• For Public
  • For Healthcare Professionals

MediShield Life FAQs

17 Sep 2018

TOP FAQs ON MEDISHIELD LIFE

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

MediShield Life replaced MediShield from 1 Nov 2015.

MediShield Life is a basic health 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 treatment in the public hospitals.

MediShield Life will offer

·         Better protection and higher payouts, so that patients pay less Medisave / cash for large bills

·         Protection for all Singapore Citizens and Permanent Residents, including the very old and those who have pre-existing conditions.

·         Protection for life

Government will also provide significant help to Singaporeans to keep premiums affordable:

·         Premium Subsidies for the lower- to middle-income

·         Pioneer Generation Subsidies for the Pioneer Generation

·         Transitional Subsidies to ease the shift to MediShield Life (for Singapore Citizens only)

·         Additional Premium Support for the needy who are unable to afford their premiums after subsidies.

MediShield Life premiums will be affordable, and may be fully paid from Medisave. No Singapore Resident will drop out of MediShield Life due to the inability to pay for premiums.

For more details, please refer to www.medishieldlife.sg


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

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

MediShield Life is a basic health insurance plan that helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. It targets Class B2/C wards and subsidised treatment in the public hospitals.

ElderShield is a severe disability insurance scheme which provides basic financial protection to severely disabled elderly who need long-term care. ElderShield will pay the insured a monthly cash payout of $300 or $400 if the insured becomes severely disabled, which can help pay some of the living expenses for the care of a severely disabled person.

Besides ElderShield, the Pioneer Generation Disability Assistance Scheme (PG-DAS) provides $100 a month to help Pioneers who permanently need assistance in at least 3 activities of daily living with their care needs.


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?

From 1 Nov 2015, MediShield Life will provide coverage for all Singapore Residents for life, regardless of which ward class they choose. MediShield Life will help all Singapore Residents with large hospitalisation expenses. The level of benefits is based on the costs in Class B2/C wards in public hospitals.

You will get the same level of benefits, whichever ward class you choose or if you stay in a private hospital. The benefits are calculated based on the costs in Class B2/C wards.

You can 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, so do consider your choice of ward class carefully and the premiums 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 will directly help Singaporeans with their MediShield Life premiums, such as Premium Subsidies for the lower- to middle-income, Pioneer Generation subsidies for the Pioneers, Medisave top-ups and Transitional Subsidies for Singapore Citizens to phase in the shift to MediShield Life.

The different types of subsidies are:

Premium Subsidies (up to 50%) for lower- to middle-income Singapore Residents with household monthly income per person of $2,600 and below and living in residences with an Annual Value of $21,000 and below. Individuals who own multiple properties will not be eligible. Permanent Residents (PRs) will receive half the applicable Singapore Citizens (SCs) rate.

Pioneer Generation Subsidies and Medisave top-ups for the Pioneer Generation (up to 60%) ranging from 40-60% and up to $800 a year respectively, regardless of household income and Annual Value of residences. With the Pioneer Generation Subsidies and Medisave top-ups, all Pioneers will pay lesser MediShield Life premiums than MediShield premiums today.

Transitional Subsidies for the first 4 years of MediShield Life for all Singapore Citizens regardless of household income and Annual Value of residences. This to phase in the impact of the premium increases and is over and above Premium Subsidies and Pioneer Generation Subsidies. In the first year of MediShield Life in end 2015, the Government will pay for 90% of the net increase in premiums (after taking into account various subsidies). You will pay only 10% of the net increase from MediShield premiums. The Transitional Subsidies will be stepped down so that you pay 30%, 60% and 80% of the net increase in the second, third and fourth year of MediShield Life respectively.

Additional Premium Support for all needy Singaporean families on a case-by-case basis. This is to provide help for those who are unable to afford premiums even after the subsidies provided by the Government. 


5. My MediShield Life premium has increased compared to last year due to a reduction in the amount of Transitional Subsidies. Why is there a reduction in Transitional Subsidies?

Transitional Subsidies are provided to all Singapore Citizens in the first 4 years of MediShield Life to ease the shift from MediShield to MediShield Life. In line with the intent, Transitional Subsidies will cover 90% of the net increase in premiums (after other subsidies) in the first year of MediShield Life, followed by 70%, 40% and 20% in the second, third and fourth year of MediShield Life respectively.

The phasing of the Transitional Subsidy rate from 90% to 70%, 40% and 20% over 4 years has been published as part of the MediShield Life publicity, such as the MediShield Life Welcome Booklet sent to all households in Aug 2015 and via the MediShield Life website.

While Transitional Subsidies will phase out after the first 4 years of MediShield Life, lower- to middle-income households will continue to receive permanent Premium Subsidies for their MediShield Life premiums. Pioneers will also continue to receive Pioneer Generation Subsidies.

Additional Premium Support will be available to help those who are needy and unable to afford their MediShield Life premiums even after Government subsidises, Medisave, and have limited family support.

No one will lose MediShield Life coverage because he/she is unable to pay for his/her premium.


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

There will be extensive outreach to help Singaporeans with their premiums. There are significant Government subsidies in the form of MediShield Life Premium Subsidies for the lower- to middle-income, Pioneer Generation Subsidies and Transitional Subsidies. Those who are less well-off will qualify for higher Government subsidies to reduce their premium payment.

Medisave may be used to pay the full MediShield Life premiums. The Central Provident Fund Board has several arrangements in place to help all employers, employees and self-employed persons keep their Medisave contributions current. If an insured has insufficient Medisave or no Medisave account, immediate family members such as parents and spouse, can help to use their Medisave to pay for their premiums.

If policyholders do not have family support to help them with their MediShield Life premiums, they can tap on the Additional Premium Support.


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

MediShield Life payouts are pegged at the costs of Class B2/C wards. If you would like additional coverage beyond MediShield Life, you may also consider taking up an Integrated Shield Plan (IP). 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.

The existing IPs in the market are:
-       AIA HealthShield Gold Max,
-       Aviva MyShield,
-       AXA Shield,
-       Great Eastern SupremeHealth,
-       NTUC Income IncomeShield, and
-       Prudential PruShield.

As MediShield Life is a component of IP coverage, there is no duplicate coverage between MediShield Life and your IP.

Please note that as IPs are private plans with additional coverage, premiums are much higher than MediShield Life premiums. You may therefore wish to carefully consider the affordability of premiums over the longer-term.

While MediShield Life will provide coverage for any pre-existing conditions, you may be subject to additional health checks for the additional private insurance coverage component, possibly resulting in exclusions and/or risk-loading for the additional private insurance coverage component. We advise you to carefully consider and purchase insurance coverage accordingly. Please speak to your financial advisor who will be able to share more about your options and their implications.

8. 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.

As MediShield Life will cover all pre-existing conditions, all IP policyholders will also enjoy MediShield Life coverage for life, for any pre-existing conditions. This will apply even if your pre-existing condition is excluded from the additional private insurance coverage by your private insurer. You will have peace of mind that you will continue to remain covered at the basic level, even if you have exclusions on your IP cover or you have to drop your IP cover.


9. 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.

It is available from all the insurers who sell IPs, from 1 May 2016.

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. 


10. 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.


BENEFITS UNDER MEDISHIELD LIFE

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

MediShield Life replaced MediShield from 1 Nov 2015.

MediShield Life is a basic health 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 treatment in the public hospitals.

MediShield Life will offer

·         Better protection and higher payouts, so that patients pay less Medisave / cash for large bills

·         Protection for all Singapore Citizens and Permanent Residents, including the very old and those who have pre-existing conditions.

