ENHANCED FINANCING SUPPORT FOR HEREDITARY BREAST AND OVARIAN CANCER GENETIC TESTING AND DOWNSTREAM INTERVENTIONS FROM 1 DECEMBER 2026

          Subsidised genetic testing for Hereditary Breast and Ovarian Cancer (HBOC) will be offered by the three public healthcare clusters from 1 December 2026. Financing support will also be enhanced for recommended downstream interventions for individuals with HBOC-associated gene variants. This is part of the Ministry of Health (MOH)’s broader strategy to enhance preventive care in Singapore.

2.          After subsidies, eligible patients can use MediSave to fully cover the cost of genetic testing. Subsidies, MediSave and MediShield Life will also be extended to defray the costs for recommended downstream interventions, where applicable.

3.       This initiative, which was first announced at MOH’s Committee of Supply debate in March 2026, aims to identify individuals who carry HBOC-associated gene mutations early, and reduce the risk of breast and ovarian cancer through timely interventions.

4.       Approximately 1 in 150 Singaporeans carry a mutation in genes that are associated with HBOC. Such gene mutations significantly increase a person's risk of developing breast and ovarian cancer. Females with such mutations have a five- to ten-fold higher lifetime risk of developing breast and/or ovarian cancer compared with the general female population. These gene mutations are hereditary and can be passed down to both males and females.  

Financing for HBOC Genetic Tests

5.       Subsidised HBOC genetic testing will be available at cancer specialist outpatient clinics at the National Cancer Centre Singapore, the National University Cancer Institute Singapore, and Tan Tock Seng Hospital. Genetic testing for HBOC is recommended for three groups of people:

a.    Individuals with breast and/or ovarian cancer with risk factors for HBOC;
b.    First-degree relatives of an individual who carries a HBOC-associated gene variant; and
c.     Individuals with a strong familial history suggestive of HBOC but do not have cancer-affected first-degree relatives available for testing.

6.       As announced earlier, MOH will be extending subsidies to genetic testing for HBOC from 1 December 2026, which may be further offset by MediSave usage:

a.      Eligible Singapore Citizens and Permanent Residents can enjoy means-tested subsidies of up to 70% on the genetic test. Seniors from the Pioneer Generation and Merdeka Generation are eligible for additional subsidies.
b.      The MediSave Chronic and Preventive Care scheme limits^[1] can be used to further offset the cost of the genetic test after subsidies. In the interim period before the enhanced scheme takes effect on 1 January 2027, the existing MediSave500/700 limits will be extended to cover the HBOC genetic test.
c.      Seniors aged 60 and above may use Flexi-MediSave to defray any remaining out-of-pocket costs.

^[1] MOH will enhance the withdrawal limits under the MediSave Chronic and Preventive Care scheme from 1 January 2027 by (i) increasing the basic annual limit from $500 to $700 and (ii) increasing the annual limit for patients with complex chronic conditions from $700 to $1,000.

7.         For patients who test positive, their doctor will recommend their first-degree relatives to also undergo genetic testing. This is known as cascade testing, which is similarly supported with subsidies and MediSave usage.

8.       After subsidies and MediSave, individuals with sufficient MediSave balances may expect $0 in out-of-pocket payment for HBOC genetic testing.

^[2] Includes genetic test, pre-/post-test counselling, and phlebotomy service.

9.         Subsidies for HBOC genetic testing apply to all eligible individuals, regardless of gender. This is important because mutation carriers, including males, can pass the mutation to their children. If an individual is unsure whether they or their family members should be tested, they are encouraged to speak to their doctor, who can assess their risk and refer them accordingly.

10.      MOH estimates that an average of around 2,000 individuals per year, including family members of those who test positive for HBOC-associated gene variants, may benefit from subsidised HBOC genetic testing.

Financing for Downstream Interventions

11.      Understanding an individual’s genetic predisposition is only the first step, and the real benefit comes from acting on that result through downstream interventions such as intensified surveillance, risk-reducing surgeries, and chemoprevention. For example, risk-reducing mastectomy (RRM), which removes breasts, reduces breast cancer risk by 90% or more in individuals with HBOC-associated gene variants. Risk-reducing bilateral salpingo-oophorectomy (RRBSO), which removes both the fallopian tubes and ovaries, reduces ovarian cancer risk by 80% or more.

12.      Today, subsidies may be extended to these downstream interventions where medically indicated. To further defray costs, MOH will strengthen financing support for recommended downstream interventions, including through MediShield Life and MediSave.

Risk-Reducing Surgeries

13.      MOH had announced earlier that MediShield Life coverage will be extended to cover preventive surgeries in selected instances, where the surgeries are (i) medically indicated^[3]; (ii) high-cost and of low incidence, and therefore suitable for risk-pooling; and (iii) cost-neutral or cost-saving to the scheme and do not impact affordability of premiums. Based on these principles, we are extending MediShield Life coverage for RRM and RRBSO, for patients who test positive for HBOC-associated gene variants and opt for these surgeries. MediSave use will also be extended to RRM and RRBSO.

^[3] This means that the patient has tested positive for associated genes and has been recommended by a clinician to undergo the relevant treatment and/or surgery.

14.      MediShield Life and MediSave coverage for RRM have already been extended since 28 September 2026, and MediShield Life and MediSave coverage for RRBSO will be extended by the end of the year. The MediShield Life claim limits and MediSave withdrawal limits will depend on the specific Table of Surgical Procedure (TOSP) code associated with the surgery they receive (see Annex A for full list of TOSP codes associated with RRM; the list of TOSP codes associated with RRBSO will be made available at a later date).

15.        We will continue to carefully assess whether to extend MediShield Life coverage to other preventive surgeries on a case-by-case basis to ensure that expansions are scoped carefully to keep premiums for Singaporeans affordable.

Intensified Surveillance

16.      Intensified surveillance involves regular examinations, such as yearly magnetic resonance imaging (MRI) and/or mammograms. These can be claimed under the MediSave Outpatient Scans limit, which was doubled to $600 per year in 2026, and the Flexi-MediSave limit, which was increased to $400 per year from 1 October 2025. By ensuring that surveillance remains affordable, individuals with HBOC-associated gene variants can keep up with the regular monitoring needed to detect any cancer early, when it is most treatable.

Drug Therapy

17.      Drugs such as endocrine therapies or oral contraceptives may reduce breast or ovarian cancer risk. They will continue to be subsidised if they are listed under the Standard Drug List or the Medication Assistance Fund.

Looking Ahead

18.       MOH will continue to enhance preventive care measures to support better health outcomes for Singaporeans. By making genetic testing and the full range of downstream interventions accessible and affordable, MOH aims to reduce the burden of hereditary cancers on individuals, families, and the broader healthcare system. MOH will continue to review and strengthen the suite of measures available to Singaporeans, so that more people can benefit from early detection and timely intervention in the years ahead.