Ask Salma: Q & A

New integrated shield plan

From May 1, all five insurers will offer a new standard B1 integrated shield plan (IP). This is meant to provide people who want more than subsidised care with coverage that is affordable.

Q My husband is diabetic and is covered under Medishield Life. Will he be accepted by the insurers if he wants to upgrade to this new IP plan and will his pre-existing illnesses be covered?

A Since the new standard B1 IP is a commercial product, it will be up to individual insurers if they are willing to fully cover your husband.

Some insurers might cover him but exclude all treatment for problems linked to diabetes.

Others might offer full coverage based on how well your husband is able to control his diabetes, or how severe it is.

Most IPs have relatively cheap premiums for younger people, so it might be a good investment to buy one while you are still healthy.

Q Is there a cut-off age to buy the standard IP?

A No, you can apply at any age.

However, new applicants are subject to underwriting. This means that insurers can refuse to cover someone who has a severe pre-existing illness, or decide to cover them but exclude anything to do with a pre-existing illness.

However, if you are downgrading from a higher plan, such as one catering to Class A treatment, and are sticking to the same insurance company, then you will continue to enjoy the coverage you have been getting with no additional penalties.

Q Must the five insurers offer the new standard B1 IP plan to everyone who wants it?

A No. It is up to the insurers whether they want to accept new applicants. However, they are obliged to offer it to all their existing policyholders who want to downgrade to this plan with no additional underwriting.

So someone who has a Class A plan which excludes him from heart-related treatments will be similarly excluded from such coverage if he downgrades.

However, if the same person is fully covered by the Class A plan but has since suffered a heart attack, he will continue to enjoy full coverage with no penalty if he chooses to downgrade with the same insurance company.

Q My company provides medical coverage. Do I also need an IP?

A Your company coverage will end when you retire or resign. With the introduction of MediShield Life last year, you are guaranteed this basic health insurance.

However, if you plan to opt for private rather than subsidised treatment, this will not be enough to cover you fully. You will need an IP.

Buying an IP only when you retire is possible but not advisable as most older people here suffer from some chronic ailment that could result in them being rejected by the insurer, or getting only partially insured.

Most IPs have relatively cheap premiums for younger people, so it might be a good investment to buy one while you are still healthy. The insurer cannot stop covering you should you develop medical problems later.

Q Are "as charged" plans better than those that aren't?

A In theory, premiums for the latter should be lower, since there are caps on what is paid out. But this is not always the case.

As for coverage, the Ministry of Health says that the standard B1 plan (which is not an "as charged" plan) is unlikely to fully cover the top 10 per cent of B1 bills. An "as charged" plan will fully cover these big bills.

Which is better will depend on which insurer you are with, and the premiums and benefits it offers. The standard B1 IP offered by some insurers have higher premiums than some "as charged" plans offered by other insurers.

A version of this article appeared in the print edition of The Straits Times on March 18, 2016, with the headline 'Ask Salma New integrated shield plan'. Print Edition | Subscribe