·         Protection for life

Government will also provide significant help to Singaporeans to keep premiums affordable:

·         Premium Subsidies for the lower- to middle-income

·         Pioneer Generation Subsidies for the Pioneer Generation

·         Transitional Subsidies to ease the shift to MediShield Life (for Singapore Citizens only)

·         Additional Premium Support for the needy who are unable to afford their premiums after subsidies.

MediShield Life premiums will be affordable, and may be fully paid from Medisave. No Singapore Resident will drop out of MediShield Life due to the inability to pay for premiums.

For more details, please refer to www.medishieldlife.sg 


2. When does MediShield Life coverage start?

MediShield Life coverage is applicable only for all admissions by Singapore Residents from 1 Nov 2015 (i.e. if the admission date is on or after 1 Nov 2015).

As an insurance scheme, benefits need to start from the same date for all members. Those with existing insurance coverage will still get coverage for their bills on admission before 1 Nov 2015. Significant Government subsidies of up to 80% will continue to be available to all who require treatment in public hospitals, even if insurance coverage is not available. Families can also use Medisave for healthcare bills.

Needy families who face difficulties with their healthcare bills can continue to approach the Medical Social Workers at the public hospitals for assistance through other avenues.


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?

From 1 Nov 2015, MediShield Life will provide coverage for all Singapore Residents for life, regardless of which ward class they choose. MediShield Life will help all Singapore Residents with large hospitalisation expenses. The level of benefits is based on the costs in Class B2/C wards in public hospitals.

You will get the same level of benefits, whichever ward class you choose or if you stay in a private hospital. The benefits are calculated based on the costs in Class B2/C wards.  

You can 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 will be higher, so do consider your choice of ward class carefully and the premiums 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 needs to be a basic plan which all Singapore Residents can afford. While the increase in benefits will help to cover a higher proportion of large bills, we are also mindful that this may encourage wasteful consumption, like ordering more tests than necessary because the bill will be paid by insurance.

Hence, patients should continue to co-pay for their bills to help manage potential over-servicing by healthcare providers. All co-payment amounts can be paid through Medisave and cash. Today, about 7 in 10 Class B2/C bills have $100 or less out-of-pocket cash payment after coverage by insurance and Medisave.

Needy Singaporeans who are unable to pay their share of bills can seek further 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 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 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 Package. 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.

The MediShield Life Review Committee (MLRC) had reviewed this proposal following suggestions from Singapore Residents, but decided that incentives for healthy living should not be done through “no-claims bonus” or premium discounts in MediShield Life. MediShield Life aims to protect Singapore Residents against large medical bills in public hospitals. Large bills are usually incurred when there are serious health conditions. There is concern that patients might delay treatment even though they are sick, so as to benefit from their “no-claims bonus” or premium discounts. This could have serious consequences in the form of medical complications that result in even larger hospital bills.

Moreover, the need for medical treatment may not always be avoided even when good care is taken, such as when accidents occur or for congenital conditions. Introducing “No-claim Bonus” will unduly penalise these patients even when it is no fault of theirs.

To encourage healthy living, the Ministry of Health (MOH) will continue to enhance the accessibility and affordability of health promotion efforts. The Community Health Assist Scheme (CHAS) was also enhanced to provide free screening tests for recommended screening and subsidies for the doctor’s consult. Pioneers get even higher subsidies for the recommended screening.

By encouraging more Singaporeans to undergo appropriate health screening and follow-up, and to adhere to the course of treatment, we help more Singaporeans lead healthier lives.


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

The Government has recently enhanced the subsidies for lower- to middle-income subsidised patients at the Specialist Outpatient Clinics (SOC) in public hospitals. This has helped to make outpatient treatments more affordable for Singaporeans. Needy Singaporeans can continue to tap on Medifund for assistance if they face difficulty with their outpatient bills.

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 and availability of information on patient outcomes and effectiveness.


8. Why does MediShield Life not cover hospice care?

MediShield Life is designed as a basic health insurance plan to help with large inpatient costs. There is a need to balance premium affordability with benefit coverage. As hospice care is generally affordable after Government subsidies and Medisave use, the MediShield Life Review Committee proposed to focus the limited premium dollars on support for other coverage expansions.

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

MediShield Life is designed as a basic health insurance plan to help with large hospital bills. There is a need to balance premium affordability with benefit coverage that is fair to all policyholders.

There is already substantial support for maternity and fertility expenses through Government subsidies at public hospitals, Medisave use and the Marriage & Parenthood Package.  Given the certainty of support for such expenses, we agreed with the Committee not to include maternity and fertility expenses under MediShield Life.  

CLAIMS UNDER MEDISHIELD LIFE

1. How do I claim from MediShield Life?

For admissions from 1 Nov 2015, you will be able to submit a claim under MediShield Life, subject to claim limits, deductible and co-insurance. You can submit your claims through the medical institution by informing them that you wish to make a claim. Once you have given the medical institution the authorisation to submit your claim for you, the medical institution will submit a claim to the insurer on your behalf.

If a payout is due, it will be made to the medical institution by the Central Provident Fund Board on your behalf. The outstanding amount on your bill after the payout can be covered by Medisave and/or cash.

To estimate the maximum amount that you can claim from Medisave or MediShield Life, click here.

You can find out the list of medical institutions participating in MediShield Life here.


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

As MediShield Life payouts are pegged at subsidised bills incurred at Class B2/C wards and subsidised outpatient treatments/day surgery at public hospitals, bills incurred for higher wards classes (e.g. Class A/B1) in public hospitals and private hospitals will be pro-rated for computation of claims under MediShield Life.

The applicable pro-ration factors can be found in the information booklet here.


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?

As MediShield Life claims are electronically submitted by medical institutions to the Central Provident Fund (CPF) Board for assessment, you can claim from MediShield Life through the medical institution by informing them that you wish to make a claim.

Once you have given the medical institution the authorisation to submit your claim for you, the medical institution will submit a claim on your behalf. If a payout is due, it will be made to the medical institution by the CPF Board on your behalf. The outstanding amount on your bill after the payout can be covered by Medisave and/or cash. Should there be reimbursements the medical institution will reimburse the excess cash deposit to you.


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 "my cpf Online Services".

Following are the steps to take: 

(1)  Click on "My Statement” at the side bar 

(2)  Go to Section B, Medisave and/or MediShield Life / Integrated Shield Plan Claims and Reimbursement up to last 15 months

(3)  Click on the date under "Hospitalisation Period".

(4)  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 proceed to “My Request > Other CPF matters > Request for my backdated CPF records” after you log onto "my cpf Online Services" with your SingPass. The standard service charges for retrieval of past records will apply accordingly.


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 continue to receive hardcopy Medisave Claims statements, only as long as there were withdrawals made from your Medisave Account to pay for your dependants’ or your own medical bills.

If your claim was only for MediShield Life and there was no withdrawal 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 here 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.


PREMIUMS AND SUBSIDIES

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 will directly help Singaporeans with their MediShield Life premiums, such as Premium Subsidies for the lower- to middle-income, Pioneer Generation subsidies for the Pioneers, Medisave top-ups and Transitional Subsidies for Singapore Citizens to phase in the shift to MediShield Life.

The different types of subsidies are:

Premium Subsidies (up to 50%) for lower- to middle-income Singapore Residents with household monthly income per person of $2,600 and below and living in residences with an Annual Value of $21,000 and below. Individuals who own multiple properties will not be eligible. Permanent Residents (PRs) will receive half the applicable Singapore Citizens (SCs) rate.

Pioneer Generation Subsidies and Medisave top-ups for the Pioneer Generation (up to 60%) ranging from 40-60% and up to $800 a year respectively, regardless of household income and Annual Value of residences. With the Pioneer Generation Subsidies and Medisave top-ups, all Pioneers will pay lesser MediShield Life premiums than MediShield premiums today.

