Will premiums be affordable? Should you go private? What about co-payment?
Proposals unveiled recently by a committee tasked to look at enhancing the national health insurance scheme MediShield contained much good news.
MediShield Life - enhancements to the MediShield scheme - would offer higher payouts and, therefore, lower out-of-pocket expenses for CPF members.
But there are concerns that the increase in premiums, the details of which which have yet to be released, may be substantial for some. Throw some insurance terms such as "deductible" and "co-insurance" into the picture and it's no wonder many are left with fuzzy ideas of what the reforms are all about.
A tongue-in-cheek way to remember MediShield Life is to think of it as a Look Into Future Expenses, specifically large hospital bills. The Sunday Times checks out how the new plans could affect you.
First, MediShield Life will ensure that everyone, even those with pre-existing conditions previously not covered under MediShield, will be insured.
Senior citizens can also heave a sigh of relief as all of them - a group more likely to need the insurance - will be covered. Currently, MediShield's coverage is extended only to those up to 92 years of age.
Other MediShield Life recommendations include the removal of the lifetime claim limit of $300,000, increasing the policy year claim limit by 40 per cent from $70,000 to $100,000, and higher claim limits for expenses like outpatient cancer treatments.
Under the proposals, there would also be lower co-insurance rates from between 10 per cent and 20 per cent, to between 3 per cent and 10 per cent.
"Co-insurance" is the amount of money in a large hospitalisation bill that you have to bear above the deductible.
A "deductible", meanwhile, is the initial sum that you have to pay for claims made in a policy year, before you receive a MediShield payout.
The deductible ranges from $1,500 to $3,000 and is put in place by the authorities to sieve out small claims, since the aim of MediShield is to help pay for large hospitalisation bills.
MediShield Life will continue to cover only Class B2 and C public hospital bills.
People who wish to stay in private hospitals or Class A and B1 wards in public hospitals should note that MediShield Life will cover only the amount it would for a B2 patient. It will not be able to pay the bulk of your bill, so you would need additional coverage on top of MediShield Life, known as Integrated Shield Plans (IPs).
Integrated Shield Plans
On top of the basic MediShield scheme, there are currently five insurers - AIA, Aviva, Great Eastern, NTUC Income and Prudential - which provide Medisave-approved IPs. About two in three Singaporeans are on Integrated Shield Plans.
This means you can use your Medisave savings to pay for the IPs, which are combined with basic MediShield to form a single integrated plan.
IPs provide benefits above and beyond what the basic MediShield scheme provide.
For instance, some IPs already offer lifetime coverage, coverage for certain pre-existing conditions, overseas medical treatments and the like.
With the enhanced MediShield Life scheme, there may be some overlaps with the IPs.
The Sunday Times understands that the MediShield Life Review Committee is in talks with the five insurers, reviewing the issues related to IPs, and will share its recommendations soon.