Changes to MediShield to improve coverage

SINGAPORE - Singaporeans worried about hefty medical bills even as they live longer have a new lifeline from MediShield.

It is scrapping the maximum entry age - now 75 - for joining the low-cost catastrophic illness insurance scheme that will also pay out more from March. And it is extending coverage up to age 90.

The lifetime claim limit will go up from $200,000 to $300,000, while the maximum amount claimable each year will also rise, from $50,000 to $70,000.

Last year, 43 people reached the lifetime limit of $200,000, up from 11 people in 2010. Another 63 are close to the limit, having claimed more than $190,000.

More than 90 people had annual claims exceeding $50,000 in both 2009 and 2010. Figures for last year are not available yet.

The revisions to the lifetime and annual claim limits will allow these people to continue enjoying insurance coverage.

These were among various proposals put up by the Health Ministry in July, but the lifting of the entry age cap and allowing higher Medisave withdrawal to pay for premiums came from public feedback.

All the amendments to MediShield, which covers 92 per cent of the population, will take effect on March 1.

To cater to Singapore's rapidly ageing population, it will cover people up to age 90, from 85 now. About 1,700 people aged 86 to 90 who were previously covered by MediShield will be invited to join the scheme again. They will have to pay premiums of $1,190 a year.

On Thursday, Health Minister Gan Kim Yong said that following public feedback, the maximum joining age of 75 will be removed, but anyone with pre-existing diseases will have such ailments excluded from coverage.

The insurance will not be expanded to babies born with congenital diseases or needing neonatal care. Mr Gan, speaking on the sidelines of a seniors' event at Republic Polytechnic, said these will form part of a bigger package to boost marriage and parenthood.

Other changes include allowing $100-a-day claims for acute psychiatric hospital care for up to 35 days a year.

Short stays at emergency departments will also be claimable.

To pay for these, premiums will go up by between $17 and $251 a year. The Government will give a one-off top-up to Medisave of between $50 and $400 for people on MediShield.

Deductibles - the amount patients have to pay before insurance kicks in - go up by $500: From $1,000 to $1,500 for C class, and from $1,500 to $2,000 for B2 and higher. There will be no change for those over age 80 as they already pay higher deductibles of $2,000 for C class and $3,000 for B2 and higher.

Mr Gan said MediShield is meant to cover big hospital bills, but today, it covers half the subsidised bills. With the change, it should cover about one in three C-class bills, he added.

"It is important to ensure that the deductible keeps pace with the bill size... so that premiums remain affordable," he said, noting that deductibles have to be adjusted periodically to keep pace with rising health-care costs.

To allow full payment of premiums with Medisave, the withdrawal limits will go up from $800 to $1,000 for those aged 76 to 80, and from $1,150 to $1,200 for those over 80.

But a request from the public to have Medisave pay for insurance riders, so patients will not need to pay either the deductible or co-payment, was rejected as the ministry fears such a move would "lead to overconsumption and overservicing of health care".

salma@sph.com.sg


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