Transitional Subsidies for the first 4 years of MediShield Life for all Singapore Citizens regardless of household income and Annual Value of residences. This to phase in the impact of the premium increases and is over and above Premium Subsidies and Pioneer Generation Subsidies. In the first year of MediShield Life in end 2015, the Government will pay for 90% of the net increase in premiums (after taking into account various subsidies). You will pay only 10% of the net increase from MediShield premiums. The Transitional Subsidies will be stepped down so that you pay 30%, 60% and 80% of the net increase in the second, third and fourth year of MediShield Life respectively.

Additional Premium Support for all needy Singaporean families on a case-by-case basis. This is to provide help for those who are unable to afford premiums even after the subsidies provided by the Government.


2. How much are my MediShield Life premiums? How much subsidy will I receive?

To calculate your estimated MediShield Life premiums after the applicable subsidies provided by the Government,  please click here.

3. 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.


4. 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. The MediShield Life premium payable for your MediShield Life cover will be net of the applicable government subsidies.

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

The Pioneer Generation will be eligible for Pioneer Generation Subsidies to ensure premium affordability.  The Pioneer Generation Subsidies range from 40% at age 65 to 60% at age 90.

The Government is committed to help the Pioneers aged 80 and above in 2014 to fully cover their MediShield Life premiums, through a combination of Pioneer Generation Subsidies and Medisave top-ups. For the younger Pioneers, their MediShield life premiums will be about half of the MediShield premiums after Pioneer Generation Subsidies and Medisave top-ups.

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

For Singaporeans who are unable to pay their remaining share of premiums even after the Pioneer Generation Subsidies and Medisave top-ups, Additional Premium Support will be provided. No one will drop out of MediShield Life because of the inability to pay for premiums.


6. 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 drop out due to the inability to pay for premiums. The Government will directly help Singaporeans with their MediShield Life premiums, such as Premium Subsidies for the lower- to middle-income, Pioneer Generation Subsidies for the Pioneers, Medisave top-ups and Transitional Subsidies for Singapore Citizens to phase in the shift to MediShield Life.

For Singaporeans who are needy and are unable to pay their share of premiums even after subsidies, the Government will provide Additional Premium Support, to help them further with the payment of their MediShield Life premiums.


7. 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 are applicable for the rest of the Pioneer’s life.

The Government will ensure that the process for subsidies is as simple and convenient as possible, so that those who meet the eligibility criteria can get the subsidies easily.


8. To receive Premium Subsidies, why is the household monthly income per person criteria set at $2600? Does this mean if I earn above $2600, I am considered high income and cannot receive any Premium Subsidies?

The $2,600 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. 

By providing subsidies for Singapore Residents with household monthly income per person of $2,600 and below, up to two-thirds of the population may qualify.  

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. This is because the amount they can spend on each family member will be lower if there are more family members.

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.


9. 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.

Annual Value is a relevant consideration, as among those who with similar income, those who live in homes with a higher AV would generally be better off than those who live in homes with a lower AV. The $21,000 AV threshold covers all HDB flats and a small number of private properties. Similarly, Singapore Residents who own multiple properties would also have more means to pay for their premiums.

To help with the move from MediShield to MediShield Life, all Singapore Citizens, regardless of income and Annual Value of home / multiple property ownership, will receive Transitional Subsidies over the first 4 years if they experience an increase in their premiums after subsidies.

For Singaporeans with difficulties affording MediShield Life premiums after the various government subsidies, there will be Additional Premium Support available on a case by case basis, in line with family circumstances.

Those living in homes with higher AVs or own multiple properties will also continue to benefit from substantial healthcare subsidies e.g. at polyclinics and public hospitals. From time to time, they also receive Medisave top-ups to help them with healthcare expenses.

Overall, we aim to be both fair and progressive, with general subsidies available to all Singapore Residents but the support tiered to target those who require greater support.


10. What is the difference in treatment between Singapore Citizens and Permanent Residents?

MediShield Life will cover all Singapore Citizens and Permanent Residents.

Singapore Citizens are eligible for Premium Subsidies, with those who are older, have lower income (or living in residences with lower Annual Value) enjoying higher subsidy rates. Permanent Residents will receive half of the subsidy rates applicable to Singapore Citizens. (This is aligned to the subsidy policy in public healthcare institutions.)

Transitional Subsidies apply only to Singapore Citizens.


11. My MediShield Life premium has increased compared to last year due to a reduction in the amount of Transitional Subsidies. Why is there a reduction in Transitional Subsidies?

Transitional Subsidies are provided to all Singapore Citizens in the first 4 years of MediShield Life to ease the shift from MediShield to MediShield Life. In line with the intent, Transitional Subsidies will cover 90% of the net increase in premiums (after other subsidies) in the first year of MediShield Life, followed by 70%, 40% and 20% in the second, third and fourth year of MediShield Life respectively.

The phasing of the Transitional Subsidy rate from 90% to 70%, 40% and 20% over 4 years has been published as part of the MediShield Life publicity, such as the MediShield Life Welcome Booklet sent to all households in August 2015 and via the MediShield Life website.

While Transitional Subsidies will phase out after the first 4 years of MediShield Life, lower- to middle-income households will continue to receive permanent Premium Subsidies for their MediShield Life premiums. Pioneers will also continue to receive Pioneer Generation Subsidies.

Additional Premium Support will be available to help those who are needy and unable to afford their MediShield Life premiums even after Government subsidises, Medisave, and have limited family support.

No one will lose MediShield Life coverage because he/she is unable to pay for his/her premium.


12. Are my premiums increasing because of the elderly?

No. MediShield Life premiums are age-based, i.e., set in line with the risks for each age group.

With an ageing population, it is important to try to avoid intergeneration cross-subsidy, where the young help to pay for the old. If premiums were not priced by age, premiums will keep escalating as a growing number of elderly need to be supported by a decreasing number of younger policyholders. This will impose an increasing burden on future generations, and will not be sustainable.

This is different from the social insurance schemes in other countries, where the insurance contributions paid by the working population (e.g. through payroll taxes) are used to fund payouts, which are mostly used by the more elderly or sick.


PREMIUM NOTICE LETTER

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

All Singapore Residents will enjoy the better protection and higher payouts under MediShield Life from 1 Nov 2015, but they will only pay MediShield Life premiums and receive applicable subsidies for their MediShield Life premiums from their next policy renewal.

Information on your MediShield Life premium and applicable subsidies will be sent in writing to the payer of your premium about 1 month 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). For example, if you are insured under MediShield/ an IP and your renewal is in April each year, the letter with details about your premium and applicable subsidies will be sent out in Mar 2016.

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 calculator available here.


2. How do I read my Premium Notice Letter?

Please click here for more information on how to read the letter. 

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

The different types of subsidies are as follow:

(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. The applicability of this subsidy is determined based on the eligibility check for MediShield Life.

(b)  Pioneer Generation Subsidies for the Pioneer Generation ranging from 40% - 60%. The applicability of this subsidy is determined based on the Pioneer Generation status.

(c)  Transitional Subsidies for the first 4 years of MediShield Life for all Singapore Citizens. The applicability of this subsidy is determined based on citizenship.

You may refer to the explanatory note here for the computation of the various subsidies.


4. I did not participate in the eligibility check for MediShield Life Premium Subsidies. Why does it still reflect that I am receiving subsidies?

There are different types of MediShield Life premium subsidies.

The eligibility check process was used to determine eligibility for Medishield Life Premium Subsidies for lower- to middle-income Singapore Residents.

