(b) Special Pioneer Generation(PG) Subsidies for all PGs ranging from 40% - 60%.

(c) Additional Merdeka Generation (MG) Subsidies for all MGs, of 5% for those below age 75, increasing to 10% after they turn 75 years of age.

You may refer to the information booklet by using this link for the computation of the various subsidies.


3. If I have appealed for higher subsidies or against the Additional Premium imposed, how will I know if my appeal is successful? Will this be reflected in my Premium Notice Letter?

The premium and subsidies information reflected in your Premium Notice Letter is only accurate as of the date stated in the letter.

If you have appealed, you will receive a letter informing you of the outcome of your appeal.

If there are changes to the premium payable for MediShield Life premiums arising from the change in your subsidy status, you will receive a follow-up letter informing you about the change in premiums.

To check on the status of your appeal, you can write to us or call the MediShield Life hotline at 1800-222-3399.


4. Why did I not receive any premium rebates?

Under MediShield and MediShield Life, Singapore Residents pay more premiums while they are working, so that premiums rise less steeply in old age. The additional amounts paid during working age are set aside in the MediShield Life Fund, to provide for future premium rebates which will help to moderate premium increases in their older ages.

For policyholders born before 1950 and have been insured continuously under the scheme, they will receive premium rebates from age 71 to 90 (based on age next birthday). For policyholders born in or after 1950, they will receive premium rebates from age 66 to 90 (based on age next birthday).

Please click here for more information on premium rebates.


5. Why is the private insurer writing to me about MediShield Life?

Your private insurer is writing to you about the MediShield Life component in your Integrated Shield Plans (IPs) as they act as a single point-of-contact and take care of all communications with their IP policyholders.

IPs are made up of 2 components – the MediShield Life component and the additional private insurance coverage. Those covered under IPs enjoy the combined benefits of MediShield Life which is run by the Central Provident Fund (CPF) Board, and the additional benefits of the additional private insurance coverage, which is run by private insurers.

When you pay for your IP premium, the MediShield Life component of the premium will go to the CPF Board and the additional private insurance component of the premium will be retained by the private insurer.

When you make a claim, your IP payout is also made up of a MediShield Life component and the additional private insurance component. While IP insurers pay out the entire claim to the policyholder, at the back-end, the CPF Board reimburses the MediShield Life portion of the claim to the private insurer.

 

PREMIUM PAYMENT MATTERS

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1. How do I pay the MediShield Life premiums?

The payment options for MediShield Life premiums include:

  • A family member performing a "Change of Payer for MediShield Life Cover" request to take over the premium payment using his/her MediSave.
  • Voluntary top-up to your or the premium payer’s MediSave Account via E-Cashier and select “Contribute to My MediSave”.

You can view the premium deduction in your Transaction history at the CPF website.

For further assistance, please contact us at 1800 222 3399 or email us by using this link


2. If there are insufficient funds in my MediSave Account, can I use my Ordinary Account/Special Account monies to pay for my MediShield Life premiums?

The savings in a member's various CPF accounts are for specific uses. Savings in the Ordinary Account and Special Account are primarily for housing and retirement while the savings in the MediSave Account are for payment of MediShield Life premium and hospitalisation expenses.

Generally, funds in the accounts are not inter-transferable. Therefore, the funds in your Ordinary Account/Special Account is unable to be used for payment of MediShield Life premiums.


3. How often do I have to pay MediShield Life premiums?

If you are the payer of your/your dependants’ MediShield Life premiums, the premiums will be collected annually from your MediSave Account.

You will be notified on the net premium payable and applicable subsidies via the Premium Notice Letter that will be sent about 1 month before the renewal of your MediShield Life cover.


4. What if I am unable to pay for my MediShield Life premiums?

There are various Government subsidies available to help Singaporeans with their MediShield Life premiums. In addition, there is Additional Premium Support (APS) to help those who are unable to afford their MediShield Life premiums even after Government subsidies and if they have limited family support.

The Government will send them application forms to apply for APS, and reach out to them to help them with the process if they are unable to make the applications by themselves.


5. Can I withdraw from MediShield Life?

Universal lifelong coverage under MediShield Life ensures that all Singapore Citizens (SCs) and Permanent Residents (PRs) will have assurance against large healthcare bills. This is in line with our move to a more inclusive society with stronger collective responsibility. MediShield Life is thus mandatory for all SCs and PRs.


6. I am a foreigner currently covered under MediShield Life. How can I pay for my MediShield Life premiums if my CPF account is closed?

When MediShield was replaced by MediShield Life, the Government had given concession to a small number of foreigners with MediShield cover to continue their coverage under MediShield Life.

With the closure of CPF accounts for all foreigners on 1 April 2024, foreigners would need to pay by alternative means aside from their MediSave. For more information on how to change your payment mode, please Write to CPFB. If no alternative arrangements are made to continue paying premiums, the MediShield Life cover will be terminated without refund of past premiums paid.

PREMIUM PAYMENT ARRANGEMENT FOR FAMILY MEMBERS

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1. Can I help my family members pay for their MediShield Life premiums?

Spouse, parent, child, sibling or grandchild who have sufficient MediSave balance may help their insured family members pay their MediShield Life premiums.

Other family members like uncle, aunt, in-laws may only help pay the premiums for the insured, if the insured‘s spouse, parent, child, sibling or grandchild does not have sufficient MediSave funds to pay for the insured’s MediShield Life premiums.

You can help your family members pay their premiums using your MediSave by submitting a Change of Payer Request.


2. How was I identified to pay my family member's MediShield Life premiums? On what authority does the Board automatically deduct my MediSave to pay for my family member’s MediShield Life premiums? Can I stop this payment arrangement?

You have been identified as the premium payer as you are the insured’s family member and have previously used your MediSave to pay the insured’s medical expenses or other health insurance premiums.

The Government has put in place this option to encourage family responsibility by notifying family members that they can use their MediSave to help a family member who has insufficient MediSave to pay MediShield Life premium. The intent was to make it convenient for the majority of members who wish to help their family members pay the premiums.

This process to facilitate the payment of an insured family member’s MediShield Life premium is authorised under regulation 10(7)(b) of the MediShield Life Regulations 2015.

Family members identified as potential payers have about one month to consider whether to proceed with this payment arrangement, before premium deduction takes place. To date, majority of family members approached have continued with this arrangement. By enabling this arrangement, it is more convenient for the vast majority and yet allow for the small number of individuals who disagree to stop premium payment.

You may stop this payment arrangement by completing the “Stop Premium Payment for Dependant(s)’ MediShield Life Cover” form or call us at 1800-222-3399. Once you have indicated your intent, future MediShield Life premiums for the insured family member will not be deducted from your MediSave Account.

Should you subsequently change your mind and wish to take over paying the insured’s premiums after all, you will need to submit a "Change of Payer for MediShield Life Cover" application.


3. Can I stop paying premiums for my child?

If your child is below 21 years old, you are legally responsible for your child’s premium payment. You may change payer to your child, if he or she has sufficient balance in his/her MediSave Account e.g. if your child is a Singaporean who has received MediSave Grant for Newborns or if your child has working contributions.

Otherwise, Section 4(1) of MediShield Life Act requires parents to pay their child’s premiums until their child is 21 years old. If you have valid reasons to stop paying premiums for your child, for example you have been discharged from liability to maintain the child after divorce, please write to us and attach the relevant court documents to support your case.

MEDISHIELD LIFE PREMIUM SUBSIDIES: FACILITATED ELIGIBILITY CHECK

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1. How do I appeal for MediShield Life Premium Subsidies?

You can submit your request through the Household Check e-Service, our MediShield Life hotline at 1800-222-3399 or write to us. Do note that supporting documents will be requested for assessment.


2. Will overseas Singaporeans receive Premium Subsidies?

All Pioneer and Merdeka Generation seniors, including those residing overseas, will receive the Pioneer Generation Subsidies and Merdeka Generation Subsidies automatically. This is regardless of their income, Annual Value (AV) of residence and property ownership.

Singapore Citizens’ and Permanent Residents’ eligibility for Premium Subsidies for the lower- to middle-income households will be subject to criteria such as household monthly income per person, AV of residence and multiple property ownership. It will be assessed based on the individual’s residential address as reflected on his/her NRIC.

If your residential address is an overseas address or if you or your household have confirmed with the Ministry of Health (MOH) that you are overseas, MOH will not be able to assess you for MediShield Life Premium Subsidies as they are unable to obtain the necessary information to determine your eligibility. You will need to apply and submit sufficient documentation for MOH to assess your eligibility for Premium Subsidies prior to the applicable policy year.

If you or your household wishes to request for a review of your eligibility for MediShield Life Premium Subsidies, please write to us, with the following documents:

i)     Declaration of household members staying at the overseas address;

ii)    Latest pay slips (for the past 12 months) or Income Tax returns (for the latest Year of Assessment) for each working household member;

iii)   Property tax document, property valuation document or Sales and Purchase Agreement (dated not more than 5 years ago) if you own the overseas property that you are residing in or a valid tenancy agreement if you are renting your place of residence; and

iv)   Declaration of no. of properties owned

If you are facing financial difficulties and wish to find out more about available subsidies and support, you can write to us or call 1800-222-3399 if calling from Singapore / +65 6222 3399 if calling from overseas.


3. What should I do if one of my household members has disallowed access to his means information for the purpose of MediShield Life Premium Subsidies eligibility checks?

If one of your household members has decided not to allow access to his/her means information for eligibility checks for MediShield Life and / or CareShield Life Premium Subsidies and any applicable MediShield Life and / or CareShield Life assistance measures, we will not be able to calculate the household's eligibility for MediShield Life and / or CareShield Life Premium Subsidies. As such, we are unable to extend any MediShield Life and / or CareShield Life Premium Subsidies and any applicable assistance measures to all members of your household.

Please discuss with your household member if you have concerns regarding his disclosure status. If your household member now wishes to allow access to his means information, please call our hotline at 1800-222-3399 or visit the Household Check e-Service and click “login to access the MediShield Life e-Service”.

INFORMATION USED FOR ELIGIBILITY CHECKS

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1. When should I review and update my household information?

You should review and update your household information whenever there are changes to your household (e.g. when you move house, when there are new additions to your household).

Please write to us or call 1800-222-3399 should you wish to request to update your household information. Alternatively, you may visit the Household Check e-Service and click “login to access the MediShield Life e-Service”.


2. Who should be considered as a member of my household? What is the definition of a household?

Only family members related by blood, marriage and/or legal adoption, (e.g. spouse, parents, children, grandparents, grandchildren, siblings, uncles, aunts, cousins and in-laws) and who live at the same residence are considered members of your household.

Domestic helpers, unrelated tenants, godparents and friends living at the same address are not considered members of your household. Family members not living at your address are not considered members of your household.

To view or update the household information used to compute your Premium Subsidies, log in to the Household Check e-Service.


