MediShield covers more than half of bill

11 Mar 2011, The Straits Times

Question

Name of the Person: Goh Poh Kheng (Ms)

Stumped by low MediShield payout

MY FATHER was hospitalised thrice in January - once at the Singapore General Hospital and twice at the National University Hospital (NUH).

When we received the bill for his first stay at NUH, I was surprised to note that though his payable amount was $2,300 - after a government subsidy for staying in C class - his MediShield claim was only $450.

I understand that there is a deductible of $1,000 and co-insurance of 20 per cent but even then, it does not work out to the $450 paid by MediShield.

The second bill came soon after and it was $2,200. Since we had paid a deductible, which was applicable for one calendar year, I expected the MediShield payout to be higher. But it was only $900.

I called the NUH billing department about it but they had no clue and advised me to call the Central Provident Fund (CPF) Board, which told me the amount to be calculated for the MediShield claim was not the full $2,300 submitted by NUH, but a sum after 'pro-ration', which came to $1,500.

I asked what this 'pro-ration' was and I was told it was calculated through means testing and for further details, I should call NUH.

I called the NUH patient service department and was told they would check with the CPF Board and get back to me. But, till now, no one has responded.

Who should I call now?

I wish such matters could be made more simple and transparent. A check on both the CPF Board and Ministry of Health websites has left me none the wiser.

Reply

Name of the Person: Karen Tan (Ms)

Director, Corporate Communications

Ministry of Health 

MS GOH Poh Kheng's father was hospitalised twice in a National University Hospital (NUH) Class C ward this year and she was surprised to find that MediShield could cover only less than 30 per cent of the combined bill size of $4,500 ('Stumped by low MediShield payout'; Monday).

The preliminary bills were based on incomplete information provided by the family. With the additional information that the hospital has since received, MediShield is expected to cover more than 50 per cent of the total bill, as there is a $1,000 deductible.

Nevertheless, the patient's deductible and co-payment of the bills will be fully covered by Medisave, without any out of pocket payment.

This case illustrates the affordability of health care in Singapore as a result of Medisave and MediShield. NUH staff will sort out the outstanding details with the family.

The Ministry of Health will also work with the Central Provident Fund Board and our hospitals to strengthen the patient communication process.