If you did not participate in the eligibility check, the Government will still compute the MediShield Life Premium Subsidies for your household. However, it will be based on existing information in Government records, which may not be up-to-date. For individuals who miss the date to confirm their household information and wish to make changes, please call 1800-222-3399 for further assistance.

Transitional Subsidies and Pioneer Generation Subsidies are given based on your citizenship or Pioneer Generation status and are applied automatically to your MediShield Life premium. They are not determined by the eligibility check.

5. 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 contactus@medishieldlife.gov.sg or call the MediShield Life hotline at 1800-222-3399.


6. 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 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.

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). Premium rebates are applicable only if the members joined the scheme before the last age of entry.

Please click here for more information on premium rebates.


7. 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.

 

MEDISHIELD LIFE PREMIUM CHECKER E-SERVICE

1. What is the purpose of the MediShield Life Premium Checker e-Service?

Premium payers will be notified of the premium payable before their MediShield Life or Integrated Shield Plan (IP) policy renewal.  The Central Provident Fund Board will be sending out premium notice letters for those covered under MediShield Life while private insurers will send out premium notice letters for those covered under IPs. Premium payers can expect to receive their premium notice letters about 1 month before policy renewal.  For instance, premium payers can expect to receive the premium notice letters in Oct 2015 for policy renewals in Nov 2015.    

The MediShield Life Premium Checker e-Service serves as a complementary online resource to the premium notifications. Any member (not limited to premium payer) who is insured under MediShield Life or under IPs can log on to the e-Service for details on their MediShield Life premiums and subsidies.  


2. The MediShield Life Premium Checker e-Service shows only the information for MediShield Life. I am insured under an Integrated Shield Plan (IP), how do I find out about the full IP premiums?

An Integrated Shield Plan (IP) consists of 2 components – (i) the MediShield Life component administered by the Central Provident Fund Board and (ii) an additional private insurance coverage component administered by private insurers. The IP insurer will send premium notice letters to the premium payer around 1 month before the policy renewal. The letter will show premiums for both the MediShield Life component and additional private insurance coverage component.

You can use the MediShield Life Premium Checker e-Service to check the premium and subsidies for the MediShield Life portion of your IP. The details on the additional private insurance coverage portion of your IP are currently not available on the e-Service.

For details on the additional private insurance coverage portion of your IP, please refer to the premium notice letter from your IP insurer. Alternatively, please check directly with your IP insurer for more details.


3. When can I check my MediShield Life premiums and subsidies in MediShield Life Premium Checker e-Service?

The premium information of the insured member will only be ready closer to the member’s policy renewal date.

You can check your MediShield Life premiums and subsidies at the MediShield Life Premium Checker e-Service about 2 months before policy renewal. For new insured persons covered by MediShield Life, you can check your MediShield Life premiums and subsidies about 2 weeks after you receive the MediShield Life Auto-cover package.


4. How were the MediShield Life subsidies reflected in the MediShield Life Premium Checker e-Service determined?

After you have logged in to MediShield Life Premium Checker e-Service, you can move your cursor over the "?" images next to the wordings to view information on the various types of subsidies:

(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. The applicability of this subsidy is determined based on the eligibility check for MediShield Life.

(b)  Pioneer Generation Subsidies for the Pioneer Generation ranging from 40% - 60%. The applicability of this subsidy is determined based on the Pioneer Generation status.

(c)  Transitional Subsidies for the first 4 years of MediShield Life for all Singapore Citizens. The applicability of this subsidy is determined based on citizenship.

You may refer to the explanatory note here for the computation of the various subsidies.


5. Does the MediShield Life Premium Checker e-Service show the information for my family members?

The MediShield Life Premium Checker e-Service shows the MediShield Life premium and subsidies information for you and your family members if you are paying for their premiums.

You can also use the MediShield Life Premium Checker e-Service to view the information of your child aged below 16 where the premiums are deducted from your child’s own Medisave. This is to facilitate checks for your child aged below 16 who may not have a  SingPass account to access the e-Service. However, if your child’s premium is paid by another person, only the payer can view your child’s premium information using the e-Service.


6. Does the MediShield Life Premium Checker e-Service show the premium information of my family members? Will I be able to view the information of my parents who lives with me and pay for their own premiums?

You will not be able to view the premium information of your family members if you are not paying for their premiums.

Your parents can login using SingPass to the Premium Checker e-Service to view their information.  Those without SingPass can call the MediShield Life hotline at 1800-229-3399 to find out about their MediShield Life premium and subsidies.


7. When do I have to pay for my MediShield Life premiums?

MediShield Life premiums may be fully paid from Medisave. The premium payable for your policy will be automatically deducted from your payer’s Medisave account within 1 month of the date of policy renewal. You can refer to the MediShield Life Premium Checker e-Service for the date of your policy renewal.

8. Does the MediShield Life Premium Checker e-Service show real-time data?

The MediShield Life Premium Checker e-Service reflects the information accurate as at the date indicated below the premium table in the e-Service. The e-Service may not reflect the latest information if you have recently submitted an appeal for MediShield Life Premium Subsidies, or have changed your premium payer.  For the latest information on your MediShield Life premiums and subsidies, please call MediShield Life hotline at 1800-229-3399.


MEDISHIELD LIFE PREMIUM SUBSIDIES: FACILITATE ELIGIBILITY CHECK


FACILITATED ELIGIBILITY CHECKS

1. What was the purpose of the Household Check exercise? What happens after I completed the Household Check, what else do I need to do to get the MediShield Life Premium Subsidies?

The purpose of the Household Check exercise was to verify/update your household information to ensure that you and your household members receive the correct MediShield Life Premium Subsidies. The Ministry of Health (MOH) will tap on information in Government records to determine households’ eligibility and the level of MediShield Life Premium Subsidies they qualify for.

MOH will use information in Government records and your updated household information, to compute your MediShield Life Premium Subsidies. To view or update the household information used to compute your Premium Subsidies, log in to the Household Check e-Service.


2. What if I missed the deadline to confirm my household information?

If you did not confirm your household information during the Household Check exercise, the Government will still compute the MediShield Life Premium Subsidies for your household. However, it will be based on existing information in Government records, which may not be up-to-date.

For individuals who missed the date to confirm their household information and wish to make changes, please call 1800-222-3399 for further assistance. Alternatively, you may submit the changes via the Household Check e-Service.


3. What if there are subsequent changes to my household? Do I have to inform the Ministry of Health?

Please write to contactus@medishieldlife.gov.sg or call 1800-222-3399 should you wish to request to update your household information. Alternatively, you may submit the changes via the Household Check e-Service.

4. 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 email us at contactus@medishieldlife.gov.sg. Do note that supporting documents will be requested for assessment.

5. Will overseas Singaporeans receive Premium Subsidies?

All Singapore Citizens, including overseas Singapore Citizens, will receive Pioneer Generation Subsidies and Transitional Subsidies automatically, if they meet the relevant eligibility criteria. 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 determine the necessary information for your eligibility. 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.

If you or your household wishes to request for a review of your eligibility for MediShield Life Premium Subsidies, please email your request to contactus@medishieldlife.gov.sg, 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 contactus@medishieldlife.gov.sg or call 1800-222-3399 if calling from Singapore / +65 6222 3399 if calling from overseas.


INFORMATION USED FOR ELIGIBILITY CHECKS

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 contactus@medishieldlife.gov.sg or call 1800-222-3399. You can also submit the changes via the Household Check 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. What is the financial information that the Government will be accessing for the eligibility checks for MediShield Life Premium Subsidies?

The financial 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 financial information such as bank balances.

If you do not wish to allow MOH to access your financial 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 Transitional Subsidies if you are a Singapore Citizen and experience a premium increase and Pioneer Generation Subsidies if you are a Pioneer.


4. 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 2 years.

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.