3. I am or my household is overseas but have a local NRIC address, should I inform Ministry of Health?

The Ministry of Health (MOH) will assess you and your household members' subsidy eligibility for MediShield Life and / or CareShield Life Premium Subsidies based on your residential address as reflected on your NRIC.

Please note that if you / your family member is confirmed with MOH as being overseas, MOH will not be able to calculate MediShield Life and / or CareShield Life Premium Subsidies for you / your family member, as they are unable to determine the Annual Value of the overseas residence. Overseas Singaporeans will receive Premium Subsidies if they apply and submit sufficient documentation for MOH to assess their eligibility for Premium Subsidies prior to the applicable policy year. Please write to us or call our hotline at 1800-222-3399 for more information.

If you / your family member is overseas for studies or will be returning soon, you may wish to retain him as part of your household. There is no need to inform MOH that you / your family member is overseas.


4. What is the means information that the Government will be accessing for the eligibility checks for MediShield Life Premium Subsidies?

The means information that the Ministry of Health (MOH) will access for the eligibility checks for MediShield Life Premium Subsidies refers to income and property ownership only. MOH does not have access to other types of means information such as bank balances.

If you do not wish to allow MOH to access your means information, you may register your preference through the MediShield Life Household Check e-Service . However, MOH will then not be able to assess your entire household’s subsidy eligibility for MediShield Life Premium Subsidies and all members in your household will not receive any MediShield Life Premium Subsidies. You will still qualify for Pioneer Generation or Merdeka Generation Subsidies if you are a Pioneer or Merdeka Generation senior.


5. How will the household monthly income per person be computed?

In general, annual income from work from all household members will be used.

For those who are salaried employees, their income will be based on either:

a) the average monthly income over the last available 12-month period, including bonuses, as derived by the Central Provident Fund (CPF) Board ; or

b) the average monthly income from work (sum of net employment income and annual trade income before losses brought forward) assessed by the Inland Revenue Authority of Singapore (IRAS) for the latest available assessment year.

For those who are self-employed, their income will be based on either:

a) the average monthly income from work (sum of net employment income and annual trade income before losses brought forward) assessed by IRAS for the latest available assessment year; or

b) the income declared to the CPF Board or the income assumed under the CPF Legislation within the last year.

Should there be a change in your income or employment status, you may be required to submit supporting documents to reflect this change at a later date.


6. Would changes to my income be taken into consideration immediately for the eligibility checks?

Your income will only be accessed annually when your subsidy eligibility is due for an update. This will happen at the end of the 1 year validity period, and will take into account the latest available 12 months information based on Government records.

If there are changes to your household financial circumstances that you would want us to use before your subsidy eligibility is due for an update, please approach the Ministry of Health for a re-assessment of your household’s subsidy eligibility.


7. What is the means-test Annual Value (AV) criteria as of 1 January 2024?

To ensure that Singaporeans with greater needs continue to receive support, the Government increased the AV thresholds used across social support schemes, including MediShield Life with effect from 1 January 2024, as follows:

 

Existing AV thresholds for social support schemes

(New – from 1 January 2024) AV thresholds for social support schemes

First AV Tier

Up to $13,000

Up to $21,000

Second AV Tier

More than $13,000 and up to $21,000

More than $21,000 and up to $25,000

The new AV criteria would be applied to relevant healthcare schemes that uses AV as a means-testing criteria. More information on the eligibility criteria for different healthcare schemes can be found on their respective websites.


8. How do I find out what is the Annual Value of my Property?

The Annual Value (AV) of HDB properties generally falls below $21,000, while some lower-value private properties have AV between $21,000 and $25,000.

You can find out about the AV of your residence from IRAS e-Valuation List at a nominal fee. You may also check your property tax bill or log in to myTax.iras.gov.sg.


9. Do I need to submit an application in January 2024 to be means-tested with the revised AV thresholds?

Means-tests are generally refreshed on an annual basis when your MediShield Life subsidy eligibility is due for an update. During the annual update, your latest Annual Value (AV) would be means-tested based on the latest AV criteria.

Additionally, your subsidy eligibility may be updated when there are changes to your household information, such as a new-born in your household or when you apply for / renew your status under other healthcare subsidy schemes such as the Community Health Assist Scheme (CHAS).

If your 2022 residential AV property falls between $13,000 and $25,000, your means-test record would automatically be refreshed in January 2024. No action is required from affected individuals.


9. I am living in Property A and have my registered address on my NRIC here. However, I own Property B. Which Property address will be used for the eligibility checks for MediShield Life Premium Subsidies?

The Annual Value (AV) of the address on your NRIC will be used. In this example, AV of Property A will be used for the eligibility checks for MediShield Life Premium Subsidies.

Singapore Citizens and Permanent Residents who own two or more properties will not be eligible for MediShield Life Premium Subsidies. Other members of their households (who are not multiple property owners) will still be assessed for their eligibility for subsidies.


10. I am living at Property A (which I do not own), but I own Property B. Would I be still be eligible for MediShield Life Premium Subsidies?

The Annual Value of the address on your NRIC will be used for the eligibility checks for MediShield Life Premium Subsidies.


11. What types of properties are considered for the multiple property ownership criterion for MediShield Life Premium Subsidies?

All types of properties, e.g., HDB flat, private residential property and non-residential property, are taken into account in determining the subsidy eligibility for MediShield Life Premium Subsidies.


12. What is the validity period for my subsidy eligibility for MediShield Life Premium Subsidies?

In general, your subsidy eligibility will be valid for one year. Your subsidy eligibility may be updated when there are changes to your household information, such as a new-born in your household or when you apply for / renew your status under other healthcare subsidy schemes such as the Community Health Assist Scheme (CHAS).

CHOOSING NOT TO PARTICIPATE IN THE HOUSEHOLD CHECK EXERCISE

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1. I am uncomfortable with my personal information being accessed. Can I choose not to participate in the eligibility checks for MediShield Life Premium Subsidies?

Yes, you may choose not to allow the Ministry of Health to access your means information, for example, income for the eligibility checks.

If you chose not to allow access to your means information, you and your entire household will not receive any MediShield Life Premium Subsidies as there is insufficient information for us to calculate the subsidies to be given.

Your household will still be covered by MediShield Life.

2. Will my information which was obtained for eligibility checks for MediShield Life Premium Subsidies be shared with other Government public assistance schemes?

Yes, sharing the subsidy eligibility information for MediShield Life Premium Subsidies will help Singapore Citizens and Permanent Residents benefit from other Government healthcare-related schemes easily. However, detailed means and medical information will not be shared beyond MediShield Life, in order to protect the confidentiality of the information.

If you prefer not to share your subsidy eligibility for MediShield Life Premium Subsidies with other Government healthcare-related schemes, you may exercise this option through the Household Check e-Service. Alternatively, please call 1800-222-3399 for further assistance.

Do note that if you exercise this option, you may need to re-submit separate applications and/or means information for such schemes in future. This will however, not affect your household’s eligibility for MediShield Life Premium Subsidies, unless you and/or your household members have also chosen not to allow MOH access to your means information for the eligibility check for MediShield Life Premium Subsidies.


ADDITIONAL PREMIUM SUPPORT

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1. What is Additional Premium Support and what are the eligibility criteria for Additional Premium Support?

Additional Premium Support (APS) provides financial assistance to members who are unable to afford their premiums even after premium subsidies and MediSave use, and have limited family support. This may include low-income single elderly without family support and low-income families with multiple dependants. The Government will invite these individuals to apply for APS and help them with the process if they are unable to do so themselves.

Eligibility for APS is based on, but not limited to the applicants’ and his immediate family members’ financial means. Flexibility will be exercised for individuals who may not completely meet the criteria but need help because of their financial circumstances.

No one will lose their MediShield Life and CareShield Life (if applicable) coverage due to the inability to pay premiums.


2. How will those with no income (e.g. needy, not working) be able to afford the MediShield Life and CareShield Life premiums? What if they do not have enough MediSave or do not have a MediSave account?

The Government provides Singaporeans with premium subsidies and support, such as Premium Subsidies for the lower- to middle-income, special Pioneer Generation Subsidies and Merdeka Generation subsidies. Those who are less well-off will qualify for higher Government subsidies to reduce their premium payment.

MediShield Life and CareShield Life premiums may be fully paid using your Medisave. Immediate family members such as parents and spouse, can help to use their Medisave to pay for their loved ones.

Those who are still unable to afford their MediShield Life and/or CareShield Life premiums even after Government subsidies and MediSave, and have limited family support, may apply for Additional Premium Support. The Government will send these members an application form to invite them to apply for Additional Premium Support.

No one will lose MediShield Life and CareShield Life (if applicable) coverage because of an inability to pay.


3. I am currently receiving Additional Premium Support (APS) for MediShield Life coverage, will I also receive APS for CareShield Life?

When approved, Additional Premium Support (APS) will cover MediShield Life and CareShield Life (if applicable) premiums for the next two years.

Please note that you will not be eligible for APS if you have an additional private medical insurance cover under an Integrated Shield Plan and/or Supplements under ElderShield/CareShield Life.


4. How can Additional Premium Support help me with my MediShield Life and CareShield Life premiums?

If approved, Additional Premium Support (APS) will cover your outstanding MediShield Life and/or CareShield Life premiums as well as the premiums for the next two years.

For outstanding premiums, APS will pay the premiums and any interest incurred. Any penalty will also be waived.


5. What is the processing time for my Additional Premium Support application?

Your application will be processed upon receipt of your completed application form and supporting documents where relevant.

The processing time is generally up to 20 working days for most cases as each APS application undergoes a thorough and careful assessment, including taking into consideration any extenuating cirucmstnaces that the applicant may be facing.

You will receive a letter to inform you on the outcome of your APS application.


6. I have previously applied for Additional Premium Support but was rejected. Can I apply for assistance again to help pay my premiums for the next policy year?

As you were previously assessed to be ineligible to receive Additional Premium Support (APS), we encourage you to pay your outstanding premiums (if any) via any of the options enclosed in the Rejection for Additional Premium Support Application Letter (Ref: APCREJ).

You may re-apply for APS if there is a change in your financial circumstances or if you face any extenuating circumstances that were not highlighted during your previous application.


7. I am on a Government financial assistance scheme. Can I conserve my MediSave and apply Additional Premium Support to pay my MediShield Life and/or CareShield Life premiums?

If you are currently on a Government financial assistance scheme, and you fulfil the APS criteria, there is no need for you to apply for Additional Premium Support (APS). You will automatically be granted APS if you have insufficient MediSave to pay your MediShield Life and/or CareShield Life premiums.

APS is a financial assistance scheme designed to support members who cannot afford their premiums even after subsidies and MediSave use, and have limited family support. If you have sufficient MediSave to pay your MediShield Life and/or CareShield Life premiums, you will not be eligible for APS.


