MOH's reply
MediShield Life, MediSave helped nine in 10 subsidised patients cover chemotherapy costs
We thank Mr David Soh Poh Huat for his suggestion to raise MediSave withdrawal limits for outpatient chemotherapy (“Double MediSave withdrawal cap for chemotherapy”; June 18).
The Ministry of Health (MOH) adopts a multi-tiered financing framework to support the healthcare expenses of Singaporeans. Patients who receive outpatient chemotherapy at public healthcare institutions can receive subsidies of up to 75 per cent. They can also tap MediShield Life, the national basic health-insurance plan, and MediSave, Singapore’s medical-savings scheme, to defray outpatient chemotherapy costs.
To enhance affordability, the MOH in 2015 raised MediShield Life claim limits for chemotherapy from S$1,240 for every 21-day or 28-day cycle to S$3,000 a month. Patients can use MediSave to pay for any outstanding amount after MediShield Life, up to a withdrawal limit of S$1,200 a month.
The MediShield Life and MediSave limits are generally sized to be adequate for subsidised treatments. Together, the MediShield Life and MediSave monthly limits were enough to fully cover chemotherapy costs for nine in 10 subsidised patients in 2017.
In addition to chemotherapy, patients can use MediSave to cover the costs of scans and other diagnostics needed for cancer treatment, up to a withdrawal limit of S$600 a year. This is designed to provide further peace of mind through different stages of recovery.
We will continue to review our financing frameworks to provide comprehensive support for patients.
Those who face difficulties with medical bills after government subsidies, MediShield Life and MediSave may approach medical social workers at public healthcare institutions for help. No Singaporean will be denied access to appropriate healthcare because of an inability to pay.
Cham Dao Song
Director, Finance Policy
Ministry of Health
Forum Letter
Today, withdrawals for chemotherapy from MediSave, the national medical-savings scheme, are capped at S$1,200 a month.
This is barely enough to cover the costs of cancer treatment, based on the experiences of a relative who has undergone chemotherapy and other patients I talked to.
The MediSave cap has been in place for many years and has not factored in increases due to inflation.
Each chemotherapy session can cost S$4,000 or more, depending on the drug. While patients may also tap the MediShield Life health-insurance plan for chemotherapy — capped at S$3,000 a month — the Ministry of Health (MOH) should review the MediSave cap and double it to at least S$2,400.
This is because patients undergo an average of two chemotherapy sessions a month, which can cost up to S$10,000.
With new drugs being introduced over the years, the cost of chemotherapy has been on the rise and this has taken a toll on patients. This is unlike other treatments, such as dialysis, where costs largely remain fixed.
At times, the side effects of cancer drugs, such as swollen legs or hands, may also necessitate treatment and other incidental expenses.
The MOH should also expand MediShield Life to help patients to pay for other types of treatment, such as physiotherapy, to counter these side effects.
David Soh Poh Huat