Introduction of Outpatient Flexi-Medisave for the Elderly from 1 April 2015

From 1 April 2015, Flexi-Medisave will be introduced in the outpatient setting to allow the elderly to use their Medisave more flexibly and further reduce their out-of-pocket costs for outpatient medical care. 

2.            Medisave was first introduced to help pay for larger healthcare expenses such as hospitalisations, especially during retirement. Over the years, it has been carefully extended to more types of outpatient treatment, so as to support clinical practice and lower patients’ cash payments, while balancing against what is available from the Medisave contributions.

3.            The elderly tend to have greater healthcare expenses.  Their concerns have mostly focused on the cost of outpatient care, especially over the long term, and many have asked to tap on their Medisave more easily. Flexi-Medisave will provide support by allowing Singaporeans aged 65 and above to use up to $200 of their Medisave a year, for outpatient medical treatments at public sector specialist outpatient clinics (SOCs), polyclinics, and General Practitioner (GP) clinics under the Community Health Assist Scheme (CHAS). 

4.            As Medisave is meant to cater for our lifetime healthcare needs, we also need to ensure prudent use of Medisave so that the elderly have enough for their lifetime healthcare needs. The Ministry will continue to review Flexi-Medisave and Medisave use regularly together with other healthcare financing policies to ensure that outpatient care remains affordable for all elderly Singaporeans.

Who can use Flexi-Medisave?

5.            A patient aged 65 or above can use Flexi-Medisave for his outpatient visits.  

6.            A patient can tap on his own or his spouse’s Medisave, provided that his spouse is also aged 65 or above.

How much Flexi-Medisave can be used?

7.            Each patient can use up to $200 of Medisave per year. This amount of money can be drawn from the patient’s own Medisave account, or his spouse’s, if she is also aged 65 or above. The total amount is capped at $200 a year for each patient.

When can the elderly start using Flexi-Medisave?

8.            Flexi-Medisave can be used for visits for outpatient medical treatment starting from 1 April 2015.

What can Flexi-Medisave be used for?

9.            Flexi-Medisave can be used for outpatient medical treatment received at designated healthcare institutions, and generally covers medical services and drugs, tests and investigations which are necessary for diagnosis or treatment of a medical condition and ordered by a doctor.

10.         Flexi-Medisave can also be used for screening tests that are currently under the Integrated Screening Programme. This includes recommended screenings for selected chronic diseases and cancers.

11.         In addition, Flexi-Medisave can supplement other outpatient uses of Medisave.  This includes the new $300 limit for outpatient scans that was implemented on 1 January 2015, the existing $400 Medisave400 limit[1], the various limits for cancer treatment and diagnostics, and other outpatient withdrawal limits. For example, if an elderly has used up his Medisave limit for outpatient scans, he can use Flexi-Medisave to pay for the remaining bill amount.  In addition, the elderly can also use Flexi-Medisave to pay for the 15% co-payment when using Medisave for chronic disease treatment.

Are there types of treatment which Flexi-Medisave does not cover?

12.         Flexi-Medisave aims to help elderly patients reduce their cash payment, with the focus on outpatient medical treatment.  It is also necessary to ensure prudent use of Medisave. Flexi-Medisave cannot be used for the following types of services:

        a.    Treatment administered for non-medical purposes, such as for lifestyle and/or cosmetic purposes (e.g. treatment for slimming, erectile dysfunction, hair loss etc.);

        b.    Administrative fees not related to the medical treatment, including charges for medical reports;

        c.    Retail items (e.g. mobility aids, skin products);

        d.    Purchase of medical devices (e.g. devices for monitoring blood pressure or blood glucose level);

        e.    Vitamins and health supplements (unless they are part of Clinical Practice Guidelines or the patient has an established clinical deficiency); 

        f.     Traditional and complementary medicine;

        g.    Medications that are not licensed by the Health Sciences Authority;

        h.    Non-HSA approved uses of licensed medication;

        i.      Dental treatments;

        j.      All Accident & Emergency expenses incurred at the Emergency Departments; and

        k.    Ambulance fees.

Where can Flexi-Medisave be used?

13.         Flexi-Medisave can be used for outpatient medical treatment at designated healthcare institutions. For a start, these are:

        a.    Specialist Outpatient Clinics (SOCs) at the public hospitals and national specialty centres;
        b.    Polyclinics; and
        c.    Medical GP clinics participating in the Community Health Assist Scheme (CHAS).

MINISTRY OF HEALTH

11 JANUARY 2015

[1] Currently, elderly patients can already use the Medisave400 limit for the following expenses:

a.    Outpatient treatment of 15 approved chronic conditions under the Chronic Disease Management Programme (CDMP);

b.    Screening mammograms for women aged 50 and above; and

c.    Vaccinations including Hepatitis B, pneumococcal and flu vaccinations.