How will the new requirements for Integrated Shield Plan riders affect you?
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New riders sold from April 2026 will not be allowed to cover the minimum deductibles that patients have to pay for hospital care before insurance kicks in.
ST PHOTO: LIM YAOHUI
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SINGAPORE – New Integrated Shield Plan (IP) riders sold from April 1, 2026, will no longer be allowed to cover the minimum deductibles
IP holders with the new riders will also need to pay a larger portion of their bills, as the co-payment cap on their maximum out-of-pocket cash will be doubled from the current $3,000 to $6,000.
As a result, these new riders are expected to cost a lot less, with the Ministry of Health (MOH) estimating premiums to be about 30 per cent lower than those of existing riders with maximum coverage.
The Straits Times looks at the impact of these upcoming changes announced by the ministry.
Q: Who will be affected by the changes?
A: Those who bought IPs with riders before the Nov 26 announcement will not be affected immediately, pending insurers’ decisions.
Those who intend to buy IPs with riders by March 31, 2026, have to meet MOH’s requirements.
Q: What is the difference between MediShield Life and an IP?
A: All Singaporeans are insured under the national MediShield Life scheme, which covers subsidised care in public hospitals and certain outpatient treatments, such as radiotherapy and kidney dialysis. Premiums can be paid for entirely from your MediSave account.
An IP is optional health coverage provided by private insurers on top of MediShield Life, typically to cover stays in A- or B1-type wards in public or private hospitals. Premiums can be paid for with MediSave up to a cap based on your age.
Today, around 71 per cent of residents here, or about three million people, have IPs.
Q: What does a rider offer?
A: IP insurers sell riders on top of the IP to cover the patient’s share of the bill – the deductible and the remainder of the bill not covered by MediShield Life and IPs. Premiums for riders must be paid fully in cash.
Today, about two-thirds of IP holders, or about two million residents, have riders. Among them, two-thirds have riders with maximum coverage, which means they pay only the deductible and a 5 per cent co-payment, capped at $3,000, if they receive panel or pre-authorised treatment.
The minimum IP deductible set by MOH ranges from $1,500 for stays in a Class C ward to $3,500 for a Class A ward or a private hospital stay. This is the amount the patient has to pay before insurance kicks in. Multiple bills in the same year can count towards the deductible, which is paid once a year.
Q: How much does a rider cost?
A: Rider premiums, just like other health insurance premiums, increase with age, and are usually several times the cost of MediShield Life premiums.
Currently, a 40-year-old policyholder has to pay around $3,400 in premiums each year for a private hospital IP and rider, while a 60-year-old policyholder pays about $9,500 each year.
Q: Is this the first time the authorities have imposed stricter requirements on IP riders? If not, why is there a need to act on riders again?
A: MOH introduced rider co-payment in 2018, with policyholders of all new riders then facing a minimum 5 per cent co-payment. This means that after the patient pays off the deductible, at least 5 per cent of the remaining bill still needs to be borne by the patient.
To protect against huge bills, insurers also had to set a co-payment cap of at least $3,000 each policy year for treatments that were pre-authorised or provided by doctors on the insurer’s approved panel.
However, MOH noticed that the very comprehensive coverage of riders that protects up to almost the last dollar could be very expensive and drives up healthcare costs.
The ministry’s data shows that private hospital IP holders with riders are 1.4 times as likely to make a claim, with an average claim size 1.4 times that of policyholders without riders.
As a result, bill sizes and claims are rising significantly; this in turn drives up insurance premiums, especially for riders.
MOH hopes the new rider requirements will instil discipline in healthcare consumption, particularly for minor episodes. For instance, it is commonly known that some patients choose to be hospitalised for scans as the stay is covered by insurance, even though this is “non-essential admission”.
Q: When can I buy or switch to the new riders that have lower premiums?
A: All seven IP insurers have told The Straits Times they will launch new riders that meet MOH’s requirements at the latest by April 1, 2026.
Q: If my existing rider does not cover the minimum IP deductibles, should I upgrade to one that covers deductibles before April 2026?
A: The Life Insurance Association Singapore (LIA) encourages policyholders to proactively consult their financial advisers to review their existing insurance coverage.
Policyholders who upgrade their riders will have to pay higher premiums.
Q: If I already have a rider, should I switch to the new riders from April 2026?
A: LIA encourages policyholders to proactively consult their financial advisers to review their existing insurance coverage.
Existing rider policyholders can switch to the new riders launched from April 2026 without additional underwriting if these offer similar or lower benefits, said LIA.
For those who wish to upgrade their riders – either during the transition period, or to the new riders when they are launched – additional underwriting will be required.
Q: If I have an IP but do not have a rider, should I buy it now before the new requirements kick in?
A: Premiums for riders are generally higher than premiums of the base IPs.
If you buy a rider during this transition period but it does not meet the new requirements, you would still have to switch to one that fulfils the requirements when your policy is due for renewal from April 1, 2028.
IP insurers will facilitate the transition without additional underwriting
Q: Does the $6,000 annual co-payment cap mean that no matter how big my bill is, that will be all I need to pay?
A: Yes, but only if you are treated by the insurer’s panel of doctors or have received pre-treatment approval from the insurer.
Should you choose a doctor not on the panel or seek treatment that has not been pre-approved, the insurer may not cap what you need to co-pay at $6,000 a year.
This means that you will have to pay 5 per cent of the remaining bill after deductibles, no matter how large it is.
Q: Will the new rider requirements bring down private healthcare costs and premiums for everyone in future?
A: MOH said changes to rider design should, over time, help moderate overall healthcare costs and arrest the escalating trend of private healthcare costs and premiums.
It has also taken a suite of measures to address rising private healthcare costs, including setting fee benchmarks doctors who make inappropriate claims
Correction note: This story has been updated for clarity.
