All Singapore residents to enjoy universal coverage under MediShield Life, with no exclusions

Less than 1% of Singaporeans will need to pay Additional Premiums

1. MediShield Life, when implemented on 1 November 2015, will cover all Singapore Citizens (SCs) and Permanent Residents (PRs) for life, including those with pre-existing conditions that are not covered under MediShield today. Those with exclusions will have their exclusions lifted and benefit from full coverage under MediShield Life.

2. The Government will support most of the cost of extending MediShield Life coverage to those with serious pre-existing conditions, while these individuals will only need to pay 30% Additional Premiums for 10 years. About 25,000 (or less than 1% of Singapore Residents) have been identified with serious pre-existing conditions and will need to pay Additional Premiums:

• Of the currently uninsured, about 23,000 will need to pay Additional Premiums.

• Of those currently insured under MediShield or Integrated Shield Plans (IPs) but with exclusions, about 2,000 will need to pay Additional Premiums.

Serious Pre-existing Conditions Requiring Additional Premiums

3. 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.

4. The broad categories of serious pre-existing conditions that will be subject to Additional Premiums are shown in Table 1. 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 have to pay Additional Premiums depends on factors such as the specific nature and severity of the individual’s medical condition.

5. The following are examples of individuals who will not need to pay Additional Premiums:

• Those whose pre-existing conditions are less serious or are well-controlled, such as well-controlled diabetes, or hypertension with no complications, osteoarthritis, pre-cancers, fibroids or cysts.

• Those who were hospitalised due to a one-off event, such as an accident or dengue.

6. Medical conditions that develop after the start of the individual’s MediShield (or IP) cover are not considered to be pre-existing conditions and will not be subject to Additional Premiums. Please refer to Annex A for examples of different groups of individuals.

Notification Letters on Additional Premiums

7. The CPF Board will write to inform individuals of their need to pay Additional Premiums from today until late October. For an overview of the notification letters, please refer to Annex B.

8. Individuals subject to Additional Premiums will pay an additional 30% premium for 10 years, following which they will pay the same standard premiums as the rest in their age group, regardless of their health condition in future. The various subsidies1 for MediShield Life premiums will also apply to the Additional Premiums. Medisave may be used to pay the full MediShield Life premiums, including the Additional Premiums.

9. Minister for Health, Mr Gan Kim Yong said, “We have taken a fair and compassionate approach in identifying Singaporeans who will be subject to the Additional Premiums and they make up less than 1% of all residents. Most of them would not be able to purchase insurance and would have been bearing high medical costs without any insurance protection over the past years. With MediShield Life, they can now be covered for life and receive help with their large medical bills.”

10. Members looking for more information may visit www.medishieldlife.sg, call the MediShield Life hotline (1800-222-3399) or write to contactus@medishieldlife.gov.sg.

1These are: Premium Subsidies for lower- to middle-income households, Pioneer Generation Subsidies, and Transitional Subsidies for SCs who face a net increase in their MediShield Life premiums. Additional Premium Support is available for those who cannot afford their premiums even after subsidies.

MINISTRY OF HEALTH
21 SEPTEMBER 2015

Annex A

Hypothetical Examples of Serious Pre-existing Conditions subject to Additional Premiums

Examples of those who need to pay Additional Premiums

Example 1: Mr Lee, 60, is currently uninsured. He is unable to obtain health insurance coverage as he has chronic renal failure and requires regular dialysis treatment. As chronic renal failure is a serious pre-existing condition, he will need to pay the nominal 30% Additional Premiums for 10 years as a reflection of his higher health risks. He will be fully covered under MediShield Life and will be able to claim up to $1,000 per month for his dialysis treatment when MediShield Life is launched.

Example 2: Ms Zarinah, 48, is currently insured under MediShield since 2014. She was diagnosed with breast cancer in 2013, before her entry into MediShield in 2014. The cancer condition is considered a pre-existing condition and is excluded from her MediShield coverage today. She will have to pay the nominal 30% Additional Premiums for 10 years as a reflection of her higher health risks. She will be fully covered under MediShield Life and will be able to claim for cancer-related treatments, subject to the MediShield Life scheme benefits and conditions.

Example 3: Mr Lim, 50, first took up health insurance coverage under an Integrated Shield plan (Diagram A) in 2010 with an exclusion for treatments related to liver conditions as he has liver cirrhosis. His liver condition is considered a serious pre-existing condition and he will have to pay the nominal 30% Additional Premiums as a reflection of his higher risks. He will be fully covered under MediShield Life but will continue to be excluded for treatments related to liver conditions under the additional private insurance component of his Integrated Shield Plan.

Examples of those who do not need to pay Additional Premiums

Example 4: Mr Tan, 55, is currently uninsured. He has well-controlled diabetes since 2010 and has not been admitted to the hospital for any related complications. As his diabetic condition is not considered a serious pre-existing condition, he will not need to pay Additional Premiums. He will be fully insured under MediShield Life.

Example 5: Mr Gopal, 40, is currently uninsured. He was hospitalised due to dengue in 2014. As this is not a serious pre-existing condition, he will not need to pay Additional Premiums. He will be fully insured under MediShield Life.

Example 6: Mrs Koh, 45, has been insured fully under MediShield without exclusions since 2005. She was hospitalised for a heart attack in 2010. As the heart attack occurred after she joined MediShield, it is not a pre-existing condition. She will not have to pay Additional Premiums. She will remain fully insured under MediShield Life.

Example 7: Mr Muthu, 65, has been insured under an Integrated Shield Plan (Diagram A) since 2005. The cover currently includes an exclusion on knee-related conditions, as he had a knee replacement in 2001. If he has since fully recovered and does not need further treatment, this will not be considered a serious pre-existing condition under MediShield Life and he will not need to pay Additional Premiums. He will be fully covered under MediShield Life. He will however continue to be excluded for knee-related conditions under the private insurance component of his Integrated Shield Plan.

Diagram A: The Integrated Shield Plan includes a MediShield (Life) component and an additional private insurance component from the private insurer

Annex B

* If you have a serious pre-existing medical condition and have to pay 30% Additional Premiums, you will receive a letter by October 2015.