Lifetime limit for MediShield now up to $300,000

When dialysis patient Job Loei heard that the lifetime limit of his MediShield claim will be increased from $200,000 to $300,000 next year, he was relieved. It means he will be covered for at least another 10 years.

This is one of the proposed changes to MediShield, which will come into effect in the first quarter of next year.

Medishield is Singapore's basic medical insurance scheme that focuses on large bills. The 47-year-old told The New Paper that he is nearing the lifetime limit of $200,000 and will exceed it by the end of the year.

The monthly cost of his dialysis at the National Kidney Foundation (NKF) is $1,800, of which $1,000 is paid from MediShield, with the NKF subsidising $500.

Mr Loei pays just $300 from his own pocket.

If the lifetime limit were not revised to $300,000, Mr Loei estimates that, after subsidies from NKF, he will be out of pocket by$1,000 for his dialysis - an increase of $700.

He said: "I'm the sole bread-winner. My wife doesn't work. I have only one child, but I have ageing parents to support too. We live in a three-room flat and this comes as a huge relief."

Mr Loei, who works at NKF as its senior manager of admissions and support group management, has been undergoing dialysis for 18 years, thrice weekly at NKF, with each session lasting an average of four hours.

With the lifetime limit being revised upwards, Mr Loei reckons his MediShield will last him another 10 years.

Other changes to MediShield include raising its maximum coverage age from 85 to 90 and extending the scheme to include inpatient psychiatric treatment. There is also a possibility of congenital and neonatal conditions being covered under MediShield.

What the proposed changes mean is that MediShield premiums will rise, but a one-time Medisave top-up will offset part of or the full premium increase for two years.

Those aged between 21 and 60 will see their MediShield premiums increase by about $1 to $5 a month.

Worried

Ms Sharon Siak, a fast-food restaurant worker who falls in this age-group, is worried. The 45-year-old's take-home pay, after CPF deductions, is $800.

Said Ms Siak: "I used to have $12,000 in my CPF, but it's now $3,000 because I used (most of) it for my late mother's treatment, who was diabetic.

"I'm worried that if something happens to me and I have to use my Medisave, will there be enough from my to pay for my MediShield premiums?"

She told TNP that should the premiums become unaffordable and there is insufficient fund in her Medisave, she would have "no choice" but to opt-out or let it lapse.

However, older Singaporeans aged 65 and above will receive annual Medisave top-ups under the GST Voucher Scheme, in addition to the one-time Medisave top-up.

The last round of adjustments to MediShield was in 2008. Since then, MediShield claims have increased, both in terms of numbers and the average payout per policyholder.

The number of claims per policyholder has increased by 9 per cent per year, while the average payout per policyholder has risen by 12 per cent per year.

This is mainly due to a bigger and ageing population, greater awareness and use of medical services, higher costs associated with new and improved medical technology and treatments, and the general medical inflation of about 3 per cent per year.

Speaking on the sidelines of the opening launch of the Simulation and Integrated Medical Training And Advancement Centre at Tan Tock Seng Hospital yesterday, Health Minister Gan Kim Yong said: "This is in line with our topline inflation over the last few years.

"In addition to this underlying inflation, we would also see a growing population and a greying population, so we tend to use health-care facilities more often."

Furthermore, new methods of treatment and drugs tend to be more expensive, increasing health-care costs, he added.

Therefore, the Government will "regularly review" MediShield to make sure it remains "relevant" and provides "adequate cover" for Singaporeans.

The public can provide its feedback on these proposed changes to MediShield at the Reach website (www.reach.gov.sg) or e-mail moh_info@moh.gov.sg

Enhancements to MediShield

To make MediShield more inclusive, the proposed changes to take effect in the first quarter of next year include:

Increasing MediShield coverage for large bills by increasing policy year limit - the maximum a policy holder can claim within a policy year - from $50,000 to $70,000. And by increasing the lifetime limit from $200,000 to $300,000.

Extending MediShield to cover accident-and-emergency department short-stay wards.

Adjusting Class B2 and C deductibles from $1,500 to $2,000 and from $1,000 to $1,500 respectively.

Deductibles are a specified amount of money that the insured must pay before an insurance company will pay a claim.

Raising MediShield coverage age from 85 to 90.

Extending MediShield to cover inpatient psychiatric treatment. Public feedback will be sought on coverage for congenital and neonatal conditions.

To make premiums affordable through the one-time top-up and regular top-ups for low- and middle-income elderly Singaporeans, the following were considered:

For younger policyholders (aged 65 and below), premium increase is less than or equal to $10 per month. After the top-up, premium increases will be $5 or less per month for the next two years.

For older policyholders (66 and above), premium increases can be fully offset by various top-ups. After top-ups, premium payable will drop by up to $29 per month.

Medical schemes available

MEDISAVE

Medisave, a component of your CPF account, can be used to pay for hospitalisations, expensive outpatient treatments like chemotherapy, selected chronic outpatient care, and premiums for MediShield and Integrated Shield Plans.

The Government also provides ad hoc Medisave top-ups for Singaporeans, which have averaged about $270million per year, or a total of $2.2 billion since 2005.

MEDISHIELD

MediShield is a basic medical insurance scheme that focuses on large bills.

It enables you or your dependants to settle part of the expenses arising from prolonged hospitalisation and certain outpatient treatments for serious illnesses.

It is designed to manage your hospitalisation expenses due to long-term medical treatments incurred in class B2 or C wards in restructured hospitals.

It complements the Medisave scheme, which may be greatly strained in the event of prolonged illnesses that require longer-term medical treatment.

MEDIFUND

A safety net to help people who cannot pay their bills in spite of subsidised bill charges, Medisave and MediShield coverage. Another $600million was injected into the endowment fund in April, increasing annual patient assistance from $80million to $100million.

Source: CPF Board and Ministry of Health

This article was first published in  The New Paper .

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