Speeches
OPENING SPEECH BY DR KOH POH KOON, SENIOR MINISTER OF STATE, FOR THE SECOND READING OF THE CARESHIELD LIFE AND LONG-TERM CARE (AMENDMENT) BILL
15 October 2025
1 Mr Deputy Speaker, on behalf of the Minister for Health, I beg to move, "That the Bill be now read a second time."
Background
2 Sir, let me begin with a fact that underscores the importance of today’s Bill. One in two Singapore Residents is expected to develop severe disability at some point in their lifetime.
3 CareShield Life, our national long-term care insurance scheme, was launched in 2020 to provide basic financial protection against long-term care costs. It is an integral part of our long-term care financing framework and sits alongside other layers of support that work together to help those with long-term care needs. These include:
a. Government subsidies for nursing homes as well as home-based and community-based care;
b. Grants such as the Home Caregiving Grant and Seniors’ Mobility and Enabling Fund;
c. MediSave withdrawals for long-term care; and
d. Safety nets such as ElderFund and MediFund.
4 As an insurance scheme, CareShield Life works on the basis of risk-pooling. This means that each birth cohort pays premiums that go towards meeting the claims of those from that cohort who might develop severe disability.
a. This approach allows us to come together to support one another's future needs.
b. It is also a more sustainable approach, as every cohort pays premiums that go towards supporting the long-term care needs of that cohort.
5 CareShield Life covers all Singapore Citizens and Permanent Residents born in 1980 and later, from when they turn 30. This is regardless of pre-existing disabilities or health conditions.
6 For those born in 1979 and earlier, we encourage them to enrol in CareShield Life, but kept participation optional when CareShield Life was first launched in 2020, as their circumstances and needs could vary widely and they may have already made their own plans. This is the group we term as the Optional Cohort.
7 Currently, new Singapore Citizens and Permanent Residents born in 1979 and earlier are also covered under CareShield Life if they are not severely disabled when they become a Citizen or Permanent Resident. We term this group as “New SCs/PRs”.
8 Under CareShield Life, policyholders pay premiums from their age of entry until age 67, or for up to 10 years, whichever is longer. I would like to highlight that policyholders are covered for life, even after they stop paying premiums.
9 If policyholders are assessed to be of severe disability, or in other words, unable to perform at least three out of the six activities of daily living, they will receive monthly cash payouts.
a. These activities of daily living include
i. washing,
ii. dressing,
iii. feeding,
iv. toileting,
v. walking or moving around, and
vi. transferring between bed and chair.
b. Upon successful claims, if the individual had still been paying premiums, he or she will no longer need to do so.
c. Policyholders receive cash payouts for as long as they remain in severe disability.
CareShield Life 2025 Review
10 Sir, the CareShield Life Council undertook its first review of the scheme, five years after its implementation, to ensure that it continues to provide meaningful protection in a sustainable and affordable manner.
11 The Council released its recommendations in August 2025, after extensive public engagement and careful deliberation, with its recommendations accepted in full by the Government.
a. Notably, the Council recommended doubling of the growth rate of CareShield Life payouts from 2% to 4% annually.
b. These increased payouts will better cushion against rising long-term care costs driven by inflation of manpower and technology costs.
c. With this enhancement, a policyholder making a claim in 2030 will receive $806 per month, compared to $731 per month under the previous annual growth rate. This is an increase of $900 annually.
d. For younger policyholders, the benefits are even more significant over time.
e. Take for example a 30-year-old who joins CareShield Life in 2026. Should he or she make a claim at age 70, the payout will be $2,940 per month. This is more than double the payout of $1,406 per month under the current, lower growth rate.
12 The Council also recommended adjusting premiums to sustain the higher payouts. This will keep the scheme financially sustainable.
a. To help policyholders cope with the premium adjustments, the Government has also committed to providing over $570 million in additional support over the next five years.
b. This will moderate annual premium increases from 2026 to 2030 to about $38 on average, and no more than $75. Without this support, premiums in 2026 would have increased by approximately $126 on average, with a 4% per annum increase thereafter.
c. To keep premiums affordable and fair, the Council has also recommended adjusting CareShield Life’s underwriting criteria, as planned earlier. I will explain this in greater detail later.
13 These CareShield Life enhancements complement the long-term care subsidy and grant enhancements announced at Budget 2025, where
a. We will be raising subsidies for long-term care services, to up to 80% for nursing homes, and 95% for home and community care services.
b. We are also expanding the eligibility criteria to cover seven in 10 households, so that more can benefit.
c. We will increase Home Caregiving Grant cash payouts from a maximum of $400 to a higher maximum value of $600, and will expand the coverage of the Seniors' Mobility and Enabling Fund.
d. These enhancements will be progressively implemented from January 2026.