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

Your income will only be accessed when your subsidy eligibility is due for an update. This will happen at the end of the 2 years’ validity period, or any time:

-       there is a new-born in your household;

-       there is a new Singapore Citizen / Permanent Resident joining your household; or

-       when you apply for/renew your status under other household-based healthcare subsidy schemes such as the Community Health Assist Scheme (CHAS), Specialist Outpatient Clinic (SOC) Subsidies, and specific Intermediate and Long Term Care (ILTC) schemes.

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.


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

The Annual Value (AV) of all HDB properties fall below $13,000, while some lower-value private properties have AV between $13,000 and $21,000.

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.


7. 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 property owners) will still be assessed for their eligibility for subsidies.


8. 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.

9. 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.

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

In general, your subsidy eligibility will be valid for 2 years. 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), Specialist Outpatient Clinic (SOC) Subsidies, and specific Intermediate and Long Term Care (ILTC) schemes.

CHOOSING NOT TO PARTICIPATE IN THE HOUSEHOLD CHECK EXERCISE

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 financial information, for example, income for the eligibility checks.

If you chose not to allow access to your financial 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 financial 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 financial 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 financial information for the eligibility check for MediShield Life Premium Subsidies.


ADDITIONAL PREMIUM SUPPORT

1. What is Additional Premium Support?

Additional Premium Support is designed to help those who are needy and unable to afford their MediShield Life premiums even after Government subsidies, and have limited family support.

The Government will send you/them an application form to invite you/them to apply for Additional Premium Support if you/they have insufficient Medisave and have limited family support to help you/they pay for your/their MediShield Life premiums.

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

From 1 Nov 2015, all Singaporeans are covered under MediShield Life, which protects them against large medical bills for life.

The Government will directly help Singaporeans with their premiums through MediShield Life Premium Subsidies for the lower- to middle-income, Pioneer Generation Subsidies for Pioneers and Transitional Subsidies for all Singapore Citizens. Those who are less well-off will qualify for higher Government subsidies to reduce their premium payment.

MediShield Life premiums may be fully paid using your Medisave. The Central Provident Fund (CPF) Board has several arrangements in place to help all employers, employees and self-employed persons keep their Medisave contributions current. If an insured member has insufficient Medisave or no Medisave account, immediate family members such as parents and spouse, can help to use their Medisave to pay for their premiums.

For those who are still unable to afford their MediShield Life premiums even after Government subsidies and have limited family support, there is Additional Premium Support to help them. The Government will send these members an application form to invite them to apply for Additional Premium Support.

No one will lose MediShield Life coverage because he/she is unable to pay for his/her premiums.

3. Who can qualify for Additional Premium Support? What are the eligibility criteria for Additional Premium Support?

Insured members who have the means to pay for their premiums should do so. Premiums may be fully paid by Medisave. They can top up their Medisave with cash if their Medisave balance is low.

Additional Premium Support is designed to help those who are needy and unable to afford their MediShield Life premiums even after Government subsidies and have limited family support. Possible examples include low-income single elderly without family support, low income families with multiple dependents, and people receiving Public Assistance. The Government will invite these individuals to apply for Additional Premium Support, and help them with the process if they are unable to do so themselves.

Eligibility for Additional Premium Support 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 MediShield Life coverage because he/she cannot afford his/her MediShield Life premiums.


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

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?

With higher premiums paid during working ages, the MediShield Life Review Committee’s recommendation is for premium rebates to start at an earlier age from age 66, instead of age 71.  Please click here for more information on the enhanced premium rebate table applicable to incoming cohorts.

For younger Singapore Residents who pre-pay more during their working ages, the scheme is designed so that they 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?

What everyone in the same age group pays ahead in premiums are pooled to help cushion the future increases in premiums during older ages. While some members may pass on earlier, the remaining pool of funds will need to help those of the same age who live longer and need to draw on more rebates.


UNIVERSAL COVERAGE FOR ALL

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. To achieve this, the MediShield Life Review Committee has recommended that MediShield Life coverage be 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. What does the Government intend to do about the recommendations on Employer Medical Benefits?

The MediShield Life Review Committee called on employers and unions to work together to reduce duplication of coverage between employer medical benefits and MediShield Life, in line with suggestions received from the National Wages Council (NWC), National Trades Union Congress (NTUC) and Singapore National Employers Federation (SNEF). The Committee also recommended that the Government consider strengthening incentives for companies that are willing to provide portable medical benefits that ride on MediShield Life for their employees.

The Government welcomes the observations made by the Committee on employer medical benefits. The Government encourages companies to look into how they can move towards portable medical benefits, in support of the national insurance plan.  Employers who wish to implement portable medical benefits options today are supported by incentives to do so.  We will study how we can help support more companies make this shift. 


6. How do I know whether my dependant(s) and I are covered under MediShield Life?

All Singapore Citizens and Permanent Residents are covered under MediShield Life from 1 Nov 2015.

If you are the payer for the premiums, you will also receive a premium notice letter 1 month before the commencement or renewal of your dependant(s)’ or your MediShield Life cover.

If you wish to check the status of MediShield Life coverage online, your yearly CPF Statement of Account and “My Messages” will also show the status of your/your dependant(s)’ MediShield Life coverage. You will need your CPF Account Number and SingPass to login and access “My Messages”.

Alternatively, please email us at contactus@medishieldlife.gov.sg or call us at 1800-222-3399.


7. 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.


8. 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.

9. What are the areas of duplication between MediShield Life and Hospitalisation & Surgical (“H&S”) plans that are not Medisave-approved 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.

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

You may wish to consider avoiding/removing such duplication by taking up a Medisave-approved 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.


11. 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. 


12. 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


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 Government will support most of the cost of extending MediShield Life coverage to all Singapore Residents.

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, as part of their co-sharing of the total costs of covering all Singapore Residents under universal MediShield Life.


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?

If your medical condition developed before you started your MediShield or Integrated Shield Plan coverage, and is assessed to be a serious pre-existing condition, you may have to pay Additional Premiums of 30%, for a period of 10 years from the start of MediShield Life coverage.

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, 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?

Singapore Residents who have been notified that they have to pay Additional Premiums may apply to the Central Provident Fund (CPF) Board, if their condition has improved. Additional medical information may be needed for the review.

For more information, you can write in to the CPF Board at contactus@medishieldlife.gov.sg 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 Immigrated & Checkpoint Authority of Singapore (ICA), a copy of the form can be found here

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.

Exclusions on the private insurance component will be separately determined by the IP insurer. After the introduction of MediShield Life, IP insurers may choose to introduce 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 Transitional Subsidies. For Singaporeans who are not able to afford their premiums even after subsidies, the Government will provide Additional Premium Support, which will also be applicable to the Additional Premiums.

12. What is the total cost of universal coverage and how will this be split across Government, general insured population, and those with pre-existing conditions?

The total cost of universal coverage is estimated to be $1.1 billion in the first five years of MediShield Life. This is because those with pre-existing conditions are more likely to incur costs and make claims for the treatment of their conditions. The Government has accepted the MediShield Life Review Committee’s recommendation for the Government to support most of the costs of universal coverage with the remaining cost split between all insured individuals and those with serious pre-existing conditions.

This cost-sharing approach helps our fellow Singapore Residents and is line with our move to strengthen risk-pooling across society and build a more inclusive society. Many members of the public have expressed their support for sharing part of the costs of universal coverage.

The impact on insured individuals is 3% or less compared with their current MediShield premiums.



PREMIUM RECOVERY MEASURES


PREMIUM PAYMENT


1. Who is responsible for their premium?

The insured person is responsible for his own premiums.

For a minor below the age of 21, his parents or legal guardians will be responsible for his premiums if he does not have sufficient Medisave balance.


