CareShield Life will improve insurance claims system, say caregivers, doctors

Madam Sarah Liew and her 85-year-old mother, who has dementia. Madam Liew said that the family had "totally forgotten" that her mother was covered by ElderShield until they were reminded by staff at her mother's care centre. ST PHOTO: SYAMIL SAPARI

SINGAPORE - The new CareShield Life insurance system will aim to make the claims process easier than it is under the current ElderShield scheme when it takes effect in 2020 - a move welcomed by doctors and caregivers.

The ElderShield Review Committee on Friday (May 25) submitted a report containing a slew of recommendations - accepted by the Government - for when the system is revamped, which include opening up the pool of assessors to include occupational therapists, physiotherapists and nurses.

Assessments by healthcare professionals who are not accredited will also be accepted.

Currently, assessments can be carried out by only 120 general practitioners (GPs), only 13 of whom make house calls.

Madam Sarah Liew was unable to find a GP willing to go to her 85-year-old mother's home in Clementi three years ago to assess her for dementia.

The 61-year-old part-time bank associate said: "The hassle was getting the assessment done... I needed to find a clinic that is accessible by MRT, because my mother is wheelchair-bound and it's very difficult to transfer her from the wheelchair to the taxi."

She added that the family had "totally forgotten" that her mother was covered by ElderShield until they were reminded by staff at her mother's care centre.

Insurance agent Carin Soh, 42, also struggled to find an assessor for her 78-year-old father who applied for the ElderShield 300 claim after a second cardiac arrest two years ago. She believes the new system will be an improvement.

"I had to call every doctor on the list to check until I finally found one who would go to the community hospital in Changi," said Ms Soh. "That was the main frustration I had - that the doctors in the hospital couldn't do the assessment themselves."

Doctors interviewed agreed that assessments should be made more accessible, but added that the process could be further simplified.

Dr Chua Boon Ling, a GP from Simon Road Family Clinic, said it is easier to assess people in their homes, but many prefer to do it in the clinic because it is cheaper.

Currently it costs $50 for a clinic assessment and $150 for a non-clinic assessment under ElderShield. Fees are reimbursed for successful claims.

But these prices are set to increase, based on recommendations from the ElderShield Review Committee, to reflect the adjustment of salary norms over time.

To make it affordable, especially for the lower-income group, fees for the first assessment will be waived under CareShield Life - even if the claim is unsuccessful.

"It's quite a fast assessment, but the claim form is not very user-friendly," said Dr Chua.

For example, the difference between the grading levels for each activity of daily living can be quite small and nuanced, making it hard to assess the patient.

GP Paul Ang, of Zenith Medical Clinic, believes the changes give allied health professionals a greater scope of practice and encourage doctors to work with them. However, he would like to see patients given more help to access the help they need.

"Now a lot of onus lies on the patient and family to try to apply for them," said Dr Ang, who works as a medical officer at Grace Lodge nursing home. "What if they cannot fill up forms, or they don't know that they already qualify for these benefits?"

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