Policyholders worried if changes to Integrated Shield Plans will affect them

The Government announced in Parliament that those buying a new rider will need to pay at least 5 per cent of their hospital bill. PHOTO: ST FILE

SINGAPORE - Soon after The Straits Times reported on Wednesday morning (March 7) that six companies selling MediShield Life-linked health insurance had appealed to the Health Ministry (MOH) for policyholders to pay part of their hospital bills, insurance agent Alfred Toh was contacted by five of his worried clients.

But they are among the 1.1 million who already have full riders for their Integrated Shield Plans, which covers the deductible and the co-payment.

Then the Government announced in Parliament on Wednesday evening that those buying a new rider will need to pay at least 5 per cent of their hospital bill.

Mr Toh, 35, who is with Great Eastern, said soon after the announcement, six more clients contacted him. Their applications, which include full riders, are currently being underwritten by him.

Anyone buying a rider from March 8 has to switch to the new scheme by April 1, 2021.

With the changes, the total amount that a policyholder has to pay can be capped at $3,000 a year, although insurers are free to set a higher threshold.

This cap applies only if patients are treated by doctors on the insurer's approved panel, or had received prior approval from the insurer. Otherwise, the 5 per cent co-payment will not be capped.

MOH is giving insurers until April 1 next year to come up with new riders that include the co-payment and cap.

In announcing the changes, Senior Minister of State for Health Chee Hong Tat said they are to address the concerns with "overconsumption, overservicing and overcharging".

Policyholder Cathie Chew, 46, recently enhanced her coverage with a full rider that came into effect on March 5.

While relieved, she said the changes do not target the root cause - the few "rotten apples".

Ms Chew, who is also an insurance claims specialist, said: "Look at the few fraudulent cases, how they came about, and bring these people to task."

A spokesman for AIA Singapore said its clients will be informed of any changes to their coverage at least 31 days before the change takes effect.

Meanwhile, AXA said it intends to adopt the guidelines and offer the co-payment and cap rider for new customers by April 1 next year.

When asked about clients misusing full riders, insurance agent Lim Yao Hui, 37, said healthcare professionals are also responsible for overprescribing treatment and medicine.

"If you are a policyholder with abdominal pains and are referred to a specialist by your general practitioner, and if the specialist recommended a diagnostic test, you wouldn't say no, would you?

"We insurers are doing our best, but the doctors also have to make better judgment."

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