8. How can I apply for Additional Premium Support to pay for my MediShield Life and/or CareShield Life premiums?

Additional Premium Support (APS) provides financial assistance to members who are unable to afford their premiums after premium subsidies and MediSave use, and have limited family support. You will be invited to apply for APS should you have insufficient MediSave, and details on the application process will be included in the invitation letter. There is no need for you to apply for APS ahead of time.


9. Will overseas Singaporeans in financial difficulties be eligible for Additional Premium Support?

Overseas Singaporeans who have insufficient MediSave and limited family support to pay their MediShield Life and / or CareShield Life premiums will be invited to apply for Additional Premium Support (APS). Please note that all APS applications will be assessed on a case-by-case basis.

If you require further clarification, please call us at 1800-222-3399 (or +65 6222 3399 from overseas) from Monday to Friday, 8.30am to 5.30pm (GMT+8) or write in to us at aps@medishieldlife.sg.


10. Am I eligible for Additional Premium Support if I have an Integrated Shield Plan and/or active-paying ElderShield/CareShield Life Supplement?

If you were approved for Additional Premium Support (APS) before CSHL implementation and have purchased an active-paying ESH supplement, you will continue to receive APS for premiums for the two years after the approval. However, your APS will cease immediately if you purchase an Integrated Shield Plan.

If you purchase an active-paying ESH / CSHL Supplement after CSHL implementation, you will not be eligible for APS. This is to ensure that APS is targeted at members who are needy and have financial difficulties.

Should you have difficulty paying the premiums for your Integrated Sheld Plan or active-paying ElderShield / CareShield Life Supplement, you may wish to approach your financial advisor to review your healthcare insurance coverage needs.

APPLICATION FOR ADDITIONAL PREMIUM SUPPORT

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1. I am unsure of how to fill up the Additional Premium Support (APS) application form. Can I request an officer to help me with my APS application?

If you require assistance to fill up or submit the Additional Premium Support (APS) application form, you may call us at 1800-222-3399 (or +65 6222 3399 from overseas) from Monday to Friday, 8.30am to 5.30pm (GMT+8) or write in to aps@medishieldlife.sg. Our officers will guide you through the steps to fill up the APS application form.


2. I received the Additional Premium Support application form. Who are considered as my immediate family members to be included in the application form?

Immediate family members refer to parents, spouse and children who is/are related to the Main Applicant by blood, marriage and/or legal adoption, but does not refer to siblings.


3. I received an application form each for myself and my child. I wish to apply for myself and my child. Can I submit only one application form?

You only need to submit one application form for yourself if your child is below 21 years old. Please indicate in the application form that you are applying Additional Premium Support for yourself (Main Applicant). If you are assessed to be eligible for APS, we will automatically extend APS to your child.

However, if your child is above 21 years old, he/she will need to submit a separate application form with himself/herself as the Main Applicant.


4. Why did I receive the Additional Premium Support invitation letter (Ref: APCINV)?

Additional Premium Support (APS) provides financial assistance to members who are unable to afford their MediShield Life and/or CareShield Life premiums even after Government subsidies and MediSave use, have limited family support.

As you have outstanding MediShield Life and / or CareShield Life premiums, the letter was sent to invite you to apply for APS if you wish to. Alternatively, you may top up your MediSave Account to pay your outstanding premiums. Family members can also help pay for your premiums using their MediSave.


5. How can I submit the supporting documents to complete my overseas APS application?

You may scan and email your completed Additional Premium Support (APS) application form and any relevant documents to aps@medishieldlife.sg.

Alternatively, you may mail them to:

Bukit Merah Central Post Office

P.O. Box 680

Singapore 911536


6. I have received a letter from MOH stating that my Additional Premium Support (APS) application was rejected. Why was I rejected and how do I appeal for APS?

Eligibility for Additional Premium Support (APS) is based on, but not limited to the applicants’ and his/her immediate family members’ financial means. As individuals’ circumstances differ from one another, each application will be assessed on a case-by-case basis to ensure that assistance is targeted at members who are needy.

You may submit your enquiry and reason(s) for APS appeal, with any relevant supporting documents, to aps@medishieldlife.sg.


7. Do I need to re-apply for Additional Premium Support?

You will be invited to re-apply for APS if you still have insufficient MediSave to pay your premiums after your current APS ends.


8. How do I know if Additional Premium Support has been granted to fully pay my outstanding MediShield Life and/or CareShield Life premiums?

You will receive a letter to inform you on the outcome of your APS application.

For MediShield Life premiums, you may log in to "Outstanding MediShield Life premium". If you do not have any outstanding premium, you will not be able to view this page.

For CareShield Life premiums, you may log in to ‘Check My Premium’ at careshieldlife.gov.sg via SingPass. If you are eligible for APS, the ‘Net Premium Payable after Additional Premium Support’ field will be reflected as $0.

ADDITIONAL PREMIUM SUPPORT OUTREACH EFFORTS

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1. Why did I receive calls or visits from the Ministry of Social and Family Development (MSF) officers?

These officers from the Ministry of Social and Family Development (MSF) are part of the Additional Premium Support (APS) outreach team.

As you have outstanding MediShield Life and / or CareShield Life premiums and MOH has not received your APS application form after sending letter(s) to invite you to apply for APS, the MSF officer has called / visited you to explain about MediShield Life and / or CareShield Life and how to apply for APS to help you pay your premiums.


2. Why did I receive a call from someone who claimed to be an officer from the Ministry of Health (MOH) asking me to apply for APS?

As the Ministry of Health (MOH) has not received your Additional Premium Support (APS) application form after sending letter(s) to invite you to apply for APS, the MOH officer had contacted you to find out if you need assistance with the APS application. This is to ensure that adequate assistance is extended to members who are unable to afford their premiums.

DISTRIBUTING PREMIUMS MORE EVENLY OVER OUR LIFETIME (PRE-FUNDING)

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1. What does distributing premiums more evenly over our lifetime refer to? Why is there a need to distribute premiums more evenly over our lifetime under MediShield Life?

MediShield Life premiums increase with age. This reflects the higher incidence of hospitalisation among the older age groups, and the higher bills incurred.

Under MediShield Life, premiums are distributed more evenly throughout our life.  Singapore Residents pay more premiums while they are working, so that premiums rise less steeply in old age.  This is important as they would have stopped work by then. 

The additional amounts paid during working age are set aside in a pool in the MediShield Life Fund, which individuals and others in the same generation can tap on to receive premium rebates when they are older. 

Distributing premiums more evenly over our lifetime helps us to pay ahead for premiums.  Planning and saving for our future healthcare expenses will reduce concerns over whether we have enough savings during retirement. 


2. An individual can also save for his future premiums through his own Medisave account. Why do we opt for this mechanism where monies that are paid ahead are pooled?

Paying ahead for insurance premiums is a more inclusive and collective approach to boost the support for each generation’s future old-age premiums. Under this approach, everyone pools some monies during working ages which are set aside to help support the old-age premiums of those of the same generation. Doing so gives Singapore Residents a pool of pre-paid premiums to tap on in future, to cushion the impact of future increases during the retirement years.

In contrast, while MediSave is useful to help with healthcare costs, including insurance premiums, there are also many competing demands for it such as hospitalisation bills and outpatient treatment for chronic diseases, which all add to pressure on MediSave balances.


3. How much more premium rebates will Singapore Residents get in old age, with premiums distributed more evenly over our lifetime?

Please click here for more information on the enhanced premium rebate table applicable to incoming cohorts.

The scheme is designed such that younger Singapore Residents who pre-pay more during their working ages will receive greater premium rebates. This will help to offset more of old-age premiums for their generation.


4. I am in my 60s. Does this mean that I will pay higher premiums but will not enjoy the higher premium rebates?

For this age group, the MediShield Life premiums are mainly set to support the better benefits and their higher expected claims experience. They will benefit from premium rebates based on a level at which they had contributed during their working years.


5. Why do premium rebates stop at age 90?

Under MediShield, the premium rebate schedule was designed to support premium rebates up to age 90, which was the maximum coverage age under MediShield. With MediShield Life, Pioneers above age 90 will not need to pay any premiums after the Pioneer Generation Subsidies and Medisave top-ups. In view of this, there is no immediate need to extend the last coverage age of the premium rebates.

The Ministry of Health will review the premium rebates from time to time so that the distribution of rebates is able to meet the needs of the elderly then.


6. What will happen to the premiums that Singapore Residents have pre-paid in their working years should they pass away early? Will the monies be returned to their family members?

The premiums that are pre-paid are pooled together by age group to help cushion the future increases in premiums during older ages. While some members may pass on earlier, the remaining pool of funds will help those of the same age group who live longer and need to draw on more rebates.


 


UNIVERSAL COVERAGE FOR ALL

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1. Who will be covered under MediShield Life? Do I need to apply for MediShield Life?

All Singapore Citizens and Permanent Residents will be automatically covered under MediShield Life. No application is required.

If you are covered by MediShield Life only, when your plan is up for annual renewal, the current payer (who may be yourself or your family member) will receive a letter from the Central Provident Fund (CPF) Board with details about your MediShield Life premiums and subsidies.

If you are covered by an Integrated Shield Plan, when your Integrated Shield Plan is up for annual renewal, the current payer (who may be yourself or your family member) will receive a letter from your private insurer with details about your premiums and subsidies. You will receive subsidies for the MediShield Life portion of your Integrated Shield Plan if you are eligible.


2. I have my own healthcare coverage, why do I need MediShield Life? How is MediShield Life different from other insurance schemes?

All Singapore Citizens and Permanent Residents are required to join MediShield Life. Under MediShield Life, Singapore Residents will remain insured and receive lifelong protection for large hospital bills. The Government will provide support for premiums for the needy who are unable to pay. Even if you incur very large bills over your lifetime.  The insurance cover will not be terminated when you get very sick

Unlike MediShield Life, other healthcare coverage is not guaranteed for life. For example, employees with healthcare coverage from their employers will lose such coverage when they leave employment or retire. For those with other private insurance, they may lose this coverage if they are unable to pay for premiums, and they may not be able to re-apply for coverage later if they have already developed some health conditions.


3. I have been insured for many years but have not made a claim. Why should I remain insured under MediShield Life?

Insurance provides protection against the risk of undesirable outcomes.  MediShield Life protects all Singapore Residents against the risk of large hospitalisation bills.  As with all insurance plans, we would prefer not to have had to claim from our health insurance, as doing so would mean that we have fallen ill. We all want to enjoy good health as far as possible.  But with MediShield Life, we can have peace-of-mind that if we do fall sick and incur a large bill. We can enjoy better protection, with higher payouts to reduce the amount that we need to pay using Medisave and/or cash.


4. I am a pensioner retired from the civil service. Can I opt out of MediShield Life?

Universal lifelong coverage under MediShield Life ensures that all Singapore Residents will have assurance against large healthcare bills. It is in line with our move to a more inclusive society with stronger collective responsibility. MediShield Life coverage is mandatory for all Singapore Citizens and Permanent Residents, including those who receive benefits from their employer. This enables all Singapore Residents to share in our national risk pool and play our part in supporting our healthcare costs.

