If you were hospitalised just before your death and had authorised to use your Medisave to pay the bill before your demise, your Medisave balance would be used in full, without being subject to the existing Medisave withdrawal limits, to pay your last medical bill.

If you had not signed the Medisave Authorisation Form (MAF) before your demise, your immediate family members (spouse, parents, or child who is 21 years and above) or committee of person could also sign the MAF to use your Medisave to pay your last inpatient medical bill, provided it has not been paid out to your nominee(s). In the event that you do not have any immediate family members or committee of person to sign the MAF, a relative who has been taking care of you may also write in to the Ministry of Health through the hospital to seek approval for him to authorise the withdrawal of your Medisave to pay your last inpatient medical bill.

The remaining Medisave balance, after the payment of the last medical bill, would be distributed to the nominated beneficiaries of your CPF accounts if you had made a nomination before your death.
If you had not made a nomination, the balance in your CPF accounts will be distributed by the Public Trustee to your family members under the intestacy laws for non-Muslims or the Muslim inheritance law for Muslims, if you had not made a nomination. If you wish to distribute your Medisave balance differently, then you would have to make a nomination, if you have not made one yet.