14 To illustrate the impact, consider a CareShield Life policyholder with a per capita household income of $1,500. Together, the enhanced subsidies and grants will help to offset more than two-thirds of their community-based long-term care costs, with the enhanced CareShield Life payouts covering another quarter. After the financing support, the patient’s individual out-of-pocket expenses will come down to $110 per month.
15 The enhancements to CareShield Life as well as government subsidy and grant schemes will collectively provide Singaporeans with greater assurance that long-term care will remain affordable for years to come.
CareShield Life and Long-Term Care (Amendment) Bill
16 Mr Deputy Speaker, the CareShield Life and Long-Term Care Act was enacted in 2019 to support the establishment, governance and administration of CareShield Life.
17 To implement the Council’s recommendations I have just outlined, amendments to the Act are necessary.
18 This Bill makes targeted amendments to two key areas.
a. First, we will reinstate the planned underwriting criterion for Optional Cohorts and new SCs/PRs. This reinstatement was planned for right from when the scheme was first launched. This move will help moderate premiums for the older CareShield Life policyholders.
b. Second, we will strengthen our premium recovery processes to ensure the scheme's sustainability and fairness to all policyholders.
Adjustments to the Underwriting Criterion
19 Let me elaborate more on the first set of amendments, which relates to adjustments to the underwriting criterion.
20 As I mentioned, CareShield Life is kept optional for those born in 1979 and earlier, the Optional Cohorts.
a. This was a considered decision that recognised that many Singaporeans in these cohorts may have already made alternative arrangements for their long-term care needs before CareShield Life was introduced. They might also be enrolled in ElderShield, which was the earlier long-term care insurance scheme, later replaced by CareShield Life.
b. For the Optional Cohorts, they would also have had to pay higher annual premiums, as they would be enrolling at a later age, and have fewer years to pay the premiums needed to support their lifetime benefits under the scheme.
c. Nonetheless, the Government welcomed them to join if they wished to enrol, for greater assurance. We had outreach campaigns and offered participation incentives to encourage them to join. We also relaxed the underwriting criteria as a time-limited measure, so even those who already had mild to moderate disability could enrol.
21 I want to emphasise that once insurance take-up is optional, underwriting is important. This is to guard against adverse selection, where those who are more likely to claim will be more likely to enrol, driving up claims. Therefore, when the scheme was first conceptualised, it was designed such that only Optional Cohort individuals without any pre-existing disability could enrol in the scheme.
22 However, MOH decided to grant a time-limited concession to keep the scheme inclusive at its launch. Under this concession, any Optional Cohort individual without severe disability, but including those with milder forms of disability, could enrol in and benefit from the scheme. Participation incentives of up to $4,000 were also offered to offset premiums and to encourage enrolment.
23 With this approach, we have seen many from the Optional Cohort opting to join CareShield Life. As of June 2025, about 900,000, or almost half of them have done so.
24 When CareShield Life was first launched in 2020, we announced that the concession period would be for two years. However, we allowed it to run for twice as long, or about four years, as we recognised that enrolment in CareShield Life might not have been top of mind for Singaporeans during the COVID years that the initial concession was timed for.
a. Since then, sign-ups are now almost 90% lower than when the scheme was first launched for Optional Cohorts in 2021, and have levelled off.
b. This indicates that most Optional Cohort individuals who wanted to enrol have done so.
c. Hence, the CareShield Life Council has recommended reinstating the planned underwriting criteria for the Optional Cohorts from 1 January 2026 onwards.
d. This adjustment will benefit all Optional Cohort policyholders. Remember that I said earlier, risk-pooling is cohort-based, so the risk is taken on and the cost is borne by those in their cohorts. With the earlier concession, premiums had to be set higher to account for the possibility that Optional Cohort individuals with mild to moderate disabilities might be more likely to join CareShield Life. Now that the underwriting criterion will be reinstated, this risk is reduced. This allows premiums to be moderated, keeping the scheme fair and sustainable for all policyholders. For instance, a CareShield Life policyholder from the Merdeka Generation born in 1952, would see annual premiums lower by more than $100 in 2026 with this tightening.
25 The Bill implements these changes through several key provisions.
26 Clauses 2 (a) and 8 introduce a new definition of “not disabled” in the Act, with the detailed meaning set out in a new Fourth Schedule. The Schedule defines “not disabled” as being able to perform all six activities of daily living without assistance.
