National genetic testing programme results can’t be used for insurance underwriting: Ong Ye Kung

SINGAPORE – Safeguards and upcoming new laws in Singapore will ensure that genetic information from patients will not be available to their medical insurance company, the Ministry of Health (MOH) has said.

Providing this assurance at the official opening of the nation’s first genomic assessment centre (GAC) at the National Heart Centre Singapore, Health Minister Ong Ye Kung reiterated that all test results from the

national genetic testing programme for familial hypercholesterolaemia (FH)

cannot be used for insurance underwriting.

FH is a hereditary condition caused by mutations in genes, impacting the body’s ability to process cholesterol. Left untreated, the hypercholesterolaemia – high blood cholesterol levels – over time would lead to severe health issues.

When an individual has obtained a medical diagnosis needed for insurance underwriting, such as having hypercholesterolaemia, only the diagnosis needs to be disclosed as part of his medical history when purchasing insurance policies.

If the individual undergoes genetic testing for FH, he does not need to disclose the test results, and they cannot be used in insurance decisions, reiterated Mr Ong, who is also Coordinating Minister for Social Policies.

He added: “Undergoing genetic testing does not place individuals in a worse position, as far as insurance underwriting is concerned.”

However, Mr Ong did raise an exception where insurers could request additional information, including genetic test results, mainly to prevent abuse of insurance coverage.

For instance, if a person undergoes a genetic test and realises he carries a mutation that could lead to severe diseases later in life, he might abuse the system by loading up on more insurance policies, in the hope of making claims in future.

Hence, for very large policies, such as those with claims of $1 million or more, insurers may request additional information, to ensure fairness for all policyholders – a practice consistent with other countries.

MOH and the Life Insurance Association expanded a moratorium on genetic testing and insurance on June 30, 2025, to strictly prohibit life insurers from requesting and using all genetic test results obtained from the national FH genetic testing programme in their insurance underwriting.

This built on the earlier moratorium introduced in 2021 that banned life insurers here from using predictive genetic test results in assessing the outcome of insurance applications, unless certain criteria are satisfied.

Insurers are also not allowed to use genetic test results from biomedical research or direct-to-consumer genetic test results.

More than 1,000 individuals have been identified and referred for FH genetic testing at the SingHealth GAC since it started operations on June 30, 2025. However, only around 40 per cent eventually got themselves tested.

Mr Ong said that among those who declined to be tested, most expressed concerns about how the test results might affect their insurance and employment, or how they would be perceived by their relatives and society.

“These safeguards should provide individuals with better peace of mind to undergo FH genetic testing... and benefit from preventive and earlier intervention,” he said.

MOH will also be entrenching the safeguards in law to provide greater reassurance. Public and stakeholder consultation on the proposed legislation will be conducted in the first half of 2026.

According to the US Centers for Disease Control and Prevention website, untreated FH can result in heart attacks in 50 per cent of male sufferers by age 50, and in 30 per cent of female sufferers by age 60.

Reiterating the importance of being tested and treated early for genetic conditions such as FH, Mr Ong said: “The tests can provide useful and unique information about your health risks. You can then make informed decisions about your lifestyle, health and family planning.

“Ultimately... decisions about genetic testing should be guided by health considerations, not insurance considerations,” he said.

Besides the SingHealth GAC, the GACs under NHG Health and National University Health System (NUHS) have begun accepting referrals from Jan 2, to benefit more people with earlier testing for FH and timely interventions.

NHG Health told The Straits Times that it has set up two GACs – one at Tan Tock Seng Hospital Medical Centre in Novena, and another at Admiralty Medical Centre’s Diabetes Centre in Woodlands.

NUHS’ GAC is set up at National University Hospital, according to information on the hospital’s website.

FH is currently the only genetic condition subsidised under a national programme, and MOH is exploring similar programmes for other genetic conditions.

The next possible condition to be covered is hereditary breast and ovarian cancer, Mr Ong had said in November 2025.

He said on Jan 19 that MOH is also studying how to integrate artificial intelligence (AI) into genomics-enabled care.

“For example, we examine how AI can help us further refine the FH programme, enabling us to identify high-risk individuals with greater accuracy,” said Mr Ong.

He also reiterated that the professional standards of practice and societal guard rails need to evolve in tandem with technology, to continue to maintain public trust in healthcare.