More get help with medical bills under MediShield Life

Payouts higher under universal insurance scheme but premiums have also gone up

Madam Yuen Soh Ying, 92, fell and fractured her hip in April. The total bill for surgery and rehabilitation was more than $10,000. But between MediShield Life and Medisave, her family only had to pay $100 in cash. PHOTO: COUTESY OF MADAM YUEN SOH YING

One year after Singapore introduced the MediShield Life universal insurance scheme, more people are getting help with their medical bills - with payouts on the rise.

Nearly 400,000 claims were made between last November and September this year, and more than $600 million was paid out.

Of this, $102.5 million went to people who were previously uninsured, a Ministry of Health spokesman told The Straits Times. Over the same period in the previous year, $370.5 million was disbursed for 291,500 claims under the old MediShield.

MediShield Life was launched on Nov 1. It covers every Singaporean and permanent resident for subsidised care for life.

Previously, those too old or sick were not covered. It is not known how big this group was.

Within it, 25,000 people deemed to have a serious pre-existing disease have to pay 30 per cent more in premiums for the first 10 years.

Now, the previously uninsured are covered - and getting more in payouts. They made 65,000 claims and received slightly more per claim - $1,577, compared with other policyholders who got an average of $1,539. Both are higher than the average claim of $1,271 under the old MediShield, before the better coverage by MediShield Life kicked in.

One such patient was Madam Yuen Soh Ying, 92, who fractured her hip in April. She needed surgery followed by rehabilitation at a community hospital.

Her subsidised hospital bill still topped $10,000. Before Nov 1 last year, Madam Yuen would have had to pay all of it with Medisave or cash. But with MediShield Life, $6,600 of her bill was picked up by the scheme. Medisave took care of most of the rest, leaving only $100 to be paid in cash.

MP Joan Pereira, a member of the Government Parliamentary Committee for Health, said: "The impact and support afforded by MediShield Life's enhanced benefits would be more pronounced as the population ages."

There is a trade-off. Premiums rose, mounting to $1.75 billion in the 11 months from its launch, compared with $685.7 million in the same period the previous year. The premium per person is between $130 and $1,530, depending on age.

Of the total, almost half was subsidised by the Government.

Premiums collected, minus payouts made, will be invested in Special Singapore Government Securities as these have long-term stability, said Ms Fang Ai Lian, who chairs the MediShield Life Council.

The council also decides on appeals, including requests from Singaporeans living abroad who do not plan to return here to live, to be excluded from the scheme.

It announced a month ago that they can be "suspended" from the scheme, but will have to pay the full unpaid premiums plus interest if they return permanently and require medical treatment.

About 200 people have applied for such exemption, Ms Fang said.

As for appeals, such as for more subsidy, she said that not only did the council have to consider the "unique circumstances" of each case, but the solution also has to be consistent and fair to all.

facebook.com/ST.Salma

Correction note: A previous version of the story stated that premiums collected, minus subsidies given, will be invested in Special Singapore Government Securities. This is incorrect. Instead, the premiums collected, minus payouts made, will be invested.

A previous version of this story also said that $307.5 million was disbursed for MediShield claims between November 2014 and September 2015 instead of $370.5 million. It has been corrected.

Join ST's WhatsApp Channel and get the latest news and must-reads.

A version of this article appeared in the print edition of The Straits Times on November 01, 2016, with the headline More get help with medical bills under MediShield Life. Subscribe