If you are a pensioner, you will also be covered under MediShield Life. 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 by paying for their premiums in full or by providing 2% Medisave contribution, depending on their respective medical benefit schemes. The Public Service Division has notified the pensioners. If you require more information, please write in to psd_qsm@psd.gov.sg.


5. How can I find out if I am covered under MediShield Life or an Integrated Shield Plan?

You are covered under MediShield Life if you are a Singaporean or Permanent Resident.

If you are covered under an Integrated Shield Plan (IP), your premium payer will be notified by your private insurer with details about your premiums and subsidies. You will receive applicable subsidies for the MediShield Life portion of your IP, if you meet the eligibility criteria.

You can log in to visit the Healthcare dashboard 'Coverage and premium details' to check the coverage and premium information for yourself and the dependant(s) you are paying premiums for.


6. Will new Singapore Citizens and Permanent Residents be required to join MediShield Life?

New Singapore Citizens and Permanent Residents will be required to join MediShield Life, in line with the principle of universal coverage. New Singapore Citizens and Permanent Residents with serious pre-existing conditions may have to pay Additional Premiums upon joining MediShield Life. They will be eligible for Government subsidies for their MediShield Life premiums if they meet the eligibility criteria and will receive premium rebates in line with their age of entry.

They will be notified of their MediShield Life cover by Central Provident Fund Board when their covers have been issued, generally within 1 month of attaining permanent residence.


7. When will the MediShield Life cover of my new-born baby his/her cover start? Will I be notified?

New-borns who are registered as Singapore Citizens at birth are insured under MediShield Life from birth. The Central Provident Fund Board will notify his/her parent (usually the father) of the new-born’s MediShield Life coverage details generally within 1 month of the start of the MediShield Life cover.


8. What are the areas of duplication between MediShield Life and Hospitalisation & Surgical (“H&S”) plans that are not Integrated Shield Plans?

MediShield Life is a basic healthcare insurance plan that helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. It is basic because it is sized for subsidised treatments in the public hospitals. You may wish to compare the benefits of your H&S plan with those of MediShield Life at this link, to identify the areas of duplication. You may also wish to approach your financial advisor who will be able to share more with you.


9. What should I do if I want to avoid/remove such duplication between MediShield Life and Hospitalisation & Surgical (“H&S”) plans that are not Integrated Shield Plans?

You may wish to consider avoiding/removing such duplication by taking up an Integrated Shield Plan (IP), which comprises a MediShield Life component and an additional private insurance coverage component.

You may wish to note that while MediShield Life will provide coverage for any pre-existing conditions, you may be subject to additional health checks by the private insurers for the additional private insurance coverage component, possibly resulting in exclusions and/or risk-loading. Please speak to your financial advisor who will be able to share more about your options and their implications.


10. What will happen to my MediShield Life or Integrated Shield Plan cover when I renounce my Singapore Citizenship or Permanent Resident status?

Today, all Singapore Citizens and Permanent Residents are covered by MediShield Life.

Should you renounce your citizenship or permanent resident status and are only insured under MediShield Life, you will lose MediShield Life cover.

If you are insured under an Integrated Shield Plan (IP), you will no longer have a MediShield Life component (which may include coverage of any pre-existing conditions) in your IP. Please inform your private insurer if you have plans to renounce your citizenship or permanent resident status so that your insurer can advise you on the available coverage options. If you wish to terminate your IP, you will also need to notify your private insurer in a manner as required by your insurer. 


11. What will happen to the MediShield Life or Integrated Shield Plan premiums I paid when I renounce my Singapore Citizenship or Permanent Resident status?

Should you renounce your citizenship or permanent resident status and are only insured under MediShield Life, your MediShield Life cover will cease. The annual premium that you have paid will be pro-rated and the amount for the period after your renouncement date will be refunded to the Medisave Account of the premium payer.

If you are insured under an Integrated Shield Plan (IP), please inform your private insurer if you have plans to renounce your citizenship or permanent resident status so that your insurer can advise you on the available coverage options and explain what will happen to the premiums you have paid. If you wish to terminate your IP, you will also need to notify your private insurer in a manner as required by your insurer. 



UNIVERSAL COVERAGE AND PRE-EXISTING CONDITIONS

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1. What is universal coverage?

Universal coverage means providing MediShield Life coverage for all Singapore Residents for life, regardless of pre-existing conditions or other circumstances that they face. With MediShield Life, all Singapore Residents will be covered regardless of their health condition and life circumstances. Those who were insured under MediShield with exclusions for pre-existing conditions, their exclusions are lifted and are now fully covered under MediShield Life.

A list of standard exclusions, such as cosmetic treatment and overseas medical treatments , will still apply under MediShield Life. All insured individuals will not be able to make claims for bills related to such exclusions.


2. What are pre-existing conditions? What are considered serious pre-existing conditions?

A pre-existing condition is a medical condition or illness that an individual already has before he is covered under an insurance plan.

A serious pre-existing condition is one that may require intensive medical intervention to treat or manage; or have high risk of future complications or recurrence, and therefore may require prolonged treatment.


3. For those with serious pre-existing conditions, why do they have to pay Additional Premiums? What is the reason for setting it at 30% over 10 years? Would this be too onerous for some?

The MediShield Life Review Committee recommended that the unhealthy uninsured and the insured with exclusions pay a higher premium as a reflection of the higher risks they pose to the pool and to fund part of their coverage.

The Additional Premiums balances between reflecting the higher risks of covering these individuals with serious pre-existing conditions and ensuring that premiums remain affordable and are not overly onerous. Those with serious pre-existing conditions would already have been bearing higher medical costs in the past and we are sympathetic to their circumstances. Hence the Additional Premiums do not reflect the full costs of their coverage. Instead, their Additional Premiums will be set at 30% for a limited period of 10 years.


4. How will the Ministry of Health decide on the serious pre-existing conditions that will be subject to Additional Premiums?

The Ministry has conducted an extensive review on the serious pre-existing conditions that will be subject to Additional Premiums, with specialist advice from clinicians.

A fair and compassionate approach has been adopted in identifying the Singapore Residents who will be subject to the Additional Premiums due to their serious pre-existing conditions.

Focus was placed on identifying serious conditions that require intensive medical intervention to treat or manage; or have high risk of future complications or recurrence and therefore may require prolonged treatment. Within these broad categories, whether individuals with serious pre-existing conditions will be subject to Additional Premiums depends on factors such as specific nature and severity of the individual’s medical condition.


5. What are the serious pre-existing conditions that will be subject to Additional Premiums?

A fair and compassionate approach has been adopted in identifying the Singapore Residents who will be subject to the Additional Premiums due to their serious pre-existing conditions

Focus was placed on identifying serious conditions that require intensive medical intervention to treat or manage; or have high risk of future complications or recurrence and therefore may require prolonged treatment. Within these broad categories, whether individuals with serious pre-existing conditions will be subject to Additional Premiums depends on factors such as specific nature and severity of the individual’s medical condition.

For more details on the broad categories of serious pre-existing conditions that would require Additional Premiums, please click here.


6. What if my medical condition has improved? Must I still pay the 30% Additional Premiums? Can I appeal against the imposition of the Additional Premiums?

You may apply to the Central Provident Fund (CPF) Board to lift the Additional Premiums going forward, if your condition has improved. Additional medical information may be needed for the review.

For more information, you can write to us or call 1800-222-3399.


7. Will individuals with developmental disorders have to pay the Additional Premiums?

Individuals with developmental conditions such as Down Syndrome and Autism will not need to pay Additional Premiums purely on the basis of these developmental conditions. However, if an individual with Down Syndrome or Autism also has other pre-existing conditions with serious medical complications which are likely to result in higher risk of claims, such as heart disease and kidney disease, MediShield Life will require Additional Premiums due to the serious pre-existing medical condition.


8. How were the checks for serious pre-existing conditions be done?

Prior to the launch of MediShield Life, the Central Provident Fund (CPF) Board has conducted checks to identify individuals who have serious pre-existing conditions that will be subject to Additional Premiums. To ensure that the process is convenient and minimise the need for further medical assessments or medical reports, the CPF Board has tapped on existing medical information in Government administrative databases and medical institutions. The facilitated check is provided for under the MediShield Life Scheme Act.


9. Will checks be conducted for new Singapore Residents who are subsequently covered under MediShield Life?

For new Singapore Residents who are subsequently covered under MediShield Life, we will have a range of checks, including reviewing medical records after they are covered. They will also be required to declare their health status upon receipt of the In-Principle Approval (IPA) letter from the Immigration & Checkpoints Authority of Singapore (ICA). The e-form can be found by using this link

If they are identified to have serious pre-existing conditions, they will be subject to the 30% Additional Premiums for 10 years. Those who make false health declarations will be guilty of an offence under the MediShield Life Scheme Act and will be liable to pay penalties.


10. What if I have an Integrated Shield Plan (IP), does the 30% Additional Premiums apply to my entire IP Premiums?

Integrated Shield Plans (IPs) consist of 2 components  – the MediShield component, sized for Class B2/C ward, administered by the Central Provident Fund Board and the additional private insurance component for Class B1/A wards and private hospital stays, administered by private insurers. From 1 Nov 2015, MediShield Life will replace the MediShield component in IPs.

The 30% Additional Premiums only applies to the MediShield Life component of your IP premiums.

For the additional private insurance component, IP insurers will separately assess whether to introduce exclusions or risk-loading (i.e., higher than the standard premiums) for those with pre-existing conditions.


11. Are subsidies applicable to the 30% Additional Premiums for those with serious pre-existing conditions?

Yes, all subsidies are applicable to the 30% Additional Premiums for those with serious pre-existing conditions. This includes the Premium Subsidies for the lower- to middle income, Pioneer Generation Subsidies and Merdeka Generation subsidies for Singapore Citizens. For Singaporeans who are not able to afford their premiums even after subsidies, MediSave, and have limited family support, the Government will provide Additional Premium Support, which will also be applicable to the Additional Premiums.




PREMIUM RECOVERY MEASURES

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1. Why is there a need for strong premium recovery measures?

With universal MediShield Life coverage, as part of collective responsibility, all Singapore Residents should play their part in paying their premiums in a timely manner. This ensures that MediShield Life is able to meet its commitments to all its members and pay out on claims.

The Government will provide strong support through various subsidies to help Singapore Residents with their premiums. Active measures will also be taken to facilitate the payment of premiums, including deduction of premiums fully from Medisave balances, regular reminders, switch of payment arrangement to family members and Additional Premium Support for the genuinely needy.

However there may be a small group of defaulters who have means but choose not to pay premiums. The premium recovery measures are targeted at this group to discourage freeloading and ensure that they also pay their fair share of premiums. Otherwise, premium defaults will translate to bad debts to the MediShield Life Fund and higher premiums for all.


