MOH to review medical claim limits more regularly

In a recent case, Mr Seow Ban Yam, 83, who underwent surgery at the Singapore National Eye Centre, received only $4.50 from MediShield Life for his subsidised bill of $4,477 - about $1,400 above the MediShield Life claim limit.
In a recent case, Mr Seow Ban Yam, 83, who underwent surgery at the Singapore National Eye Centre, received only $4.50 from MediShield Life for his subsidised bill of $4,477 - about $1,400 above the MediShield Life claim limit.ST FILE PHOTO

It will be done every three years or so, from every five years now

The Ministry of Health (MOH) will review more regularly the claim limits that cap MediShield Life coverage and Medisave payments - around every three years or so.

Senior Minister of State for Health Edwin Tong yesterday promised more regular reviews when he addressed in Parliament the issue of how a patient received only $4.50 from MediShield Life for his subsidised bill of $4,477.

Currently, the plan is for the limits to be reviewed every five years.

Mr Seow Ban Yam, 83, had undergone surgery at the Singapore National Eye Centre (SNEC), and his subsidised bill was about $1,400 above the MediShield Life claim limit.

His case was first reported in The Straits Times.

Mr Tong said the MOH will redouble its efforts to keep healthcare costs sustainable and affordable, and also "keep a close watch on public healthcare costs".

He said that should the current review exercise, which started last year, be completed ahead of time, the revisions will be announced earlier.

  • Payment of subsidised bills

  • AFFORDABLE HEALTHCARE

    Seven in 10 subsidised bills do not require cash payment. As for cash payment for the remaining three in 10:

    •One pays less than $100

    •One pays $100 to $500

    •One pays more than $500

    CHANGES IN MEDISHIELD LIFE

    PAYOUTS IN 2017:

    •$845 million paid out to cover 555,000 claims.

    •Average payout: $1,520

    •Average payout for top 10 per cent of bills: $5,800

    PAYOUTS IN 2015:

    •$448 million paid out to cover 344,000 claims.

    •Average payout: $1,300

    •Average payout for top 10 per cent of bills: $4,000

    From reply by Senior Minister of State for Health Edwin Tong in Parliament

Such a review "requires a careful assessment of the appropriate claim limits and also the consequential impact it may have on premiums, to ensure that the coverage of MediShield Life remains broad-based and sustainable".

Mr Tong was responding to Ms Tin Pei Ling (MacPherson) and Mr Murali Pillai (Bukit Batok) on whether MediShield Life provides adequate coverage.

He told the House that MOH had asked the SNEC to review its charges, and the centre has decided after a review to scale down its fees for the procedure Mr Seow underwent, as well as for a number of other complex procedures that are higher priced, from March 1.

The number of subsidised bills that are within MediShield Life claim limits has fallen from nine out of 10, to eight out of 10. Mr Tong explained that one reason for this is increased healthcare costs.

But even so, about half the bills that top the MediShield Life claim limits do so by $230 or less, he said.

Without claim limits, the premiums for MediShield Life, which insures people based on subsidised rates, will go up significantly, by 30 per cent or more, he added.

"Rather than impose this on all Singaporeans across the board, those who prefer to have higher coverage and are willing to pay higher premiums can consider private Integrated Shield Plans, which can include 'as-charged' features that cover 100 per cent of the bill," he said.

 
 
 

Mr Tong also promised that in reviewing claim limits, "we will ensure that they are in tandem with the cost" and that they also track inflationary cost for the healthcare sector.

Workers' Party Non-Constituency MP Leon Perera asked if there were "pertinent common characteristics" for the 10 per cent of subsidised bills that bust the claim limits by more than $230.

Mr Tong said these were largely the more complex cases, with "patients who don't pass the means test for subsidies" forming a sizeable component.

Do public healthcare institutes check with the ministry when setting their prices, asked Mr Pillai.

To this, Mr Tong said there are "several hundred thousand bills", so it is not possible for the MOH to look at every bill.

But there are guidelines and benchmarks that the ministry will constantly look at and keep within a range that fits in with the philosophy of MediShield Life, he said.

He also promised: "We will continue to review, refine and strengthen MediShield Life and other components of our public healthcare financing system, and just as importantly, manage our healthcare costs to ensure that public healthcare remains affordable for all Singaporeans."

A version of this article appeared in the print edition of The Straits Times on January 16, 2019, with the headline 'MOH to review medical claim limits more regularly'. Print Edition | Subscribe