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askST: Is MediShield Life enough or do I need an Integrated Shield Plan?
MediShield Life covers all ward classes; but for those who choose higher classes or private care, it will cover a smaller portion of the bill
MediShield Life provides coverage for all ward classes, including private hospitals, and also covers inpatient hospice care.
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Launched in 2015, MediShield Life is Singapore’s national insurance scheme, providing basic protection against large medical bills. Here are some of the common questions about the scheme.
Q: Why is MediShield Life mandatory for all Singapore citizens and permanent residents?
A: MediShield Life is mandatory for all Singapore citizens and permanent residents to ensure affordable access to essential healthcare.
Unlike private healthcare insurance schemes, MediShield Life offers lifelong coverage regardless of pre-existing conditions.
By getting everyone to share in a national risk pool, MediShield Life enables all to get access to coverage against large medical bills, while keeping individual premium payments small.
Q: Why can’t MediShield Life cover my entire medical bill?
A: MediShield Life doesn’t cover the full medical bill as it aims to ensure the responsible use of healthcare resources. This is to help keep healthcare costs and premiums affordable.
Two components of your bill must be paid before MediShield Life coverage kicks in:
- The deductible: This is a fixed amount of the medical bill that can be paid in cash or through MediSave, the national medical savings scheme.
The deductible ranges from $1,500 to $3,000, depending on your age and choice of ward class. It only needs to be paid once in any year the patient is hospitalised. For example, if you are hospitalised twice in one year, your MediShield Life will cover your entire second bill, subject to the claim limit.
- The co-insurance component: This is a percentage of the claimable amount that you have to pay, after the deductible. This amount decreases as the bill increases. It can be paid using MediSave.
To avoid excessive payouts for treatments, MediShield Life payouts are also subjected to claim limits.
- The claim limit: This is the maximum amount that you can claim for. It depends on the type of treatment you receive, and the length of your hospital stay.
For example, the amount you can claim for a stay in a normal hospital ward is different from that in an intensive care unit.
Currently, the claim limit per policy year is set at $150,000 with no lifetime limit on claims. The outstanding amount can be paid in cash or using MediSave.
The majority of bills for B2 and C class wards can be fully paid for by MediShield Life and MediSave, notes the Ministry of Health (MOH).
To find out how much of your bill can be covered by MediShield Life, visit go.gov.sg/medishieldlife.
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Q: Since I have MediShield Life, do I still need an Integrated Shield Plan?
A: MediShield Life covers all ward classes including private hospitals. To keep premiums affordable, its benefits are designed based on B2 and C class wards.
This means that MediShield Life will cover a smaller portion of the bill if you choose to stay in A and B1 class wards, or private hospitals where bills are much higher.
Those who want higher-class ward coverage can buy private Integrated Shield Plans (IPs) on top of MediShield Life. You should consider factors such as care preferences and the long-term affordability of premiums before buying IPs.
There are three tiers of IPs. The top tier, which is the most expensive, covers treatments in private hospitals. The second and third tiers cover treatments at a public hospital in A and B1 classes respectively. These are private classes where the patient is allowed to choose the attending doctor.
Earlier this year, Health Minister Ong Ye Kung noted that about half of patients with IP plus rider protection still end up using subsidised public healthcare when hospitalised or receiving day surgery.
Q: How are my MediShield Life premiums calculated?
A: MediShield Life premiums are age-based, accounting for the health risks and healthcare consumption expected for each age group.
It aims to avoid a situation where the young have to pay higher premiums to support the healthcare needs of the elderly.
Annual premiums for an adult aged 31 to 40 is about $397, while someone aged 61 to 65 pays about $1,139, according to MOH.
Older people pay higher premiums as they may be more prone to health problems and complications, which can lead to longer hospital stays, and a need for more medications and treatments.
The average hospital stay for Singaporeans aged 65 and above in 2019 was 6.9 days, nearly double that of those under 65 years old (3.9 days), notes MOH.
Government support is available for those who struggle to pay their premiums. These include means-tested premium subsidies, Pioneer and Merdeka Generation subsidies, and MediSave top-ups.
In partnership with the Ministry of Health