2. Will those who are less well-off and unable to pay their premiums face these premium recovery measures?

Before the premium recovery measures start, there will be many efforts to enable Singaporeans to pay for their premiums, and outreach to invite them to ask for further assistance if needed.

The Government will provide strong support for premiums:

a. Premium Subsidies (up to 50%) for lower- to middle-income Singapore Residents with household monthly income per person of $2,800 and below  and living in residences with an Annual Value of $25,000 and below. 

b. Additional Merdeka Generation Subsidies of up to 10% for all MGs, on top of above premium subsidies. MGs will also receive annual MediSave top-ups of $200 from 2019 to 2023, which can be used to pay premiums.

c. Special Pioneer Generation (PG) Subsidies of up to 60% for all PG seniors. PGs will also receive lifetime annual Medisave top-up of $250 - $900 a year, which can be used to pay premiums. Older PGs (aged 82 years old and above in 2021) who have serious pre-existing conditions will also receive an additional one-off annual MediSave top-up of $50-$200 for five years, from 2021 to 2025. PGs aged 87 years old and above in 2021 will have premiums fully covered by the government, while younger PGs will have about two-thirds of premiums covered.

In addition, MediSave may be used to pay the full MediShield Life premiums after subsidies. Singapore Residents can also use their MediSave to help pay for their family members’ premiums.

Measures to help with premium payment include:

a.     Helping to keep MediSave contributions current. As MediShield Life premiums are deducted from a policyholder’s MediSave Account, the first step is to ensure that MediSave contributions are kept current.

b.     Supporting switch of payment to other family members’ MediSave accounts. If an insured person has insufficient MediSave balance, immediate family members such as parents and spouses can help to use their MediSave to pay for their premiums.

c.     Regular reminder letters to top up the insured’s MediSave Account and to pay MediShield Life premiums.

The Government will also provide Additional Premium Support for the needy who face difficulties in paying premiums even after the subsidies and other payment measures.


3. What are the premium recovery measures? Who will enforce premium payment?

Prior to premium recovery, premium notices and reminders will be sent to give policyholders sufficient time to make payment. Policyholders will also be informed of alternative payment methods (e.g. tapping on family support) and the availability of government assistance (i.e. Additional Premium Support) for those who qualify. 

However, for those with the means but who choose not to pay MediShield Life premiums, a strong set of measures will be taken to recover premiums. If left unchecked, premium defaults will translate into bad debts that will affect the sustainability of the MediShield Life Fund and could lead to higher premiums for all. The premium recovery measures, which take reference from income tax recovery measures, are:

(i)          Appointment of defaulter’s agents (such as the defaulter’s employers, banks and tenants) to recover the outstanding premiums

(ii)         Offsetting outstanding premiums against one-off Government surplus-sharing transfers (e.g. Growth Dividends)

(iii)       Recovery from the Central Provident Fund (CPF) monies that are  withdrawn in cash

(iv)       Imposition of travel restrictions in certain circumstances

(v)        Legal action to recover the arrears

Penalties will be imposed on those who do not pay. Those who persistently delay premium payment may also have to pay back the interest lost to the MediShield Life Fund. 

Appointed under the MediShield Life Scheme Act, the Inland Revenue Authority of Singapore (IRAS) and the CPF Board are the recovery bodies responsible for imposing premium recovery measures.


4. Will I be arrested if I am unable to pay my premiums?

You will not be arrested if you are unable to pay for your MediShield Life premiums. Various forms of support are available to help with the payment of your MediShield Life premiums.

However if an insured person is informed that he is restricted from leaving the country until his premiums are paid, but still tries to leave the country, he will be arrested.


5. Why is there a need to impose interest?

Interest may be imposed on outstanding premiums where appropriate e.g. defaulters with premium arrears outstanding for prolonged periods. The interest may be compounded and recovered together with the outstanding premiums.

This fairly reflects the opportunity cost to the MediShield Life Fund, which would otherwise be invested in order to support future payments (e.g. MediShield Life claims) from the MediShield Life Fund. This loss translates to higher premiums for the rest of the insured if they are not recovered timely and sufficiently.



MEDISHIELD LIFE FUND

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1. What were the premiums collected and claims paid in recent years? What is the Fund’s incurred loss ratio?

The premiums collected, claims paid, change in required reserves for scheme liabilities and the Fund’s incurred loss ratio are shown in the table below. 

Table: MediShield Life Fund Incurred Loss Ratio (in $millions)

Year

Premiums Collected [A]

Total Monies Required for Fund Operations [B] + [C]

Incurred Loss Ratio ([B] + [C]) / [A]

Claims Paid [B]

Change in Required Reserves [C]

2016$1,859m $745m $1,182m104%
2017$1,882m $836m $969m96%
2018$1,914m$1,030m$1,166m114%
2019$1,923m$1,030m$1,166m114%

2016 - 2019

$7,578m

$3,533m

$4,314m

104%


2. What is the difference between incurred loss ratio and loss ratio, which is a better measure? Why do some people cite the loss ratio as being low?

The loss ratio is sometimes cited as a simple measure of premiums collected and the claims paid out in each year. This is an incomplete approach as it omits a large part of what premiums are meant to support, namely future short and long term claims and premium rebates. For example, MediShield Life’s benefits cover a dialysis patient’s treatment over many years. These are future liabilities that will not be taken into account in the loss ratio by comparing premiums versus claims paid over only one year. 

The incurred loss ratio over an extended period, on the other hand, is a more holistic measure that compares total inflow to total monies required for the Fund to meet its liabilities in the future, by taking into account changes to reserves. 

Total monies required for the Fund includes claims paid in each year and changes in reserves needed for future payouts. Reserves are monies that the Fund needs to set aside to honour projected future policyholder benefits (liabilities of the scheme). The incurred loss ratio over 2016 to 2016 was an average of 104%. Between 2016 and 2019, a total of $7.5 billion in premiums were collected. $3.5 billion in claims were paid out while $4.3 billion were set aside as reserves to support future commitments.


3. What do the reserves of the MediShield Life Fund support?

The MediShield Life Fund needs to set aside enough monies to honour pay-outs for future commitments s. These include:

a. Future premium rebates: MediShield Life is designed such that premiums continue to be affordable in old age. Part of the premiums that policyholders pay when young is set aside as reserves in the MediShield Life Fund and returned as premium rebates when they are old and no longer working. The contributions from each age cohort will be used to support their own rebates in old age. This helps to distribute premiums more evenly throughout policyholders’ lifetimes.

b. Claims incurred but not yet submitted or paid: This is for expected incoming claims, where the treatment has already taken place (and hence hospitalisation expenses have already been incurred) but claims have yet to be submitted or paid. This includes estimated provisions for claims that are still being processed and those that have not been submitted.

c. Claims not yet incurred but expected to be paid in the future: This is for claims where treatments have not taken place but are expected to occur in the future (i.e. the next few years) based on actuarial projections after allowing for future premium collections. This also includes an allowance for the fact that premiums typically remain constant for several years at a time, whereas average claims go up each year with the increasing cost of medical treatments. The reserves also help the scheme meet all its obligations to members during these years.

d. Continuing claims: The Fund sets aside provisions to cover the projected total future costs for those who have started on multi-year treatments. For example, patients undergoing dialysis claim up to $1,000 per month, or up to $12,000 per year. Such treatment continues for many years and the claims for these patients are provided for from Fund reserves.


4. Are the MediShield Life Fund’s reserves necessary?

The MediShield Life Fund has to be self-sustaining based on sound actuarial principles. Premiums collected have to cover potential current and future payouts, including amounts set aside to support future commitments. These commitments are largely made up by premium rebates that will be paid out in the future to make premiums more affordable for Singaporeans in old age. It also includes future claims for patients who have started on multi-year treatments such as dialysis and chemotherapy. In addition, reserves are also set aside to ensure that MediShield Life can continue to pay out claims should an unforeseen event occur, such as a sudden surge in claims due to disease outbreaks.

The reserves are computed by external professional actuaries in accordance with the Monetary Authority of Singapore requirements, and in line with industry standards.


5. If the Fund already has significant reserves, why do we need to increase premiums for MediShield Life? (Even if there is a need to take care of future payouts for recurring claims, e.g., for dialysis, the dialysis patient will be paying premiums in future. Can’t these future premiums be used to fund the future payouts then?)

The MediShield Life Fund has to be self-sustaining based on sound actuarial principles. Premiums collected have to cover potential current and future payouts, including amounts set aside to support future commitments as well as provide a buffer against unforeseen contingencies such as unexpected spikes in hospitalisations due to disease outbreaks.

A key feature in the MediShield Life scheme is to distribute premiums more evenly throughout the policyholders’ lifetimes, to help with premium affordability in old-age. As policyholders age, claims are likely to increase and so will premiums. Part of the premiums paid by policyholders when they are young are set aside to provide for future premium rebates, which will help to moderate premium increases in their older ages. This constitutes the bulk of future commitments set aside in the reserves.

Other commitments include future payouts for diseases currently under treatment that will require multi-year care, such as renal failure and cancer.

MediShield Life is a not-for-profit scheme. All premiums collected are placed in the MediShield Life Fund and are used solely for the benefit of policyholders and in the administration of the scheme.



MEDISHIELD LIFE COUNCIL

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1. What is the MediShield Life Council? What is the purpose of the Council?

The MediShield Life Council is an independent body set up to perform the following functions:

a.    To make recommendations to the Minister for Health on policy and scheme parameters to ensure that the MediShield Life scheme provides effective protection for citizens and permanent residents of Singapore in an affordable and sustainable manner;

b.    To review the administration of the MediShield Life scheme to ensure alignment with the directions of the Council; and

c.    To advise the Minister for Health on matters related to the investment of the Fund, and any other matters related to the Scheme or the Fund as the Minister for Health may direct.


2. Who are the Council members and how were they chosen?

The MediShield Life Council currently comprises 11 members who have been appointed by the Minister for Health based on the relevance of their expertise, experience and public standing. The members come from diverse backgrounds, with professional experience in areas such as accountancy, insurance, investment, medicine, the law, union and government. This ensures that the Council can benefit from the wide ranging expertise and experience of the members in the administration and review of MediShield Life. Please use this link for the list of members and their profile.



MEDISHIELD LIFE COVERAGE FOR OVERSEAS SINGAPOREANS


ELIGIBILITY CRITERIA FOR SUSPENSION OF PREMIUM COLLECTION

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1. Why is permanent residency in our country of residence a supporting indicator for eligibility?

The administrative arrangement is only for those who live abroad permanently with no intention to reside in Singapore. Obtaining permanent residency in another country is one of the indicators required to demonstrate an individual’s intention to reside in another country permanently.


2. Can I submit foreign citizenship documents when applying for suspension of premium collection?

No. The Singapore Government does not allow Singapore Citizens, aged 21 and above, to hold dual citizenship. The suspension application will not be processed until your dual citizenship status has been resolved with the Immigration and Checkpoints Authority (ICA).

