The Ministry of Health (MOH) announced on 29 September 2020 that it will be reviewing the existing MediShield Life coverage. As part of the review process, a public consultation will be held from 29 September 2020 to 20 October 2020 to seek Singaporeans’ views on how MediShield Life can be improved.
However, the MediShield Life Council has also identified some gaps and possible solutions that it feels can be implemented in the future to improve how MediShield Life works. Here are 5 things to know about some of the key changes for MediShield Life that are being recommended.
#1 Increase In Annual Claim Limit From $100,000 to $150,000
There is currently a claim limit of up to $100,000 on MediShield Life each year. This means that MediShield Life policyholders (i.e. Singaporeans and PRs) can only claim up to a maximum of $100,000 each year from their MediShield Life.
$100,000 may seem a lot. However, in extreme cases, it may not be sufficient even after government subsidy. According to MOH, an 8-year-old Singaporean who was hospitalised in a C class ward for 147 days due to epilepsy, including over 80 days in the Intensive Care Unit (ICU) incurred a total bill of $142,100 after government subsidy.
As such, the family had to pay $42,100 in cash, MediSave, or through MediFund. With the revised annual claim limit, Singaporeans and PRs will be better protected against such large hospital bills.
#2 Higher Claim Limit For Daily Ward & Treatment Charges For First Two Days In Hospital
Currently, the claim limit for daily ward & treatment charges are at $700 per day. However, the MediShield Life Council recognises that higher charges tend to be incurred by patients during the first two days of their hospital stay due to the need for diagnostic tests and investigations that typically occur within the initial period.
As such, it’s recommending a higher claim limit of $1,000 for daily ward and treatment charges for the first two days of acute hospital stay.
#3 Introduction Of Treatment-Specific Claim Limits For Community Hospital Care & Outpatient Radiotherapy
Currently, policyholders can claim up to $350 per day from MediShield Life for community hospital care. However, aside from rehabilitative care, community hospitals also provide sub-acute care. Sub-acute care is costlier as it is for more complicated medical conditions that require more medical and nursing care than rehabilitative care. To ensure that sub-acute patients receive similar coverage, the Council is recommending a higher claim limit of $430 a day, under the preliminarily recommended claim limit for sub-acute care in Community Hospital.
Similarly, certain types of outpatient radiotherapy are costlier and thus the recommended introduction of more treatment-specific claim limits would help to improve coverage for these costlier types of outpatient radiotherapy treatment.
#4 Removal of standard exclusions for treatments arising from attempted suicide, intentional self-injury, drug addiction, and alcoholism
There are currently standard exclusions for treatments arising from attempted suicide, intentional self-injury, or drug and alcohol abuse.
In recognition that treatment plays an increasingly important part in the support and recovery of these patients, the MediShield Life Council recommends removing these exclusions from MediShield Life.
#5 Pro-ration Factor For Private Hospital To Be Reduced From 35% To 25%
If you seek treatment at a private hospital, you would still be able to make claims against MediShield Life. That said, MediShield Life payouts are pegged at subsidised bills at public hospitals, which are generally much lower than private hospital bills. The pro-ration factor is applied on a private hospital bill to adjust it down to the equivalent level of a subsidised bill, before the payout is computed.
Currently, the pro-ration factor is 35% for private hospital. However, the recommendation is for the pro-ration factor to be reduced to 25%. This means that if you incur a private hospital bill of $50,000, MediShield Life would recognise the bill at $12,500 (25%) and any claim being made on MediShield Life will be based on the pro-rated amount.
Expect Higher Premiums For Greater Coverage
In general, most of the proposed changes to MediShield Life is meant to enhance coverage. Logically, greater coverage will come at a higher cost. This means that moving forward, Singaporeans and PRs can expect to pay higher premiums for their MediShield Life coverage.
Based on the table above, it appears that older Singaporeans will see a higher increase in premiums before subsidies are applied. According to MOH, there will be a one-off government subsidy of 70% of net increase in the first year and 30% of net increase in the second year.
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