MediSave and MediShield Coverage for Surgical Procedures

Name and Constituency of Member of Parliament
Mr Xie Yao Quan 
MP for Jurong GRC  

Question No. 330

To ask the Minister for Health (a) what portion of an average bill for a surgical procedure in each Table for Surgical Procedures, including pre-operation scans, medical tests and other work-ups as well as post-operation rehabilitation, is paid through MediSave; (b) what portion of this average bill is paid out-of-pocket; and (c) whether MediShield Life coverage for surgical procedures can be further enhanced for a member above 80 years old, beyond the present recommended deductibles for day surgeries. 

Answer

1.    Surgical procedures may be undertaken as part of an inpatient or day surgery episode. The Government provides significant subsidies of up to 80 per cent for both the surgical procedure and the daily hospital charges, which include any number of tests, scans and rehabilitative services which may be required as part of the treatment episode. 

2.    MediShield Life is targeted at helping patients with more costly bills. For hospitalisations involving a more complex surgical procedure, it will cover about 15% to 20% of the total bill in a subsidised ward on average, while MediSave pays for about 5% to 10%. About 3% of the bill is paid in cash.  For example, an average subsidised bill for a heart artery bypass surgery, a much more complex surgery, could cost about $33,000 before subsidies, where MediShield Life pays about $7,300, MediSave covers about $1,600, and the patient pays the remainder of about $200 in cash. So the bulk of it is still taken care of by subsidies and the remaining by the other components that I have just illustrated. Overall, for all treatments including less complex surgeries, 8 in 10 of all subsidised hospitalisation bills incurred by Singaporeans were paid in $100 in cash or less. 8 in 10 Singaporeans’ subsidised bills cost less than $100 in cash.

3.     The MediShield Life and MediSave claim limits for surgical procedures are pegged to the complexity of the surgery required, as indicated in the Table of Surgical Procedures (TOSP). The MediShield Life claim limits for surgical procedures were recently increased in January this year, to keep pace with rising healthcare costs and provide better coverage for more complex surgical procedures. The MediShield Life Council has recommended further adjustments to the claim limits for daily ward and treatment charges as part of the ongoing MediShield Life Review and we will also review MediSave limits in tandem with this. These adjustments will help to cover more of the inpatient or day surgery bill. In addition, the Council has also recommended to raise the policy year claim limit from the current $100,000 to $150,000. This will help older patients with exceptionally large bills due to long or multiple periods of hospitalisation within the year. We will continue to review the MediShield Life and the MediSave limits regularly, to ensure they remain adequate in protecting Singaporeans, while keeping premiums affordable. 

4.      MediFund is available for needy Singaporeans who require additional financial assistance to pay their healthcare bills after subsidies, MediShield Life and MediSave. No Singaporean will be denied appropriate healthcare due to an inability to pay.