MediShield Life payout computed separately from pensioner coverage

Mr Tan Kwong Moh hoped that the Ministry of Health would consider lowering the MediShield Life deductible amount for pensioners ("Lower MediShield Life deductible for pensioners"; Forum Online, Dec 22).

MediShield Life is a basic hospitalisation insurance plan that is designed to pay large hospital bills and selected costly outpatient treatments, such as dialysis and chemotherapy for cancer. It is sized for subsidised treatment in public hospitals.

MediShield Life has co-payment features, such as the deductible and co-insurance, to help keep premiums affordable.

The deductible is a fixed amount to be paid by the insured before MediShield Life pays out on claims. It is cumulative, and payable only once every policy year.

This allows MediShield Life to pay larger bills, while Medisave savings can be used to pay smaller, more affordable amounts.

MediShield Life payout is computed separately from the pensioner's medical benefit scheme.

In other words, for the example that Mr Tan cited, the MediShield Life payout will be calculated based on the total subsidised bill of $13,000, and not based on the smaller, remaining amount of $1,950 after pensioner coverage.

The pensioner can claim from his medical benefits first, and any remainder can be claimed from MediShield Life if this amount does not exceed the claim allowable based on the MediShield Life computation.

So, in this instance, the pensioner can claim $11,050 from his medical benefits and the remaining $1,950 can be covered by MediShield Life if it falls within the computed MediShield Life claim amount, which it likely would.

A combination of the pensioner's Civil Service benefits and MediShield Life payout will result in at least the same, if not a larger, proportion of the pensioner's hospital bill being covered, compared with if he had only Civil Service benefits.

Pensioners, thus, benefit from MediShield Life coverage.

We thank Mr Tan for his feedback.

Lim Bee Khim (Ms)

Director

Corporate Communications

Ministry of Health