MediShield Life to offer higher payouts with new claim limits

Jan 1 changes will benefit 90,000 a year although premiums will stay the same

MediShield Life is a basic health insurance plan that helps to pay for large hospital bills and selected costly outpatient treatments. PHOTO: ST FILE

Patients who need surgery will be able to claim more from their compulsory health insurance from Jan 1, the Ministry of Health (MOH) announced yesterday.

This comes as MediShield Life claim limits are being raised, a move which is expected to benefit around 90,000 patients a year.

MediShield Life is a basic health insurance plan that helps to pay for large hospital bills and selected costly outpatient treatments, such as dialysis and chemotherapy.

All Singaporeans and permanent residents are covered by MediShield Life, which is administered by the Central Provident Fund Board.

Patients undergoing surgical procedures listed in the MOH's Table of Surgical Procedures can claim from MediShield Life and tap their Medisave to pay for their surgical bills subject to claim limits.

There are currently seven tiers of MediShield Life claim limits to cater to surgical procedures of different complexities.

This number will triple to 21 from next year, allowing for more differentiation between procedures of varying complexities.

The new set of limits, offering higher payouts, will take effect for those admitted for surgical procedures from Jan 1.

For instance, Patient A who undergoes a complex uterus operation might currently be able to claim only up to $1,400 - the same amount as Patient B who undergoes a simpler uterus operation.

Under the revised limits, Patient A would be able to claim up to $2,180. Patient B would be able to claim up to $1,800 for the simpler procedure, less than Patient A, but $400 more than the previous limit allowed.

MOH said yesterday that the introduction of the new tiers will provide better coverage for more complex surgical procedures, which tend to be costlier.

There will be no adjustments to premiums at this point, as the Government committed to keeping premiums constant for five years when MediShield Life was launched in November 2015.

The claim limits were adjusted to keep pace with increasing healthcare costs since 2015.

The claim limit revisions were recommended by the MediShield Life Council as part of its review exercise, which started last year and is expected to be completed by the end of next year.

Senior Minister of State for Health Edwin Tong said yesterday that the new claim limits would be implemented first so patients can benefit earlier from the changes.

He added: "The new claim limits will improve MediShield Life coverage for more complex surgical procedures and better protect Singaporeans against large hospital bills... We will continue our efforts to keep healthcare costs sustainable and affordable for all Singaporeans."

Patients do not need to take any steps to benefit from the new limits, which will be automatically applied to their MediShield Life claims.

Dr Lily Neo, deputy chairman of the Government Parliamentary Committee for Health, said: "It is useful to have such revisions... Not all conditions are the same or require the same standardised procedures, so if we can have more tiers, that will better accommodate various conditions that require different types of treatment or better technology."

In its statement, MOH emphasised that the Government provides significant subsidies of up to 80 per cent to keep healthcare costs low, and that there are various forms of financial assistance available for those in need.

It added: "No Singaporean will be denied appropriate healthcare due to an inability to pay."

CLICK HERE TO LISTEN TO ST'S HEALTH CHECK PODCAST

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 December 28, 2019, with the headline MediShield Life to offer higher payouts with new claim limits. Subscribe