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MediShield Life coverage to widen from next year

This article is more than 12 months old

Proposal includes raising the yearly claim limit from $100,000 to $150,000

The compulsory national health insurance scheme is set to get a massive revamp next year, with wider benefits proposed so it can cover more and larger hospital bills.

The proposal includes raising the yearly claim limit under MediShield Life from $100,000 to $150,000.

To pay for these benefits and rising healthcare costs, premiums are expected to go up next year by as much as 35 per cent.

This will be the first increase in MediShield Life premiums since the scheme was launched five years ago.

At the upper end, the proposed hike will exceed $500 a year.

But given the difficult times Singaporeans are facing now, Health Minister Gan Kim Yong said the Government will soften the impact of the premium increase with a special Covid-19 subsidy for the first two years.

In the first year, Singaporeans will get a 70 per cent subsidy on the increase.

This goes down to 30 per cent in the second year.

It will cost the Government $360 million.

This is on top of the existing subsidies of 15 per cent to 50 per cent given to middle- and lower-income groups, and 40 per cent to 60 per cent for the Pioneer Generation.

The Merdeka Generation receives additional age-based subsidies of 5 per cent to 10 per cent.

In all, subsidies for the next three years will amount to $2.2 billion. The proposal will allow for wider benefits, including:

  • Higher coverage for sub-acute care at community hospitals - such as for someone recovering from a heart attack - as this is 20 per cent more expensive than normal rehabilitative care.
  • Higher annual claim limit of $150,000, from the current $100,000.
  • Higher claim limits for some charges, such as for intensive care, which will be raised from $1,200 a day to $2,200 a day, dialysis and psychiatric care.
  • An additional $200 a day claim for daily ward charges for the first two days of hospitalisation, when most tests and investigations are done.
  • MediShield Life will in future also cover treatment for attempted suicide, self-injury, substance abuse and alcoholism.
  • Lower deductible of $2,000 (down from $3,000) for people 80 years and older for day surgery.

This brings it in line with their deductible amount in a C-class ward, so patients will not need to be hospitalised just to qualify for insurance cover.

However, the cap on claims for people treated at private hospitals will be reduced from 35 per cent of the bill to 25 per cent.

Based on recent bills, 35 per cent of private hospital care amounts to far higher sums than bills incurred by subsidised patients. The new claim limits should bring MediShield Life back in line with its original mandate to cover 90 per cent of subsidised bills beyond the initial deductible.

It was revealed last year that only 80 per cent of subsidised bills were fully covered.

These changes are expected to get rolling some time in the first quarter of next year.

MediShield Life Council chairman Fang Ai Lian said: "We have to periodically review and update the scheme benefits and premiums to keep pace with evolving medical practice, healthcare cost inflation and actual claims experience, so that it continues to provide assurance for Singaporeans while remaining sustainable."

From now, reviews will be carried out every three years.

MEDICAL & HEALTH