2. I am currently insured as a dependant under MediShield Life. How can I take over the premium payment for my own policy?

Please submit your application here (SingPass login required). Once the application is processed, you will take over the premium payment.

If you have insufficient Medisave monies to pay for your MediShield Life premium, you will be notified in writing about the various payment options to pay the outstanding premiums.

You can top up your Medisave Account to pay MediShield Life premiums by using:

  • Services at www.cpf.gov.sg -> Enquiry & Payment Services -> e-Cashier, with an internet banking account using your NRIC
  • NETS at any SingPost branch with the MediShield Life top-up form , or at any SAM.
  • AXS Station with ATM cards from major participating banks
  • Cash or CashCard at any SingPost branch with a MediShield Life top-up form
  • Cheque made payable to: 'CPF Board'


Mail the cheque and MediShield Life top-up form to the following address:

Central Provident Fund Board

MediShield Life Department

Robinson Road P.O. Box 3060

Singapore 905060

Alternatively, you may request one of your immediate family members (i.e. your spouse, parent, child or grandchild) to use his/her Medisave savings to help you pay your MediShield Life premium.

To do so, your family member can submit an application here (SingPass login required). Once the application is processed, the new payer will take over paying the premium payment.


3. Can I pay for my immediate family members’ (i.e. your spouse, parent, child or grandparent) outstanding MediShield Life premiums using my Medisave savings?

If you wish to pay for your immediate family members’ MediShield Life premiums, you can submit an application here (SingPass login required). Once the application is processed, the new payer will take over paying the premium payment.

4. If I am paying for my Pioneer Generation parents’ premiums, how can I make use of the Medisave top-ups they are receiving to pay for their premiums?

The annual Medisave top-ups for Pioneer Generation members will be credited to the Pioneer Generation members’ accounts directly. Please click here to check the amount of Medisave top-up the Pioneer Generation members will receive.

If you are paying for your Pioneer Generation parents’ MediShield premiums currently and wish to use your parents’ Medisave top-ups to pay for their MediShield Life premiums in future, your parents can request for a change of payer online via the Central Provident Fund Board’s website at www.cpf.gov.sg

To do so, please ask your parents to login to their account with SingPass, go to “My Requests” on the left panel and select “Healthcare Matters”, followed by selecting “Change of Payer for MediShield Life Cover”.

If your Pioneer Generation parents have Integrated Shield Plans (IP), they will need to approach their IP insurers to adjust the payment arrangements.


5. I will be overseas for 2 years. Do I have to pay the MediShield Life premiums?

MediShield Life was introduced to give all Singapore Citizens and Permanent Residents assurance of universal healthcare coverage, for life. In line with this more inclusive approach, all Singapore Citizens and Permanent Residents contribute to this national risk pool, as part of collective responsibility. This extends to those based overseas, as they can also benefit from MediShield Life protection anytime they choose to return to Singapore, regardless of changes to their health condition.

Today, many Singaporeans already choose to continue with their Integrated Shield Plan (IPs) (private insurance) coverage even while residing overseas to ensure that they can remain covered when they return to Singapore.

IPs comprise 2 components – the MediShield Life component administered by the Central Provident Fund Board and additional private insurance coverage component offered by private insurers. IPs are provided by AIA, Aviva, Great Eastern, NTUC Income and Prudential.

You do not need to take up a separate MediShield Life plan or pay a separate MediShield Life premium, as it is a component of your IP premium.

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


PREMIUM RECOVERY MEASURES


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.     Government will support most of the cost of extending coverage to those with pre-existing conditions;

b.     Premium Subsidies for lower- to middle-income Singapore Residents with household monthly income per person of $2,600 and below and living in residences with an Annual Value of $21,000 and below. 

c.     Pioneer Generation Subsidies and Medisave top-ups for the Pioneer Generation ranging from 40-60% and up to $800 a year respectively, regardless of household income and Annual Value of residences. With the Pioneer Generation Subsidies and Medisave top-ups, all Pioneers will pay less premiums than today.

d.     Transitional Subsidies for the first 4 years of MediShield Life for all Singapore Citizens regardless of household income and Annual Value of homes.

In addition, to minimise cash payment for Singapore Residents, 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. The Central Provident Fund (CPF) Board has in place a web of arrangements with multiple government agencies to ensure employers, employees and especially self-employed persons meet contribution requirements.

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? Why are they aligned to those for tax? Who will enforce premium payment?

Prior to premium recovery, there will be a process of active premium payment measures and extensive outreach to help Singaporeans with their premiums. For those who have missed premium payments, notices and reminders will be sent, to give them sufficient time to respond or make arrangements to pay.  They will also be informed of the availability of Additional Premium Support, before further premium recovery steps are taken. 

However, for those who have means but choose not to pay MediShield Life premiums despite the multiple notices and reminders, there will be a strong set of measures for premium recovery. Otherwise, premium defaults will translate to bad debts to the MediShield Life Fund and higher premiums for all. The premium recovery measures take reference from income tax recovery measures.

The premium 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

(vi)       Recovery from the defaulter’s hospitalisation claim payout

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. 


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


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

The incurred loss ratio serves as an operational measure of the Fund’s health on a yearly basis. It compares total premiums collected to total monies required to ensure that the Fund is able to meet its liabilities now as well as into the future. Total monies required for the fund includes immediate claims paid out each year and the change in required reserves needed for future payouts. 

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]

2012

$421m

$315m

$154m

111%

2013

$770m

$335m

$366m

91%

2014

$723m

$381m

$331m

98%

2015

$1,099m

$437m

$569m*

92%

2016

$1,858m^

$745m

$1,182m

104%

2012 - 2016

$4,871m

$4,815m

99%

Source: CPF Annual Reports

^ In 2016, the Government provided $902mil (48%) in premium subsidies and other forms of support to help keep premiums affordable for Singapore Residents.

* The change in required reserves in 2015 was adjusted to remove the effect of the one-off significant change in valuation basis mainly arising from the shift of MediShield to MediShield Life in Nov 2015 (e.g. universal coverage for all Singapore Residents, support for the Fund’s capital needs). The adjusted figure provides a more accurate reflection of the Fund’s operations within the year.  The change in required reserves before the adjustment was $12m and the corresponding ILR was 41%.


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 the period 2012 to 2016 was 99%. This is derived from the Fund receiving $4,871 million in premiums while paying out or setting aside $4,815 million to support policyholders’ claims and scheme liabilities.


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

Reserves are monies that the MediShield Life Fund needs to set aside, after allowing for future premium collections, to honour expected future policyholder benefits (liabilities of the scheme). The reserves of the Fund support the following liabilities:

a. Claims incurred but not yet submitted or paid: This is for expected incoming claims, where the treatment has taken place (and hence hospitalisation expenses have 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.

b. Claims not yet incurred but expected to be paid in the future: This is for claims where treatment has not taken place but are expected to occur in the future (i.e. the next five 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.

c. Continuing claims which have a long tail: The Fund sets aside provisions to cover the projected total future costs for those who have started on multi-year treatments. For example, renal failure patients 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.

d. Future premium rebates: Policyholders currently pay some premiums ahead to finance the higher premiums at older ages. This helps to distribute premiums more evenly throughout policyholders’ lifetime. These premiums are set aside within the Fund and used to disburse premium rebates. As the majority of policyholders are still relatively young, it is expected that more monies will be set aside for now until more policyholders reach the ages when premium rebates get disbursed.


4. Are MediShield Life Fund’s reserves necessary?

Reserves are monies that the MediShield Life Fund needs to set aside, after allowing for future premium collections, to honour expected future policyholder benefits (liabilities). 