Please contact ICA at ICA_Citizenship_Unit@ica.gov.sg to resolve your citizenship status if you are aged 21 and above and holding dual citizenship.


3. Can minors who hold dual citizenship apply for suspension of premium collection?

Minors aged below 21 who hold dual citizenship may apply for suspension of MediShield Life premium collection, subject to the eligibility criteria. Minor dual citizens (DCs) must possess a valid permanent residency permit in their country of residence, or other foreign residency documents permitting them to reside in their country of residence permanently with no end date.

This is considering that Singapore citizens who have acquired a citizenship of a foreign country can only renounce their Singapore citizenship after they turn 21 years old. If the application is approved, minor DCs will be granted suspension of MediShield Life premiums starting from the next policy year at point of application until the age of 20 years (inclusive).


4. My child is less than five years old. How will he meet the overseas residency qualifying period of five years?

Minors less than five years old will have their overseas residency qualifying period eligibility criteria correspondingly reduced, according to their age. All other criteria will apply.


5. Why is there a cap on the number of days I visit Singapore? How did you decide on 140 days over five years?

Universal lifelong coverage under MediShield Life is in line with our move to a more inclusive society with stronger collective responsibility. MediShield Life coverage is thus mandatory for all Singapore Citizens and Permanent Residents.

The MediShield Life Council’s recommended administrative arrangement is targeted at overseas Singaporeans who live abroad permanently with no intention to reside in Singapore. The criterion of 140 days over five years was included to help to determine administratively who can be regarded as permanently away, save for short visits to Singapore.  The duration takes into consideration the general length of stay granted to tourists coming to Singapore for short visits, but with flexibility to be assessed on a cumulative basis over five years.

For those who live abroad permanently but need to stay in Singapore for a longer period of time than the specified limit, we can review their specific circumstances on a case by case basis.


6. I am planning to live overseas permanently from next year onwards. Can I apply for the suspension of MediShield Life premium collection now?

In order to qualify for suspension of premium collection, you must have resided outside Singapore for at least five years immediately preceding your application, except for short visits back to Singapore (not exceeding 140 days in total during the five years). As such, you may wish to apply only after you have fulfilled all the criteria.


7. If I received a payout from MediShield or MediShield Life during the past five years, can I apply for suspension of premium collection?

The suspension of MediShield Life premium collection is meant for Singapore citizens living outside Singapore permanently with no intention to reside in Singapore. One of the eligibility criteria for the suspension of premium collection is that the applicant has adequate healthcare coverage in their country of residence and does not need to rely on MediShield Life. If you have received a payout and benefitted from MediShield or MediShield Life in the five years preceding your application, you will not be eligible for suspension of premium collection.


8. Can overseas Singaporean male minors apply for suspension of premium collection before National Service obligations are fulfilled?

National Service is a key institution that is vital to the security and defence of Singapore. Under the Enlistment Act, all Singapore Citizens and Permanent Residents above the age of 18 years are required to serve National Service.

In line with this, only the following overseas Singaporean males will be eligible to apply for the suspension of MediShield Life premium collection:

a)    Those who have completed full-time National Service; or

b)    Those who have been informed by MINDEF that they are not required to serve full-time National Service.


9. Are those insured with Integrated Shield Plans eligible for suspension of MediShield Life premium collection?

Integrated Shield Plans (IPs) automatically include a MediShield Life component. You will have to pay the premium (inclusive of the MediShield Life component) to retain your IP.

As coverage for IPs are designed for local treatment please consider if you wish to retain your IP if you are planning to move overseas permanently.


10. Are Singapore Permanent Residents eligible for Suspension of Premium Collection?

MediShield Life is a compulsory, basic health insurance which helps members meet the large costs of hospitalisation at Class B2 or C wards and certain outpatient treatments in Singapore’s approved medical institutions. All Singapore Citizens and Singapore Permanent Residents are required to be covered under MediShield Life. The intent of this insurance is to give all Singapore residents assurance of universal healthcare coverage, including those with pre-existing conditions, for life.

Overseas Singapore citizens who live abroad permanently with no intention to reside in Singapore can apply for suspension of MediShield Life premium collection. Singapore Permanent Residents will not be eligible for the suspension of premium collection. Permanent Residents have applied to reside in Singapore and should continue to meet their MediShield Life obligations.


APPLICATION FOR SUSPENSION OF MEDISHIELD LIFE PREMIUM COLLECTION

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1. Where can I find the application form? When can I start applying for suspension of MediShield Life premium collection?

To apply for suspension of MediShield Life premium collection, please complete the application form. When submitting your application, please ensure that your application form is duly completed with the necessary supporting documents uploaded. If you face any difficulty submitting the online application, please write to us


2. When will I find out whether my application has been approved?

The MediShield Life Team will notify you once your application has been processed.


3. If my application is approved, when will suspension of MediShield Life premium collection start?

If your application is approved, suspension of MediShield Life premium collection will start prospectively from the next policy year based on the date of receipt of the application by the MediShield Life Team.


4. I have already submitted my application for suspension of MediShield Life premium collection. It is pending approval. Why am I still receiving reminder letters to pay my MediShield Life premiums?

The premiums for your MediShield Life cover are still payable while your application is being processed.  If your application is successful, premium collection will be suspended prospectively from the next policy year based on the date of receipt of your application.  

Any outstanding premiums prior to the start of the Suspension Period remain payable. Please make payment promptly through either of the following modes to avoid any further enforcement action:

  • A family member can pay the outstanding premiums using their MediSave via submitting a 'Change of Payer for MediShield Life Cover' Request.
  • Top up to MediSave Account via e-Cashier.

You may do these through by using this link.


5 How can I inform if there is a change in my address?

All notification letters relating to MediShield Life will be sent to the last known address on your Singapore Identity Card (IC), which is the official address as registered with the Singapore Government. You may update your residential address by accessing the Immigration & Checkpoints Authority of Singapore's (ICA) change of address e-Service using your SingPass. Any updates will automatically be transmitted to all participating government organisations via the One-Stop Change of Address Reporting Service (OSCARS).

If you do not hold an identity card but wish to update your address, please write to us and we will further advise you on your request.


CESSATION OF SUSPENSION OF PREMIUM COLLECTION

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1. Under what circumstances would I be required to pay the accumulated sum of premiums suspended from collection with compound interest?

You would only have to pay the accumulated sum of premiums suspended from collection with compound interest if (a) you choose to relocate back to Singapore, (b) no longer meet the eligibility criteria for suspension of premium collection, or (c) choose to claim and benefit from MediShield Life payouts. Once this happens, your suspension of MediShield Life premium collection will cease and you will have to pay the full sum of premiums suspended from collection, with compound interest.


2. What is the interest rate used to calculate the amount of premiums I have to pay if I choose to relocate back to Singapore?

The interest rate is currently 4% per year and will be subject to applicable laws as may be amended from time to time. Interest will be imposed and computed on a compounded basis on full insurance periods that have passed.


3. If my application for suspension of MediShield Life premium collection is approved and I decide to renounce my Singapore Citizenship in the future, is any action required on my part to cancel my MediShield Life coverage?

No further action is required from you. Your MediShield Life coverage will cease when you renounce your citizenship. The Central Provident Fund Board will automatically be updated about the change in your citizenship status. You will not receive any further notifications on MediShield Life coverage.


4. What should I do if my application for suspension of MediShield Life premium collection is approved and I later decide to relocate back to Singapore?

Suspension of MediShield Life premium collection is only for those who live outside Singapore permanently with no intention to reside in Singapore.

Please inform the Central Provident Fund Board once you have relocated back to Singapore. Your suspension of premium collection will cease and the accumulated sum of premiums suspended from collection, with compound interest, will be payable.

Should you face any concerns with the affordability of premiums, you may apply to be assessed for financial assistance with your premiums. We will consider requests on a case by case basis.


5. What should I do if my application for suspension of MediShield Life premium collection is approved and I do not renew my permanent residency permit in my country of residence in future?


Please inform the Central Provident Fund Board if your permanent residency permit in your overseas country of residence is no longer valid.

Suspension of MediShield Life premium collection is only for those who live abroad permanently with no intention to reside in Singapore. Obtaining permanent residency in another country is one of the indicators required to demonstrate an individual’s intention to reside in another country permanently. Therefore, if you do not renew your permanent residency permit in your overseas country of residence, it is an indication that you may not be able to permanently reside in that country. Your suspension of premium collection will cease and the accumulated sum of premiums suspended from collection, with compound interest, will be payable.


6. If my application for suspension of MediShield Life premium collection is approved, what happens if I wish to return to Singapore to seek medical treatment and claim from MediShield Life in future?

One of the eligibility criteria for the suspension of premium collection is that the applicant has adequate healthcare coverage in their country of residence and does not need to rely on MediShield Life. Hence, if you return to Singapore to seek medical treatment and claim from MediShield Life, your suspension of premium collection will be terminated. You will have to pay the full sum of premiums suspended from collection, with compound interest.

Please contact the Central Provident Fund Board for further information.


7. Will overseas Singaporeans who relocate back to Singapore be eligible for the subsidies for all premiums?

Overseas Singaporeans approved for suspension of premium collection will be treated similar to other Singaporeans and receive all prevailing subsidies, if eligible. They will automatically receive Pioneer Generation Subsidies and Transitional Subsidies for the applicable policy years. They will receive Premium Subsidies if they apply and submit sufficient documentation for MOH to assess their eligibility for Premium Subsidies prior to the applicable policy year. These subsidies will be factored into the total net amount to be paid should the overseas Singaporean relocate back to Singapore.

Besides subsidies, financial assistance may be available on a case by case basis upon return and the Insured may apply for assessment.



INTEGRATED SHIELD PLANS (IPs)

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1. I already have an Integrated Shield Plan. How is MediShield Life relevant to me?

Integrated Shield Plans (IPs) comprise 2 components – the MediShield Life component and the additional private insurance coverage. Those covered under IPs currently enjoy the combined benefits of MediShield Life, which is run by the Central Provident Fund Board, and the additional benefits of the additional private insurance coverage, which is run by private insurers.

As MediShield Life is a component of your IP coverage, you need not worry that there is duplicate coverage between MediShield Life and your IP.

MediShield Life will cover all pre-existing conditions, even if they are excluded by your private insurer from the additional private insurance coverage of your IP. Should you decide to drop your IP cover one day, you will remain covered by MediShield Life.


2. Will my Integrated Shield Plan premiums be affected by the increase in MediShield Life premiums?

Integrated Shield Plans (IPs) are made up of two components: (i) the MediShield Life component which is sized for subsidised Class B2/C bills in public hospitals and (ii) an additional private insurance component offered by a private insurer targeted at covering higher ward classes or private hospitals. Correspondingly, IP premiums are made up of MediShield Life premiums and premiums for the additional private insurance component.

