To keep a lid on spiralling premiums, insurer AIA is making several changes, including forming a panel of preferred private doctors for clients to choose from.
The firm, one of six offering MediShield Life integrated plans (IP) here, will also tweak its rider schemes so that patients might have to bear part of their medical bills, instead of paying nothing out of pocket like they do now.
AIA will also require pre-authorisation for clients seeking certain types of treatment. This way, they can be assured that the treatment is covered by their policy.
These moves are in line with a report by the Health Insurance Task Force in October aimed at reining in the rising cost of insurance here, making AIA one of the first insurers to implement some of the measures proposed by the task force.
The insurer, which has a significant share of the IP market, will be able to negotiate prices with the panel of doctors. The list should be ready by the early part of next year, said Ms Ho Lee Yen, AIA's chief marketing officer. Mr Richard Wyber, head of AIA's Healthcare & Vitality Marketing, said it will be big enough so there is "more than enough choice for customers".
One indication of quality, said Ms Ho, is for patients not to be re-admitted or need a second operation for the same condition.
Mr Wyber added: "We see clear patterns from the data. Overtreatment is not in the best interests of cost or quality." A clear example of overtreatment would be someone who is admitted to hospital for stomach pain and gets a gastroscopy, colonscopy, MRI and an abdominal scan, and is warded for two nights and billed $25,000.
To encourage customers to use its panel or go to a public hospital, AIA put out a cheaper rider earlier this year. It pays for both the deductible, which is the initial amount before insurance kicks in, and the 10 per cent co-payment for the rest of the bill - but only if they go to a public hospital or choose a doctor from the panel. Those who don't have to pay the deductible, but not the co-payment.
The difference in premiums is significant and increases with age. A 65-year-old, for instance, has to pay $2,128 a year for a full rider, but only $1,087 for the "saver" rider.
The cost of "as charged" plans, which pay whatever the doctor charges, will go up, said Mr Wyber, but those who wish to can continue with the current option.