In addition to the reserves, the Fund holds capital to buffer against adverse scenarios, in line with the Monetary Authority of Singapore’s (MAS) Risk Based Capital (RBC) framework.  This framework is applied to MediShield Life because, similar to other insurance funds, the Fund too is vulnerable to adverse scenarios such as higher than expected claims experience.  If such scenarios occur, it will impact the solvency and sustainability of the Fund. It is therefore important for the Fund to set aside buffers to help it continue paying for policyholder’s benefits during such times and minimise the need to make sudden incremental adjustments to the premiums. 

It would not be prudent to only hold the absolute minimum buffer as a small variation in claims may result in the Fund being unable to meet its claim liabilities subsequently. The objective is to ensure sufficient funds to meet both short-term and long-term payouts, even in bad times.


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?)

MediShield Life is not-for-profit. Premiums are actuarially priced to meet policyholders’ claims over time taking into account MediShield Life’s expected claims experience. This helps ensure that the Fund is adequate to sustain policyholders’ claims and provide for future expected payouts. 

Depending on future premiums to cover future payments on existing claims is not prudent. This is because it is not a certainty that premiums will always be enough to cover claims then. Premiums are priced to ensure that MediShield Life remains sustainable in the long term. If the premiums do not take into account possible future payouts, the Fund’s ability to meet its long-term commitments will have to depend on future ad hoc premium increases beyond healthcare inflation to make up for the shortfall. 

Instead, by setting aside monies now to support future claims, the Fund better ensures that policyholders are assured of their payouts even if the Fund is unable to collect enough in premiums in future. For example, renal failure patients claim up to $1,000 per month, or up to $12,000 per year. Such treatment continues for many years and the payouts must be supported to provide patients with peace of mind. Hence, the claims for these patients are prudently provided for in the Fund reserves. 

To better help Singaporeans with their MediShield Life premiums, the Government has announced various support, such as Premium Subsidies for the lower- to middle- income, Pioneer Generation Subsidies and Medisave top-ups, and Transitional Subsidies to phase in the premium increases.


6. How is the MediShield Life Fund’s investment strategy determined?

One of the roles of the MediShield Life Council is to review the investment strategy of the MediShield Life Fund and recommend an optimal strategy to the Minister of Health of the MediShield Life Fund.


MEDISHIELD LIFE COUNCIL


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 ensure that the administration of the MediShield Life Scheme is in line with the policy intent and to review the scheme to ensure that it remains relevant and sustainable.

The Council will provide advice on the administration of the scheme, in areas such as the design of scheme benefits and parameters and provision of Additional Premium Support for those in financial need. The Council will also consider views from stakeholders and the public as they review the administration of MediShield Life. The Council may appoint various advisory panels to advise the Council on key issues and appeals where necessary.

Its functions are:

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 12 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 click here for the list of members and their profile.

3. How will the roles of the Ministry of Health and Central Provident Fund Board change with the establishment of the MediShield Life Council?2


The Ministry of Health (MOH) will continue to remain responsible for overall healthcare financing policy, including the role of MediShield Life. The Central Provident Fund (CPF) Board will continue to administer the MediShield Life Scheme.

The Council will provide additional guidance and overview for the specific administration of the MediShield Life Scheme, e.g. in areas such as premium recovery measures. The Council will be supported by CPF Board and MOH in its work.



MEDISHIELD LIFE COVERAGE FOR OVERSEAS SINGAPOREANS


ELIGIBILITY CRITERIA FOR SUSPENSION OF PREMIUM COLLECTION


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. 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.

3. 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.


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

Applicants should not have benefitted from MediShield or MediShield Life payouts in the five years prior to the start of suspension of premium collection. If you received a payout previously, the eligibility assessment will be based on the five years after the policy year of the payout.

6. 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.


7. 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.


APPLICATION FOR SUSPENSION OF MEDISHIELD LIFE PREMIUM COLLECTION


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

The application form for suspension of MediShield Life premium collection will be available from 7 Oct 2016 on the MediShield Life website. When submitting your application, please ensure that your application form is duly completed with the necessary supporting documents enclosed. The Central Provident Fund Board will acknowledge the receipt of your application. 

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

The Central Provident Fund Board will notify you once your application has been processed.

3. 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?

You are still covered under MediShield Life while your application is being processed. As such, the premiums for your MediShield Life cover are still payable. If your application is successful, premium collection will be suspended for as long as you continue to meet the eligibility criteria. If your application is unsuccessful, any outstanding premiums will remain payable.

4 How can I inform the Central Provident Fund (CPF) Board of a change in my address?

All notifications from the Central Provident Fund (CPF) Board will be sent to the address stated on the back of your identity card (IC). You may update this address at the Immigration & Checkpoints Authority of Singapore (ICA) or any Neighbourhood Police Post/Centres. Any updates will automatically be transmitted to all participating government organisations via the One-Stop Change of Address Reporting Service (OSCARS). Therefore, the CPF Board will be informed of your updated address on the next working day.

If you do not hold an identity card but wish to update your address, please contact us at member@cpf.gov.sg and we will further advise you on your request.


CESSATION OF SUSPENSION OF PREMIUM COLLECTION


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?

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?

If you seek medical treatment in Singapore during suspension of MediShield Life premium collection (e.g. while visiting), you may continue to choose to claim and benefit from MediShield Life payouts. However, your suspension of premium collection will cease and 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)


INTEGRATED SHIELD PLANS (IPs)


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.

As MediShield Life will cover all pre-existing conditions, all IP policyholders will also enjoy MediShield Life coverage for life, for any pre-existing conditions. This will apply even if your pre-existing condition is excluded from the additional private insurance coverage by your private insurer. You will have peace of mind that you will continue to remain covered at the basic level, even if you have exclusions on your IP cover or you have to drop your IP cover.


2. How will my Integrated Shield Plan premiums be affected in the first year from launch of MediShield Life?

Integrated Shield Plans (IPs) are private plans that have been integrated with the MediShield Life to form a single integrated plan. IP policyholders enjoy the benefits and coverage of the MediShield Life component, plus additional coverage provided by their private insurers for Class A/B1 ward and private hospital stays.

IP premiums include the MediShield Life components and additional coverage offered by the private insurer. IP premiums are much higher than MediShield Life premiums because of their targeted coverage at Class A/B1 ward and private hospital stays.

The IP insurers have committed to keeping premiums for the additional private insurance coverage component of all IPs unchanged for a year after implementation of MediShield Life (i.e. until 31 Oct 2016).

In the first year from launch of MediShield Life, IP policyholders can expect to see an increase in overall IP premiums due to the increase in premiums for MediShield Life. However, the net IP premium that each IP policyholder needs to pay would also depend on the amount of MediShield Life premium subsidies they are eligible for.


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

MediShield Life payouts are pegged at the costs of Class B2/C wards. If you would like additional coverage beyond MediShield Life, you may also consider taking up an Integrated Shield Plan (IP). 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.

The existing IPs in the market are:
-       AIA HealthShield Gold Max,
-       Aviva MyShield,
-       AXA Shield,
-       Great Eastern SupremeHealth,
-       NTUC Income IncomeShield, and
-       Prudential PruShield.

As MediShield Life is a component of IP coverage, there is no duplicate coverage between MediShield Life and your IP.

Please note that as IPs are private plans with additional coverage, premiums are much higher than MediShield Life premiums. You may therefore wish to carefully consider the affordability of premiums over the longer-term.

While MediShield Life will provide coverage for any pre-existing conditions, you may be subject to additional health checks for the additional private insurance coverage component, possibly resulting in exclusions and/or risk-loading for the additional private insurance coverage component. We advise you to carefully consider and purchase insurance coverage accordingly. Please speak to your financial advisor who will be able to share more about your options and their implications.