Hence, the increase in overall IP premium will be the sum of the following:

·        With the increase in MediShield premiums, the premiums for the MediShield Life component of IPs will be increased accordingly.

·        Premiums for the additional private insurance component of IPs are set, reviewed and adjusted by private insurers based on commercial and actuarial considerations. Insurers may adjust their premiums upwards/downwards taking into account the impact of the MediShield Life benefit changes, their own claims experience, medical inflation and other factors. Insurers have an incentive to keep premiums competitive, to attract and retain policyholders. Singaporeans concerned with the affordability of IP premiums may wish to consider switching to more affordable insurance options, in line with their preferences for hospitalisation coverage.


3. What are Medisave-approved Integrated Shield Plans and should I consider getting one?

MediShield Life is a basic scheme designed to cover Class B2/C bills. As the bills for Class B1/A wards and private hospitals are much higher, MediShield Life will cover a smaller portion of the bill.

The Integrated Shield Plans (IP) provide additional coverage beyond MediShield Life. IPs consists of 2 components – the MediShield Life component and an additional private insurance coverage component. Those covered under IPs enjoy the combined benefits of (i) MediShield Life, run by the Central Provident Fund Board; and (ii) the additional private insurance coverage for Class A/B1 and private hospital stays, run by private insurers. There is no duplicate coverage between MediShield Life and IPs.

The existing IPs in the market are:

-       AIA HealthShield Gold Max,

-       Singlife Shield,

-       HSBC Life Shield,

-       Great Eastern SupremeHealth,

-       Income IncomeShield,

-       Prudential PruShield, and,

-       Raffles Health Insurance Raffles Shield.

Please note that as IPs are private plans with additional coverage, premiums are much higher than MediShield Life premiums and will increase with age. You may also be subject to additional health checks possibly resulting in exclusions and/or risk-loading for the additional private insurance coverage component. We advise you to carefully consider your ward preferences and the affordability of premiums over the longer-term, when deciding whether to buy an IP. Please speak to your financial advisor who will be able to share more about your options.


4. With the introduction of MediShield Life, should I continue to stay on my Integrated Shield Plan?

Integrated Shield Plans (IPs) are private plans comprising coverage of the basic MediShield Life component, plus the additional private insurance coverage from private insurers so that policyholders can be adequately covered for Class A/B1 or private hospital stays. IP Premiums are much higher than MediShield Life premiums because of their targeted coverage at Class A/B1 ward and private hospital stays.

We advise you to buy a plan that meets your needs taking into consideration your preferred ward class and affordability of premiums over the long-term.


5. Will I receive subsidies even though I am insured under an Integrated Shield Plan? Do I have to downgrade my insurance plan to MediShield Life to receive subsidies?

Yes, you will still be able to receive the applicable MediShield Life subsidies (i.e. Premium Subsidies for lower- to middle-income; Pioneer Generation Subsidies; Merdeka Generation Subsidies) if you meet the eligibility criteria, even if you are insured under an Integrated Shield Plan (IP). You do not have to downgrade your plan to receive the subsidies.

IPs are made up of 2 components: (i) MediShield Life and (ii) additional private insurance coverage providing additional benefits and/or coverage (in private hospitals or Class A/B1 ward classes in public hospitals).

For holders of IPs who meet the eligibility criteria for the various subsidies, the subsidies will be applied on the MediShield Life component of their IPs.


6. With MediShield Life, will the Integrated Shield Plans cover pre-existing conditions? Can I now get coverage under Integrated Shield Plans for my pre-existing conditions?

Integrated Shield Plans (IPs) are private plans comprising coverage of the basic MediShield Life component, plus additional private insurance coverage from private insurers so that policyholders can be adequately covered for Class A/B1 or private hospital stays.

You can get coverage for pre-existing conditions, and be assured of lifelong coverage, under the MediShield Life component. This is even if the condition is excluded from the additional private insurance coverage by your IP insurer.

Underwriting decisions on the additional private insurance component of IPs are separately determined by the private IP insurers. Private insurers assess, applications for the additional private insurance component of the IP based on their own risk assessment frameworks, as these are commercial decisions. You may wish to check with your private insurer or financial advisor on coverage for pre-existing conditions.


7. What does it mean if I have an exclusion on the Additional private insurance coverage component but not on the MediShield Life component? How do I find out what exclusion I have?

Integrated Shield Plans (IPs) comprise 2 components – the MediShield Life component and the additional private insurance coverage. Those covered under IPs enjoy the combined benefits of MediShield Life, which is run by the Central Provident Fund Board, and the additional benefits of the additional private insurance coverage, which is run by private insurers.

As MediShield Life covers all pre-existing conditions, all IP policyholders will also enjoy MediShield Life coverage for any pre-existing conditions, even if the private insurer has imposed an exclusion for the pre-existing conditions on the additional private insurance coverage component of your IP.

If you are hospitalised for the excluded condition, you will not be able to claim for coverage under the additional private insurance component under your IP. You will be able to claim for coverage under MediShield Life.

To find out more about your specific exclusion, please contact your financial advisor or private insurer.


8. If I downgrade to a lower coverage Integrated Shield Plan (IP) or to MediShield Life, or switch to an IP with another insurer, will I need to go through health assessment/ underwriting again?

You can downgrade your plan to a lower coverage plan with the same insurer at any point in time, without additional underwriting involved. You can also drop your IP at any point in time, and continue with MediShield Life coverage.

If you switch your plan from one insurer to another insurer, your original Integrated Shield Plan (IP) under your original insurer will be automatically terminated. You will also need to undergo underwriting again when you switch to the plan under the new insurer. You may lose coverage for existing medical conditions covered by your original plan, and may not be able to re-apply for your original coverage later. Regardless of any changes in your IP, you will remain continuously covered by MediShield Life without any exclusions.

Please speak to your financial advisor to find out more about the implications of switching plans before making your decision. Please also highlight any medical conditions you have to your financial advisor. 


9. Why have my Integrated Shield Plan premiums increased?

Integrated Shield Plans (IPs) comprise 2 components – the MediShield Life and the additional private insurance coverage. Similarly, IP premiums have 2 components: a MediShield Life component, and an additional private insurance component.

The Ministry of Health sets the premiums for the MediShield Life component, and provides subsidies to keep MediShield Life premiums affordable. With the increase in MediShield Life premiums, the premiums for the MediShield Life component of IPs will be increased accordingly.

Premiums for the additional private insurance component of IPs are set, reviewed and adjusted by insurers based on commercial and actuarial considerations. Insurers may adjust premiums upwards or downwards taking into account the impact of the MediShield Life benefit changes, their own claims experience, medical inflation and other factors. Insurers have an incentive to keep premiums competitive, to attract and retain policyholders. Singaporeans concerned with the affordability of IP premiums may wish to consider switching to more affordable insurance options, in line with their preferences for hospitalisation coverage.


10. Can we use Medisave to pay for IPs and riders?

Medisave can be used to pay for premiums of Integrated Shield Plans (IPs), subject to Additional Withdrawal Limits. All IPs are required to have co-payment features such as deductibles and co-insurance, similar to MediShield Life. The co-payment can be paid for using Medisave, up to the prevailing withdrawal limits which are set to be sufficient for subsidised care.

Co-payment is an important feature in healthcare insurance to mitigate the risk of over-consumption and over-servicing which in turn could lead to escalation in healthcare costs and insurance premiums for all Singaporeans. Hence, riders that cover co-payments fully and allow policy holders to have zero co-payments are considered as separate products from IPs and their premiums cannot be paid using Medisave.

Medisave savings are intended to be sufficient for basic healthcare needs.  We need to be careful about expanding the use of Medisave, as Singaporeans need to ensure that they have sufficient savings for healthcare expenses over their lifetime, especially after retirement. Supporting more uses will mean higher contribution rates are required.


ADDITIONAL WITHDRAWAL LIMITS (AWLs)

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1. What are the Additional Withdrawal Limits?

The Additional Withdrawal Limits (AWLs) will apply to the additional private insurance coverage component of Integrated Shield Plan (IP) premiums from and allow Singapore Residents to use Medisave, up to a cap, to pay for their IP premiums (see Diagram below for illustration).

IP

The AWLs are set as follows and will apply to all IPs renewing or commencing on or after the launch of MediShield Life:

  • $300 for those with age next birthday 40 and below;
  • $600 for age next birthday 41 to 70; and
  • $900 for age next birthday 71 and above

2. How were the Additional Withdrawal Limits determined?

The Additional Withdrawal Limits (AWLs) allow Singapore Residents to continue using Medisave to pay for their Integrated Shield Plan (IP) premiums, in part or in full.

The AWLs strike a balance between helping Singapore Residents pay for their IP premiums using Medisave, and ensuring that they have enough Medisave for their other healthcare needs.

The AWLs were set to be sufficient to cover the amount of Medisave that policyholders had been using to pay for the premiums of the additional private insurance coverage component of IPs under the previous Medisave withdrawal limits. This will allow policyholders to use the same amount or more Medisave to pay the additional private insurance component of their IP premiums.

For older IP policyholders, the AWLs will enable them or their family members to use more Medisave than before for the additional private insurance component of their IP premiums.


3. How many/ what proportion of Integrated Shield Plan (IP) policyholders will benefit from the use of more Medisave for the additional private insurance component of their IP premiums?

There are about 2.4 million Integrated Shield Plan (IP) policyholders today. From 1 Nov 2015, about 200,000 (~8%) of IP policyholders will be able to use more Medisave for the additional private insurance component of their IP premiums with the new Additional Withdrawal Limits (AWLs). This estimate is based on the assumption that IP policyholders remain on the same IP and do not move into different age bands.


4. Will the Additional Withdrawal Limits affect those without Integrated Shield Plans?

Those who do not have Integrated Shield Plans will not be affected by the Additional Withdrawal Limits.


5. How will the new Additional Withdrawal Limits impact how much cash an Integrated Shield Plan (IP) policyholder will have to pay for his IP premium?

If the Integrated Shield Plan (IP) policyholder does not move into a higher age band and does not change plan, and has sufficient Medisave, he will pay the same or less cash with the new Additional Withdrawal Limits (AWLs).

This assurance is based on the Life Insurance Association’s (LIA) commitment that the IP insurers will not be increasing their additional private insurance component of all IPs for one year from the launch of MediShield Life, but may not hold, should there be significant increases in the claims for the additional private insurance component of IP thereafter.


6. How often will the Ministry of Health (MOH) be reviewing the Additional Withdrawal Limits (AWLs)? Will MOH be reviewing the AWLs taking into account Integrated Shield Plan (IP) premium increases over time?

The Ministry of Health will review the Additional Withdrawals Limits (AWLs) from time to time, and will take into account changes in Integrated Shield Plan premiums as well as the need to ensure that all Singapore Residents have sufficient Medisave for their health care needs over their lifetime.


7. Will the Ministry of Health be increasing Medisave contribution rates due to the impact of the Additional Withdrawal Limits?

