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How to make a MediShield Life Claim

17 Jul 2018

Making a claim under MediShield Life is easy

If you have no Integrated Shield Plan

  1. Inform the staff handling your hospital admission or outpatient treatment that you wish to make a claim.
  2. The medical institution will submit your claim for you.
  3. The CPF Board will settle the bill on your behalf.
  4. The remaining amount on your bill can be covered by Medisave and/or cash.

If you have an Integrated Shield Plan

  1. Your private insurer will process your claim and make the total payment to the medical institution on your behalf. This will include the MediShield Life portion of the payout. 
  2. The remaining amount on your bill can be covered by Medisave and/or cash.

How To Claim

Understanding what parts of your bill you can claim

Bill

You are responsible for paying parts A, B and C of your bill from your MediSave account and/or in cash. Your MediShield Life plan will cover part D.

A = MediShield Life claim limit - Under MediShield Life, the maximum claim limit per policy year is set at $100,000 with no lifetime limit on claims. More details on claim limits can be found  here.

B = The deductible – This is the fixed amount you have to pay of the bill (from your MediSave and/or in cash) before MediShield Life payout starts. You only have to pay this once in any year you are hospitalised. So if you are hospitalised twice in one year, your MediShield Life plan pays everything in your second bill except portions A and C. The following chart illustrates how much you would pay as a deductible in any one year if you are hospitalised.

Deduct

C = Co-insurance component - is a percentage of the claimable amount that you have to pay. The larger the bill, the lower the co-insurance payable. Under MediShield Life, the co-insurance rate ranges from 10% to 3% as the bill size increases. 

D = The portion covered by MediShield Life - MediShield Life benefits are designed to cover subsidised bills incurred by Singapore Citizens at Class B2/C wards and subsidised outpatient treatments/day surgery at public hospitals. Bills for other wards, private hospitals and non-subsidised treatments, as well as bills for Permanent Residents will be pro-rated.

More information can be found on the MediShield Life Information Booklet.

An example in action

Co-insurance