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; Transitional 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).

Holders of IPs who meet eligibility criteria will receive Premium Subsidies 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.

The MediShield Life Review Committee had recommended for the Government to allow for IP insurers to manage those with pre-existing conditions differently from healthy policyholders, including allowing for risk-loading, i.e. charging policyholders higher premiums to insure their pre-existing conditions. The Government will work with the private insurers on how to do this in a way that benefits policyholders.


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 will cover all pre-existing conditions, all IP policyholders will also enjoy MediShield Life coverage for life, for any pre-existing conditions. MediShield Life payouts are pegged at the costs of Class B2/C wards. Any exclusions on pre-existing conditions imposed by your private insurer will continue to apply 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, up to the equivalent Class B2/C level.

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 switch to MediShield Life at any point in time, without any exclusions imposed on the MediShield Life component.

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. The additional private insurance premiums of IPs are set, reviewed and adjusted by insurers as necessary, based on commercial and actuarial considerations.

Insurers adjust premiums from time to time in order to sustain increasing IP claims costs. You may wish to check with your insurer on the reasons for the increase in additional private insurance premiums.

Singaporeans who want to keep their health insurance premiums affordable, including at older ages when private insurance premiums tend to be much higher, should carefully consider if they need IPs.


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)


1. What are the new Additional Withdrawal Limits and when will they commence?

The new Additional Withdrawal Limits (AWLs) will apply to the additional private insurance coverage component of Integrated Shield Plan (IP) premiums from 1 Nov 2015 and will 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 will Integrated Shield Plan policyholders be affected under the new Additional Withdrawal Limits?

The new Additional Withdrawal Limits (AWLs) will apply to all Integrated Shield Plans (IPs) being renewed or commencing from 1 Nov 2015.

Singapore Residents will be able to use the same amount or more of their Medisave to pay the additional private insurance coverage component of their IP premiums.

For older Singapore Residents who have IPs, the AWLs may enable them or their family members to use more Medisave than before for the additional private insurance component of their IP premiums.

Impact of New AWLs on IP Policyholders
(based on Premiums in 2015) 
 

Age Next BirthdayAWLsImpact of AWLs on IP Policyholders
1 - 40$300IP policyholders can use the same amount of Medisave to pay for their additional private insurance premiums
41 - 70$600IP policyholders can use up to ~$250 more Medisave to pay for their additional private insurance premiums, compared to today
>= 71$900IP policyholders can use up to ~$400 to ~$700 more Medisave to pay for their additional private insurance premiums, compared to today

Note: The impact is computed on the basis of no change in plans or age bands of policyholders.


3. Why is there a need to review the existing limits of Medisave used to purchase Integrated Shield Plans?

Integrated Shield Plans (IPs) today are made up of 2 components: (i) MediShield Life, sized for Class B2/C ward stays, administered by the Central Provident Fund (CPF) Board and (ii) additional private insurance coverage for Class A/B1 wards and private hospital stays, administered by private insurers.

Similarly, premiums for IPs also consist of premiums for these 2 components. With MediShield Life, IP premiums will differ for policyholders in the same age band, as MediShield Life premiums differ from person to person due to:

  • MediShield Life premium subsidies that depend on each policyholder’s unique circumstances
  • Additional Premiums payable by a small number of policyholders with serious pre-existing conditions.

The previous Medisave Withdrawal Limits for IPs apply to the entire IP premium (made up of both the MediShield premium and the premium for additional private insurance coverage). As MediShield Life premiums will differ from person to person, setting limits applicable only to the additional private insurance coverage component, instead of the entire IP premium, will ensure that IP policyholders in the same age band can use the same amount of Medisave for the additional private insurance coverage component of their IP premium.

At the same time, MediShield Life premiums may be fully paid using Medisave.

Taken together, the new approach will give more clarity and certainty to IP policyholders as to how much they can utilise from Medisave to pay for their IP premiums.


4. 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.


5. 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.

6. Will the new 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.

7. The Additional Withdrawal Limits dollar limits appear to be lower than that of the previous Medisave limits for Integrated Shield Plan (IP) premiums. Does this mean that IP policyholders can use less Medisave in future to pay for their IP premiums?

The Additional Withdrawal Limits (AWLs) apply to only the additional private insurance component of the Integrated Shield Plan (IP) premium, while the base MediShield Life layer may be separately and fully paid by Medisave.

In comparison, the previous Medisave withdrawal limits apply to the total IP premium (made up of the MediShield component and the additional private insurance component). Hence, the previous Medisave limits naturally appear higher numerically.

The new approach gives certainty and clarity to policyholders. Certainty that MediShield Life premiums can be fully paid using Medisave. Clarity in knowing how much more Medisave can be used for the rest of the IP premiums. The latter is to pay for the additional private insurance component of IPs.

IP policyholders can be assured that they will be able to use the same amount or more of their Medisave to pay the additional private insurance component of their IP premiums with the AWLs, than under the previous Medisave withdrawal limits.

For older Singapore Residents who have IPs, the AWLs may enable them or their family members to use more Medisave than before for the additional private insurance component of their IP premiums.


8. 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.


9. 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.

10. 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.


11. 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.


12. With MediShield Life, will the Integrated Shield Plans (IPs) cover pre-existing conditions? Can I now get coverage under IPs 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.

The MediShield Life Review Committee had recommended for the Government to allow for IP insurers to manage those with pre-existing conditions differently from healthy policyholders, including allowing for risk-loading, i.e. charging policyholders higher premiums to insure their pre-existing conditions. The Government will work with the private insurers on how to do this in a way that benefits policyholders.



STANDARD INTEGRATED SHIELD PLANS (IPs)


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.

It is available from all the insurers who sell IPs, from 1 May 2016.

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. When can I get the Standard Integrated Shield Plan?

Sale of the Standard Integrated Shield Plan (IP) started from 1 May 2016.

Please speak with a financial advisor on your specific situation before making a decision. 


4. 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.


5. 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. 


6. 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.


7. 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.


8. 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. 


9. 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.


10. 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.


11. 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.


12. 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.


13. 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.


14. 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.


15. 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.


16. 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

1. What does the Government intend to do about the MediShield Life Review Committee’s recommendations on managing healthcare inflation?

The Government agrees with the Committee’s recommendations on the need to better manage healthcare costs and will study their suggestions. The management of healthcare costs will require the support of all parties, including Singapore Residents, healthcare providers and insurers.

Singapore Residents can play their part by actively pursuing healthy lifestyles and being careful to avoid over-consumption when seeking healthcare treatment. The Government will continue to support Singapore Residents in choosing healthy lifestyles, as laid out in the Healthy Living Masterplan. 


2. What does the Government intend to do about the MediShield Life Review Committee's recommendations on increasing public awareness of our healthcare financing system?

As part of the roll-out for MediShield Life, the Government will look into how it can strengthen public education on our healthcare financing system and MediShield Life.

Having a good understanding of our healthcare system will enable Singapore Residents to better plan and prepare for their healthcare needs. 


3. What is the difference between MediShield Life and ElderShield?

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

MediShield Life is a basic health insurance plan that helps to pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer. It targets Class B2/C wards and subsidised treatment in the public hospitals.

ElderShield is a severe disability insurance scheme which provides basic financial protection to severely disabled elderly who need long-term care. ElderShield will pay the insured a monthly cash payout of $300 or $400 if the insured becomes severely disabled, which can help pay some of the living expenses for the care of a severely disabled person.

Besides ElderShield, the Pioneer Generation Disability Assistance Scheme (PG-DAS) provides $100 a month to help Pioneers who permanently need assistance in at least 3 activities of daily living with their care needs.



Back To Top