This article first appeared on fundMyLife, the platform that connects financial planning questions to the right advisers.
MediShield Life is a national health insurance scheme that protects all citizens and PRs regardless of economic status and health to cope with large hospital bills. They can also purchase Integrated Shield Plans as an upgrade to their basic plan to stay in higher class wards. We had the impression that there is plenty to add on top of our previous piece on the most common misconceptions about Integrated Shield Plans. As such, in this article fundMyLife asks another three of its financial advisers – Michelle Ngiam from Great Eastern, Roshan Belani from AIA, and Melvin Liu from Manulife – about the most common questions on Integrated Shield Plans.
Michelle Ngiam, Great Eastern
# 1 “Do I still have to pay for MediShield Life when I buy an Integrated Shield Plan?”
Yes, an Integrated Shield Plan is an upgrade of MediShield Life. Therefore, MSHL is still embedded within the IP. By paying the premium to the private insurer, you are actually paying for 2 components – MediShield Life premium and private insurance company premium. CPF still deducts the MSHL premium from your payment.
# 2 “I already have MediShield Life. Why do I need an Integrated Shield Plan?”
MediShield Life will provide coverage for your large hospital bills in Class B2/C wards in government hospitals. If you prefer to seek treatment in Class A/B1 or in private hospitals, MediShield Life will not be able to cover the bill fully, leading to you forking out more from your MediSave account or cash.
Therefore, by upgrading your MSHL with an Integrated Shield Plan, you have the choice to cover all the way up to private hospitals. This allows you to have the option to go to any ward of your choice.
# 3 “Will premiums increase after I purchase an Integrated Shield Plan?”
Yes, generally premiums will increase as you get older. However, there are also a few factors at play here.
Firstly, it depends on how the insurance companies price their premiums. Most insurers also use an age-band premium scheme like MediShield Life. For example, if you are 35 years old, you will be paying the same premium as the rest of the people insured within the same age band of 31 to 40 years old. The premium will increase once you enter the next age band (in this example, 41 to 50 years old).
Secondly, they are affected by government policies regarding health insurance in Singapore. In 2015 when the government upgraded MediShield to MediShield Life (MSHL), the premiums were also increased with added benefits. With the upgrade of MSHL, insurance companies had to reprice their plans to cover the new premiums of MSHL, with enhanced benefits for better overall coverage.
Lastly, how the claims experience for the insurer has been like. In recent years, many insurers have faced rising claims and it has affected the premiums leading to premium hikes. The increases were largely focused on plans covering private hospital treatments and stays.
Roshan Belani, AIA
# 1 “Will I be covered for treatment overseas?”
The answer is both yes and no. For most integrated shield plans, overseas treatment is only covered if it is deemed to be an emergency. At best, even if a plan allows for general overseas coverage, the benefit payable is still limited to the level of Reasonable and Customary charges in a Singapore private hospital. With this limit, say if a surgery in the US cost $20,000, had the same surgery been performed in a private hospital in Singapore at $10,000, then the claimable amount would only be based on the customary charges in Singapore, which is $10,000 in this example.
As such, it is important to determine whether overseas coverage is necessary. For most who are working in Singapore, shield plans generally provide good level of coverage for the individual based here. However, for those who are working or studying overseas, having a global plan or even a plan that is available in that country will be a great complement to the shield plan. The shield plan should still be active in case the individual decides to come home to Singapore for various reasons such as finding a job, starting a family or even retirement.
# 2 “Does an Integrated Shield Plan cover me for pregnancy?”
This is a question commonly asked by first-time mothers as they prepare themselves for the cost of pregnancy. To be very clear from the beginning, a pregnancy without complications with straight forward procedures will not be covered under a integrated shield plan. This is because there was no ‘risk’ or incident that required protection from per se and thus, the bill would not be reimbursed. However, should pregnancy complications arise during the pregnancy, and if it falls within the definitions as stated in the integrated shield plan, the bill would be reimbursed accordingly.
Of course there are maternity insurance plans out there that provide cover for even normal deliveries and prenatal consultations. However, they are in addition to the integrated shield plan and generally cost much higher premiums.
# 3 “Can I be covered for outpatient treatments?”
Again, the answer is yes and no. For outpatient treatments, they are claimable only under two conditions: 1) Treatments and consultations eventually lead to confinement in the Hospital for hospitalisation or a surgery being done and 2) falls within the allowed number of days for pre & post hospitalisation benefit. Both conditions must be met and if either one fails, the outpatient treatments is not claimable.
To give an example of how condition 1) might not be met, an individual who fractured his foot was referred to a specialist but was told that no hospitalisation or surgery was necessary. Consultations and treatment costs for its healing would not be covered since the individual did not have to stay in the hospital or require a surgery.
To give an example of how condition 2) might not be met, an individual recalled having seen a specialist about 4 months (120 days) from his hospitalisation. His integrated shield plan only allowed for 100 days for pre-hospitalisation treatment. As the number of days exceeded the allowable limit (120>100), the consultation and treatment that day would not be reimbursed.
Melvin Liu, Manulife
#1 “Can my hospital plan cover me for diagnostic procedures like colonscopy or endoscopy?”
Colonscopy, endoscopy and similar procedures are considered as day surgery procedures and will be covered under shield plans. However, it’s important to note that this will depend on whether its a routine check-up or whether it is ordered by your doctor during a consultation. It may not be covered if it is simply a health screening.
#2 “Can my shield plan cover me if I am hospitalised overseas?”
Overseas cover generally apply to emergency hospitalization, and for some insurers, benefits may allow for pre-arranged overseas inpatient treatment which is pre-approved by the insurer. It is best to buy additional travel insurance if going overseas.
#3 “I recall I have bought a hospital plan, but I can’t remember which insurance company I bought from or what plan I bought. How do I check?”
You can login to your CPF account under: My Messages > Healthcare > MediShield Life/ Integrated Shield Plan. From there you should be able to see which company is your insurer. You can contact your insurer to find out the details of your plan.
Discussion Round Up
Michelle provided the rundown on common consumer concerns on getting Integrated Shield Plans, such as what it is and whether premiums will increase.
Roshan explained that Integrated Shield Plans do not cover normal pregnancies, but will kick into effect when there are complications that occur during pregnancy. He also shared that Integrated Shield Plan claims for outpatient treatments can be a bit complicated, as it depends on whether the outpatient treatment results in hospitalisation or surgery and that the outpatient treatment fell within a stipulated time frame from hospitalisation.
Both Roshan and Melvin wrote about whether Integrated Shield Plans will help when the consumer is overseas – they both recommend that it’s wiser to get travel insurance when travelling. Melvin cautions that endoscope procedures is covered if it is ordered by a doctor, but a routine checkup is not covered. He also gave advice on how to check which company the consumer bought the Integrated Shield Plan, by going to the CPF website.
We hope this article shed light into the most commonly asked questions on Integrated Shield Plans. If you have more queries or are considering to get insurance but don’t know who to ask, you can head over to fundMyLife. Alternatively, you can connect with either Michelle Ngiam from Great Eastern, Roshan Belani from AIA, or Melvin Liu from Manulife and ask them questions directly on their profile pages.
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