Changes to Your Medical Insurance | Health Plus

On 7 March 2018, the Senior Minister of State for Health Chee Hong Tat made some pretty big announcements about medical insurance coverage in Singapore.

As of April next year, you’ll no longer be able to purchase Integrated Shield Plans that offer 100% coverage for hospitalisation and medical treatment.

Not sure what that means for you?

Call our hotline at +65 6812 3776 or WhatsApp +65 8799 7787 to let our claims advisor explain out how these changes may affect you. You can also email your questions to askme@parkwaypantai.com. Our financial counsellor will verify with you on the kind of insurance coverage you have, clarify on bill size, payment methods available, and explain the claims applicable for your procedure.

If you’re unsure what is an Integrated Shield Plan, ‘rider’, and what these changes mean for you, read on for the full breakdown.

What is an Integrated Shield Plan?

Integrated Shield Plans offer an additional layer of coverage on top of your mandatory MediShield Life plan. They cover care up to standard single rooms at private hospitals such as Mount Elizabeth Hospitals.

If you have an Integrated Shield Plan (with a full rider), you have the freedom to select the doctor you wish to see, enjoy the privacy of staying in a single room during your treatment, and full coverage on medical costs before, during, and even after your hospitalisation.

Only 6 insurers in Singapore offer Integrated Shield Plans, and these are some of the plans they offer. If you’re covered by any of them, you have an Integrated Shield Plan that can cover treatment at private hospitals:

• AIA HealthShield Gold Max A
• Aviva MyShield Plan 1
• AXA Shield Plan A
• Great Eastern SupremeHealth P Plus
• NTUC Enhanced IncomeShield Preferred
• Prudential PRUshield Premier

If you don’t have an Integrated Shield Plan, you should seriously consider buying one to protect yourself from potentially hefty medical bills in the future. Whether you’re considering to sign up for one or concerned if the recent changes affect your current insurance plan, read on to find out about the changes.

What is a rider?

Basically, insurance ‘riders’ are optional benefits built into your plan that you pay a little bit of extra money for.

All the Integrated Shield Plans listed above offer a ‘full rider’ option. This has always been a popular choice in Singapore because it provides complete coverage for any insurance plan’s deductible (the fixed amount you must pay before your insurance kicks in) and co-insurance (the percentage you must pay after your insurance kicks in).

Deductible for a private hospital with a regular Integrated Shield Plan, for example, is usually set at $3,500, while co-insurance is usually fixed at 10% of the remaining bill. If you opt for a full rider, you don’t pay a cent, even if the total bill size is large.

Not sure if you’ve got a full rider? We can help you make sense of it – Call our affordability hotline at +65 6812 3776 or WhatsApp +65 8799 7787 to find out whether your integrated shield plan can fully cover your hospital bill. Our claims advisor can also share with you estimated bill sizes for common procedures so you can have peace of mind before you decide to undergo treatment.

You can also email askme@parkwaypantai.com. If your insurance does not fully cover your hospital bill, our financial counsellor will give you an estimate of how much you may have to pay out of pocket.

So, what’s all this got to do with the changes?

From 1 April 2019, Integrated Shield Plans with full riders will no longer be available for you to purchase.

All 6 insurance providers who currently offer Integrated Shield Plans with full rider options (listed above) will need to launch partial riders instead, with a minimum co-payment of 5%.

So, in other words, if you choose to purchase an Integrated Shield Plan after 1 April 2019, a full rider won’t be an option. You will have to pay at least a 5% co-payment for hospitalisation and medical treatment.

Will the co-payment be capped?

Yes. If you seek prior approval from your insurer and opt for treatment within their medical network, co-payment costs will usually be capped at $3,000 per year.

Bear in mind, though, that some insurers may choose to set their cap higher than $3,000.

But why has this change been made?

The cost of healthcare has been rising steadily over the years. In the last 2 years alone, insurance premiums have grown by up to 225%.

The Ministry of Health believes this is because of ‘buffet syndrome’. Basically, there are too many people claiming unnecessary or overly expensive procedures using their full riders, which in turn is driving up insurance premium costs for the general public.