Employer Medisave contribution rates for Medisave were increased by 1% in Jan 2015. This helps to ensure that Singapore Residents can afford their MediShield Life premiums.

Medisave is designed to help Singapore Residents with basic healthcare expenses, especially after retirement. Medisave contribution rates and withdrawal limits are set in line with this principle. With the introduction to Additional Withdrawal Limits (AWLs), MediShield Life premiums will always be fully payable by Medisave, but the AWLs will limit how much Medisave can be used to pay for the additional private coverage component of Integrated Shield Plan premiums.

MOH will monitor and review the adequacy of Medisave contributions. There will not be any changes to Medisave contribution rates arising from the introduction of the AWLs.


8. Can the Government allow us to use more of our Medisave to pay for our Integrated Shield Plan (IP) premiums? Why aren’t withdrawal limits sized such that IP policyholders do not experience cash outlay for their IP premiums?

Medisave is designed to help with basic healthcare expenses, especially after retirement. Medisave contribution rates and withdrawal limits are set in line with this principle. The previous Medisave withdrawal limits for insurance premiums were set to be sufficient for the basic MediShield component, to prevent depletion of funds of old-age use. Hence, those who wish to purchase Integrated Shield Plans (IPs) may have to co-pay part of the premium in cash.

MediShield Life premiums will continue to be fully payable by Medisave, while there will be a limit (the Additional Withdrawal Limit) set on the additional private insurance coverage to ensure Medisave adequacy is maintained. This is no different from the previous withdrawal limits set, those who wish to purchase IPs may have to co-pay part of the additional private insurance coverage premium in cash.



STANDARD INTEGRATED SHIELD PLANS (IPs)

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1. What is the Standard Integrated Shield Plan?

The Standard Integrated Shield Plan (IP) is a private insurance product targeted at covering large hospital bills and selected outpatient treatments at the Class B1 level in Singapore’s public hospitals.

The Standard IP will give Singapore Residents an option for additional coverage beyond basic MediShield Life in a standardised, easily understood package. It will also be a viable option for those who want to switch from their Class A and Private Hospital IPs to a more affordable plan.

The Standard IP benefits are regulated by the Government and are identical across all IP insurers.

Similar to all other IPs, premiums for the additional private insurance coverage component of the Standard IP are set by the private insurers. 


2. What are the Standard Integrated Shield Plan benefits?

o   Claim limits sized to fully cover 9 out of 10 Public Hospital Class B1 bills. 

o   Coverage for hospitalisation stays and selected outpatient treatments, such as chemotherapy and kidney dialysis.

o   Co-payment features of claim limits, deductible and co-insurance, in line with ongoing efforts to manage healthcare costs.


3. Why does the Standard Integrated Shield Plan not provide additional benefits (e.g. pre- and post-hospitalisation)?

In designing the Standard Integrated Shield Plan (IP), it was important to balance between providing adequate coverage and ensuring premiums remain affordable.

The Standard IP was thus intended to be a “no-frills”, affordable product targeted at large hospital bills and selected costly outpatient treatments.


4. Why did the Government design the Standard Integrated Shield Plan (IP) to have claim limits, instead of as-charged coverage? Since it is not as-charged, is the Standard IP enough for Class B1?

The Standard Integrated Shield Plan (IP) was designed with claim limits, to balance between providing adequate coverage and ensuring that premiums remain affordable.

In general, claim limits in insurance plans are also useful to serve as a cap against over-servicing/over-consumption and overcharging, which contribute to claims escalation, and premium increase over the longer run.   

Although the Standard IP has claim limits, they are sized to fully cover 9 out of 10 Class B1 bills. It will therefore be sufficient for most policyholders who opt to stay in a Class B1 ward if they are hospitalised.  Patients can tap on Medisave to help pay for the co-payment. 

The Ministry of Health will regularly review the Standard IP claim limits to ensure that they continue to provide sufficient coverage at Class B1 level. 


5. How often will the Government review the Standard Integrated Shield Plan claim limits?

The Standard Integrated Shield Plan (IP) claim limits are sized to fully cover 9 out of 10 Public Hospital Class B1 bills.

The Ministry of Health will regularly review the Standard IP claim limits to ensure that they continue to provide sufficient coverage at Class B1 level.


6. Will the Government regulate any future changes to the Standard Integrated Shield Plan benefits?

The Ministry of Health will review the Standard Integrated Shield Plan (IP) benefits from time to time to ensure that the benefits remain relevant to policyholders.

Any changes to the Standard IP benefits will apply across all the insurers.


7. Why are the Standard Integrated Shield Plan premiums different across all the insurers, even though benefits are the same?

While the Ministry of Health has worked with the private insurers to standardise the Standard Integrated Shield Plan’s (IP) benefits, the plan is provided and administered by insurers.

Similar to other existing IPs, premiums and underwriting for the additional private insurance component of the Standard IP are thus determined by insurers based on their own commercial considerations and risk assessment frameworks. There is therefore variance in the premiums, depending on each insurer’s approach. 


8. I want to get the Standard Integrated Shield Plan (IP) but my insurer’s premiums are higher than other insurers. Should I switch to a Standard IP under another insurer?

If you switch to a Standard Integrated Shield Plan (IP) with another insurer, your original IP under your original insurer will be automatically terminated.

You will also need to undergo underwriting when you switch to the plan under the new insurer. As such, you may lose coverage for existing medical conditions covered by your original plan, and may not be able to re-apply for your original coverage later. Regardless of any changes in your IP, you will remain continuously covered by MediShield Life without any exclusions.

Please speak to your financial advisor to find out more about the implications of switching insurers before making your decision. Please also highlight any medical conditions you have to your financial advisor.


9. Can I fully pay for the Standard Integrated Shield Plan premiums using Medisave at all ages?

Based on the current Additional Withdrawal Limits (AWLs) for Medisave use, you can use Medisave to fully pay for the Standard Integrated Shield Plan (IP) premiums until age next birthday 75.

As the Standard IP is a private product that provides additional coverage at B1 level, premiums are higher than MediShield Life premiums, and rise sharply at the older ages. As such, there will still be some cash outlay for policyholders at the oldest ages.

Singapore Residents should therefore carefully consider the affordability of premiums over the longer-term, when deciding if they should get the Standard IP.


10. Why does the Standard Integrated Shield Plan not cover pre-existing conditions with risk-loading?

Similar to all other Integrated Shield Plans (IPs), the additional private insurance component of the Standard IP is provided by private insurers. Coverage under the Standard IP is therefore a business decision based on the risk assessment framework of each insurer.

Since the launch of MediShield Life, MOH has allowed all IP insurers to introduce risk-loading options for policyholders who would like coverage for their pre-existing conditions. The insurers are allowed to assess, approve with or without exclusions/risk-loading, or reject applications for the additional private insurance component of the IP based on their own risk assessment frameworks.  However, no IP insurers have started to offer such risk-loaded policies yet.


11. Why can’t the Government provide and administer the Standard Integrated Shield Plan, to ensure that premiums are more affordable and to cover pre-existing conditions with risk-loading, similar to MediShield Life?

The Government’s focus is to provide basic and affordable health insurance coverage for all Singapore Residents through MediShield Life, regardless of their health condition. Therefore, MediShield Life is designed to provide sufficient coverage for subsidised Class B2/C wards. Singapore Residents who wish to have coverage beyond MediShield Life can purchase private Integrated Shield Plans (IPs), which will come at higher premiums than MediShield Life due to the additional private insurance component.

The Standard IP was developed in response to the MediShield Life Review Committee’s recommendation in 2014, to provide a “no-frills” IP option, for those who want to switch from their more expensive IPs to a more affordable one, and for those who wish to have higher coverage beyond MediShield Life. The Standard IP was also designed to have standardised features to facilitate comparison of premiums by consumers.

As the Standard IP is an optional plan designed for higher coverage in Class B1 wards and is not a basic product, it is provided by private insurers.

Similar to all other IPs, premiums and underwriting decisions are determined by insurers based on their own commercial considerations and risk assessment frameworks.

The Ministry of Health will continue to review MediShield Life and IPs, to ensure that they remain relevant to Singapore Residents with different needs.


12. I currently have an Integrated Shield Plan (IP) that covers me for Class A / Private Hospitals, but the premiums are getting more expensive especially as I get older. Should I switch to the Standard IP?

If you are concerned with being able to afford the premiums of your Integrated Shield Plan (IP) as you get older, you can consider switching to a more affordable IP, including the Standard IP, or to MediShield Life, in line with your circumstances and preferences for hospitalisation coverage.

For example, if you intend to use Class B2/C wards but have an insurance plan intended for private hospitalisation, you may wish to adjust your coverage to MediShield Life. Or, if you intend to use Class B1 wards and are satisfied with the Standard IP benefits, you may wish to adjust your coverage to the Standard IP, subject to your affordability level.

The premiums of the Standard IP will be higher than MediShield Life premiums, as it provides additional coverage up to B1 wards.

You should carefully consider your insurance coverage and get a plan that meets your needs, taking into consideration your preferred ward class and affordability of premiums over the long-term.

You may wish to speak to your financial advisor who will be able to advise on your options. You can also refer to a comparison of IP benefits and premiums at this link.


13. If I switch from a higher coverage Integrated Shield Plan (IP) to the Standard (IP) with the same insurer, will I need to go through additional underwriting and will my previous exclusions remain?

If you are intending to switch to a plan with lower coverage within the same insurer, you will not need to go through additional underwriting*.

However, any exclusions on medical conditions you had on your original Integrated Shield Plan (IP) will be retained when you switch to a new plan.

You may wish to speak to your financial advisor who will be able to advise on your options.

*However, if you are on a higher coverage IP and had gone through moratorium underwriting, you will need to go through underwriting to switch to the Standard IP.


14. Can I get a pro-rated refund of the premiums for my original Integrated Shield Plan (IP) if I downgrade or switch from a higher coverage plan to the Standard IP before my premium renewal date?

If the downgrade or switch takes place before your next premium renewal date, your insurer will provide you with a pro-rated refund of your original Integrated Shield Plan premium.

Please speak to your financial advisor to find out more about the implications of downgrading or switching insurers before making your decision. Please also highlight any medical conditions you have to your financial advisor.


15. Can I upgrade to a higher coverage Integrated Shield Plan (IP) in future, if I buy the Standard IP now?

When policyholders apply to upgrade to a higher coverage Integrated Shield Plan, they will need to go through another round of underwriting for the new additional coverage that they are purchasing. The insurers are allowed to assess, approve with or without exclusions, or reject applications for upgrading based on their own risk assessment frameworks, as these are essentially business risk decisions.



OTHERS

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1. What is the difference between MediShield Life and CareShield Life?

Both MediShield Life and CareShield Life are insurance plans, but they serve different purposes. They complement each other in providing lifetime protection against different types of healthcare expenses.

MediShield Life helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. Whereas CareShield Life provides cash payouts to help severely disabled individuals with their long-term care costs.



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