ADHD not covered by Medisave as it is less common among population

MOH’s Reply:

TODAY, 27 May 2016

ADHD not covered by Medisave as it is less common among population

Ms Jacelyn Chia Yee Fang asked the Ministry of Health to consider extending Medisave use to more psychiatric conditions (“Extend Medisave to cover more psychiatric conditions”; 12 May).

The Chronic Disease Management Programme (CDMP) was introduced in 2006 to improve outpatient chronic disease management. Under the CDMP, Singaporeans can use up to $400 per year from their Medisave account to pay for their chronic disease treatment. Immediate family members can also use up to the same amount from their Medisave account for the patient's bills.

The coverage of CDMP has been expanded over the years and now covers 19 common chronic conditions. These conditions were included based on various considerations, such as how common the disease is among the general population and the effectiveness of early treatment in reducing complications. Since 2014, under CDMP, Medisave can be used to pay for the treatment of anxiety disorders, which includes obsessive-compulsive disorders (OCD). However, attention deficit hyperactivity disorder (ADHD) is less common at the population level, and is not currently covered under the CDMP. 

Nevertheless, patients requiring outpatient psychotherapy services for management of ADHD can receive between 50% to 70% subsidies at public healthcare institutions. Singaporeans who still face financial difficulties after subsidies can approach Medical Social Workers who will review each case based on each family's circumstances and needs.

We thank the writer for her feedback, and will continue to review the coverage of the CDMP, while bearing in mind the need to ensure sufficient Medisave balances to meet our lifetime healthcare needs.

Ms Lim Bee Khim
Director, Corporate Communications
Ministry of Health

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Forum Letter

TODAY, 12 May 2016

Extend Medisave to cover more psychiatric conditions  

Medisave is a national savings scheme to help Central Provident Fund members save for future medical expenses. It does not, however, cover all health conditions.

For example, under chronic psychiatric conditions, one can use Medisave only for major depression, bipolar disorder, anxiety, schizophrenia and dementia. If Medisave is for medical conditions, why is the selection of psychiatric ones, in particular, so limited?

Obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) are some of the conditions not covered by Medisave. Yet, the World Health Organization lists OCD in the top 10 most debilitating conditions.

ADHD is ranked fourth among mental disorders in the latest edition of the Singapore Burden of Disease Study (2010), which measures the extent to which conditions affect individuals.

A recommended form of treatment for OCD sufferers is cognitive behavioural therapy, which is usually administered in hospitals. One session with a psychologist at a public hospital costs S$70 to S$80 under the subsidised patient scheme.

No wonder people stop treatment. It is costly even for middle-class households, who do not qualify for more subsidies owing to their income, despite seeking help from medical social workers.

Similarly, one of the treatment methods for ADHD, psychotherapy, costs nearly S$100. I hope that if more hospital services are included under the Medisave umbrella, cost would not be a factor in hindering individuals from recovery.

Jacelyn Chia Yee Fang