27 This provides the foundation for our reinstated underwriting criterion.
28 Clause 6 provides the Minister with powers to amend this Fourth Schedule by order published in the Gazette. Any such order must be presented to Parliament after publication for proper oversight.
29 Clause 3 amends the underwriting criterion or eligibility criteria for CareShield Life under Section 6 of the CareShield Life and Long-Term Care Act 2019 which applies to New SCs/PRs.
a. From 1 January 2026, these new Singapore Citizens and Permanent Residents can only enrol in CareShield Life if they are "not disabled".
b. This means that they have no pre-existing disability and are able to perform all six activities of daily living independently.
30 We will be amending the relevant regulations so that this underwriting criterion of being “not disabled” will likewise apply to the Optional Cohorts.
31 In implementing these changes, I want to assure members that we remain committed to fairness, inclusivity and sustainability.
32 The Optional Cohorts have had sufficient time – four years – to join CareShield Life under the more inclusive underwriting criterion.
a. The adjustment of underwriting criterion applies only to new Optional Cohort enrolment from 1 January 2026.
b. Existing policyholders will see no change to their coverage.
c. Importantly, those with pre-existing disability can continue to benefit from other Government financing schemes such as long-term care subsidies and grants, including the Home Caregiving Grant.
Strengthening Provisions to Support Premium Recovery Efforts
33 Sir, I will now elaborate more about the second set of enhancements to provisions relating to the service of documents, which strengthen our premium recovery process.
34 Like any other insurance scheme, CareShield Life relies on collective responsibility through risk-pooling within each cohort, to provide policyholders with peace of mind in the event of severe disability.
35 As part of this collective responsibility, all policyholders must play their part by meeting their premium obligations. This ensures that CareShield Life can continue to support potential claimants in a timely and sustainable manner.
36 We also recognise that premiums must be kept affordable, especially for those who are vulnerable.
a. This is why the Government provides support, in the form of premium subsidies for lower and middle-income households, and has also announced transitional support to help policyholders manage the upcoming round of premium adjustments.
b. Additional Premium Support is also available to fully offset the remainder of the premiums for those who remain unable to afford their premiums even after subsidies and have limited family support.
c. Here, I want to emphasise that no one will lose CareShield Life coverage due to an inability to pay premiums. Because from what I have just said, those in the worst and most dire situations, who cannot afford to even pay the premiums after our subsidies, the Government will step in and pay fully whatever is left for them to bear. This will be something we want to give assurance to all our citizens and residents here in Singapore.
37 However, there are also some individuals who can afford to, but wilfully decide not to pay their premiums despite repeated reminders, and eventually become defaulters.
a. Owed premiums that cannot be recovered will affect the CareShield Life Fund’s financial sustainability, and ultimately affect CareShield Life’s ability to meet its claims.
b. Consequently, such unrecovered premiums will have to be shouldered by other policyholders within their cohorts in the form of higher premiums.
c. Premium recovery and enforcement measures are therefore needed to ensure fairness for all policyholders. This involves the service of demand notes.
38 To support these recovery efforts, Clause 5 of the bill introduces the new Section 61A to scope the modes through which demand notes may be effectively served.
a. Demand notes are formal notices served to defaulters stating their outstanding premiums, and any interest imposed that is payable by the defaulter.
b. These demand notes are a key enabler to our premium recovery process.
c. Demand notes will be served before recovery measures can commence.
d. Such recovery measures may include imposing interests or penalties, or appointing agents to recover outstanding premiums.
39 The current provisions enable demand notes to be served through various channels, including registered mail.
a. However, we face operational challenges when policyholders fail to update their addresses or reside overseas.
b. This often makes it difficult to reach them through traditional postal methods.
c. Clause 5 will enhance our premium recovery efforts by allowing demand notes to be served via additional modalities such as digital means, on top of existing methods such as physical letters. Such an effort is in line with the overall move across the Government to complement, not replace, physical touchpoints with digital channels.
d. These amendments will also align the approach with similar provisions already in place for MediShield Life, and will improve operational efficiency and streamline premium recovery actions.
40 Those with genuine difficulties affording their premiums will continue to be supported by premium support measures. I would like to reassure this House again, that nobody will lose CareShield Life coverage due to an inability to pay their premiums.
Conclusion
41 Mr Deputy Speaker, sir, the amendments we propose today will help ensure that CareShield Life remains a robust and sustainable pillar of our long-term care financing system.
42 Together with the substantial subsidy and grant enhancements announced at Budget 2025, these amendments and the changes to CareShield Life will continue to provide Singaporeans with the assurance they need as they age.
43 Mr Deputy Speaker, sir, I beg to move.