The MediShield Life Review Committee (MLRC) today outlined its recommendations on the benefit features of MediShield Life, to enable all Singaporeans to benefit from better protection against large medical bills, for life. The Committee has carefully considered the balance between the impact of the benefit enhancements and the resulting indicative premium levels.
MediShield Life Benefit Recommendations
The Committee’s recommendations on MediShield Life benefit features are as follows:
a. Remove the lifetime claim limit of $300,000;
b. Increase the policy year claim limit by 40% from $70,000 to $100,000;
c. Increase the daily claim limits for normal wards and ICU wards by up to 55%;
d. Increase the claim limits for surgical procedures by between 25% and 93%;
e. Increase the daily claim limits for community hospitals by 40% from $250 to $350;
f. Substantially increase the claim limits for outpatient cancer chemotherapy and radiotherapy treatments, to better cover the cost of subsidised cancer treatment;
g. Lower co-insurance rates from the current range of 10-20% to 3-10%; and
h. Start premium rebates earlier from age 66, instead of age 71.
Collectively, these enhancements will lead to higher payouts from MediShield Life, and hence patients will pay less. Please see Annex A for more details of the MLRC’s recommendations for MediShield Life benefit features.
Universal and Life-long Coverage
With MediShield Life, the current age limit of 90 will be lifted, so that all Singaporeans can enjoy life-long coverage. Those with pre-existing conditions will also be covered.
At its earlier update on 1 Mar 2014, the Committee recommended that the additional costs arising from the expected higher claims from those with pre-existing conditions be shared across those with pre-existing conditions, the existing insured policyholders, and the Government. As requested by the Committee, the Government has agreed to bear most of the costs of universal coverage.
The Committee recommends that those with pre-existing conditions pay higher premiums reflective of their higher risks, at an additional 30% for a period of 10 years. The premium increase for the remaining policyholders as a result of universal coverage should be no more than 3% from current premiums. This reflects the public support for inclusiveness that the Committee has gleaned from its feedback sessions with Singaporeans.
Please see Annex B for examples of how patients can benefit from the proposed enhancements.
The proposed enhancements to MediShield Life will result in the following improvements in benefits and payouts for Singaporeans:
| With Current MediShield
| With MLRC's recommendations for MediShield Life
| Improvement from current
|
|---|
% of Class B2/C patients who pay less than $3,000 a year (in Medisave and cash) after MediShield or MediShield Life payouts
| 83 out of every 100 | 91 out of every 100 | +9% |
| % of Class B2/C patients with large bills* who pay less than $3,000 a year (in Medisave and cash) after MediShield or MediShieldLife payouts | 9 in 100 | 55 in 100 | +532% |
| % of subsidised patients receiving outpatient chemotherapy treatmentwho pay less than $1,000 a year after MediShield or MediShield Life payouts | 65 out of every 100 | 80 out of every 100 | +23% |
* “Large bills” refer to Class B2/C bills above $10,000
Premiums and affordability
Based on the enhanced benefits and life-long, universal coverage under MediShield Life, premiums will have to increase to support the additional payouts. The Committee recommends that the premiums should continue to be fully payable within Medisave withdrawal limits and contributions. The Committee welcomes the Government’s commitment to support Singaporeans in paying for their MediShield Life premiums through substantial premium subsidies and other forms of funding. These Government measures address affordability concerns which the Committee had heard during its consultations with the public, including help for the Pioneers, lower- to middle-income, and those in financial need.
The Committee has asked MOH to analyse the indicative premium impact for lower- and middle-income Singaporean households, in view of public feedback that many Singaporeans are also paying for the premiums of their dependants. The Committee notes that based on typical household types, household premiums will remain within Medisave contributions, with no additional cash outlay needed. The additional 1% employer Medisave contribution will be sufficient to cover the increases in MediShield Life premiums for most people.
a. For a lower income Singaporean nuclear family (2 adults and 2 children) with a monthly income of $2,000 and monthly Medisave contribution of $180, their net indicative premiums for the whole family will be about $32 per month after premium subsidies for the lower income and first year transitional subsidies. After the transitional subsidies are phased out after 4 years, net premiums for the whole family after premium subsidies for lower-income, will be about $55 a month, still within their monthly Medisave contribution.
b. For a middle income Singaporean nuclear family (2 adults and 2 children) with a monthly income of $5,000 and monthly Medisave contribution of $450, their net indicative premiums for the whole family will be about $33 per month after premium subsidies for the lower income and first year transitional subsidies. After the transitional subsidies are phased out after 4 years, net premiums for the whole family after premium subsidies for lower-income, will be about $59 a month, well within their monthly Medisave contribution.
c. For a middle income Singaporean extended family (2 adults, 2 children and 2 grandparents (younger than Pioneer Generation), with a monthly income of $8,000 (dual income) and monthly Medisave contribution of $720, their net indicative premiums for the whole family after premium subsidies for the lower income and first year transitional subsidies will be about $111 per month. After the transitional subsidies are phased out after 4 years, net indicative premiums for the whole family after premium subsidies for lower-income, will be $147 a month, well within their monthly Medisave contribution.
d. For a typical Pioneer Generation retiree household, they will see a decrease in their total payable premiums.
Conclusion and Next Steps
The Committee will be finalising its recommendations and premium details over the next month.
Said Committee chairman Mr Bobby Chin: “My Committee would like to thank all who have given us feedback and shared their concerns. We have listened to what Singaporeans valued most in MediShield Life. Our recommendations will provide better protection against large hospital bills for all Singaporeans, for life. I am grateful that the Government has pledged its commitment to help with premiums. My Committee and I will submit the full report to the Government in a month’s time.”
MEDISHIELD LIFE REVIEW COMMITTEE
5 JUNE 2014