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COVERING special needs children for treatment relating to congenital or pre-existing illnesses under Medishield is not a viable option, as premiums paid by policyholders may go up by seven-fold if so.
Health Minister Khaw Boon Wan said this in Parliament on Monday in response to a question posed by MP for Jalan Besar Denise Phua Lay Peng.
Ms Phua had asked the minister if it were possible to cover children born with congenital illnesses, and how much it would cost families to cover such children.
In reply, Mr Khaw said: 'It will be unusual for insurers to cover preexisting illnesses or to cover treatment relating to congenital diseases, (as) to do so will be to load the burden on the rest of the policyholders who may not support a manyfold increase in premiums to take on this additional liability.'
He stressed that 'if medishield were to cover pre-existing illnesses, it will encourage potential policyholders to delay subscription until they are sick'.
This, he said, would 'defeat the whole purpose of insurance, which is based on the sharing of burden, among policy holders with similar risk profiles'.
To mark his point, Mr Khaw said a person below the age of 18, or 30 even, who pays a premium of $30 a year today, could find this cost raised to more than $200 a year if they were to load this liability on.
'I think to load this onto the rest of the population, with such a hefty increase in payment, i think it is hard to justify,' he said.
While it was not sustainable to cover special needs children under basic Medishield, Mr Khaw said some private insurers such as Prudential, HSBC and NTUC do offer cash benefit products.
These products pay lump sum amounts, if, for example, a baby is diagnosed with specific congenital anomalies.
But subscription for these products must be made prior to the discovery of any known anomaly.
Nonetheless, Mr Khaw said that persons with congenital illnesses can still join medishield like all other Singaporeans and obtain coverage for medical treatment, as long as it is not related to their congenital condition.
Update on Medishield reforms
Speaking in Parliament on Monday, the minister also gave an update on average payouts since the implementation of the recent Medishield reforms.
For Medishield, which covers Class B2 and C Hospitalisation, the average payout has increased from $837 per claim to $1,274 - an increase of more than 15 per cent.
For large hospital bills, basic Medishield now covers about 60 per cent of class B2 and C bills above $10,000, up from 40 per cent before the reforms.
The average payout for these large bills has now risen to $9.800 per claim from $7,300 before reforms.
Going forward, Mr Khaw said he aimed to reduce the burden of patients with large bills even further, from 40 per cent to 20 per cent.
This he said, 'would require an increase in premiums, but we will see if the required increase can remain affordable'.
Details are expected to be finalised by early next year.
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