In fact, in 2016, the average medical bill size for policyholders with full riders was around 60% higher than the average bill size for policyholders without them.

The Ministry of Health hopes this new change will lower average medical bill sizes, therefore keeping premium costs down, and in the long term, result in more savings for you.

I already have an Integrated Shield Plan with a full rider. What does this mean for me?

If you’re one of the 1.1 million Singaporeans who bought an Integrated Shield Plan with a full rider before 8 March 2018, you will not be affected by this change.

Your insurer must continue to honour the contract they have with you.

However, it’s important to be aware that all the insurers are reviewing the current policy plans and can change your coverage at any time, providing they let you know 31 days in advance.

If this happens, you will have the option to cancel your contract.

Of course, if you’d rather go ahead and switch to the new rider format in 2019, you can. But remember to check that your pre-existing conditions are still covered after the switch. You’ll just need to start paying the required co-payment for any hospitalisation and treatment charges incurred.

I’m planning to buy an Integrated Shield Plan with a full rider in the next few months. What does this mean for me?

If you’ve purchased a full rider since 8 March 2018, or you go ahead and purchase one before 31 March 2019, you will only have full coverage until 31 March 2021.

After 1 April 2021, your coverage will switch to at least a 5% co-payment for hospitalisation and medical treatment. This switch is mandatory and you won’t be able to change it back.

I’m planning to buy an Integrated Shield Plan later down the line. What does this mean for me?

If you purchase an Integrated Shield Plan after 1 April 2019, your coverage will include at least 5% co-payment for hospitalisation and medical treatment.

The exact percentage you need to pay should be clear before you sign any contracts.

OK. So, let’s say I’m going to need to pay 5% – what might that cost me in practice?

Concerned about what a 5% co-payment might mean for you? Here’s an example based on an average inpatient procedure (hospitalisation for 1 night):

• You fall at work and need to undergo a knee meniscectomy, a minimally invasive surgery, to treat torn cartilage (tissues) around your knee joint.
• The treatment and stay at a single room at Mount Elizabeth Hospital would usually cost $14,539 (including hospital fees, doctor fees and GST, and at 50th percentile – meaning half of patients pay less than this amount) to treat this.
• With a 5% co-payment, you’d have to pay $727 out of pocket.

I’m still a bit confused about all this. What should I do?

First of all, don’t panic and rush to change providers based on the news! Remember, if you’ve had a full rider since before 8 March 2018, your coverage won’t change.

Secondly, if you do intend to change your plan, make sure you check that pre-existing conditions will be covered if you a) switch to a new insurance provider, or b) upgrade your plan with your current provider.

Call us at +65 6812 3776 or WhatsApp +65 8799 7787 and our claims advisor will advise whether your integrated shield plan can fully cover your hospital bill. You can also find out the estimated bill sizes for common procedures to help you plan your expenses.

You can also email askme@parkwaypantai.com with your queries. Our financial counsellor can help to verify your insurance coverage, and explain whether it can fully cover your hospital bill, the payment methods available, and claims you may make for your treatment. We can also give you an estimate of how much you may have to pay out of pocket if your insurance does not fully cover your hospital bill.

 

Article reviewed by claims advisor at Mount Elizabeth Hospitals

References

Baker, J. A. (2018, 7 March). 5% Co-Payment for New Integrated Shield Plan Riders to Help Address Over-Consumption of Medical Services. Retrieved 24 April 2018 from https://www.channelnewsasia.com/news/singapore/5-per-cent-co-payment-new-integrated-shield-riders-10021398

Ho, T. (2018, 12 March). 5 Facts About the Latest Integrated Shield Plan Changes that Singaporeans Need to Know. Retrieved 24 April 2018 from https://sg.finance.yahoo.com/news/5-facts-latest-integrated-shield-002046065.html

Ng, K. (2018, 24 April). Co-payment Mandated for New Insurance Riders in Bid to Curb ‘Buffet Syndrome’. Retrieved 24 April 2018 from https://www.todayonline.com/singapore/5-co-payment-required-all-new-integrated-shield-plans-full-riders-moh