MediShield is an affordable basic medical insurance scheme which helps its members with  large hospitalisation costs at Class B2 or C wards.  It has co-payment and deductible features which can be paid by cash or Medisave. 

Members may join the scheme at any age, subject to good health and the maximum coverage age is 90 years old.   The annual premium increases with age.  Medishield premiums can be paid by Medisave.

You may wish to consider purchasing Medisave-approved private Integrated Shield Plans if you wish to stay at Class B1 or higher wards.

MediShield is an opt-out scheme. This means that Singaporeans or Permanent Residents will be extended a MediShield cover when they make their first working contribution to their CPF accounts, unless they choose to opt out. If you are not sure whether you or your dependents are insured under MediShield, you can check your CPF Statement of Account or login to "my cpf Online Services" under "My Messages" on CPF Board's website at www.cpf.gov.sg.  Alternatively, you can check with CPF Board at member@cpf.gov.sg (or at 1800-227 1188) or the hospital staff handling your hospital admission.

MediShield is a basic insurance scheme meant to help patients pay for large bills at the Class B2/C levels. The patient will have to first pay the deductible and co-insurance portions, while the remainder is covered by MediShield, subject to prevailing claim limits. The patient can use Medisave or cash to pay for the portion of the bill not covered by MediShield.

The MediShield claimable amount computed is based on the number of days of hospitalisation, the type of surgical operations carried out (if any), and if there are any implants used. The inpatient benefits are as follows:
Daily claim limits: $450 (normal hospital stays) / $900 (ICU stays). These limits cover ward charges, consultation, treatment fees, as well as the cost of investigations and medications;
Claim limits for surgical procedures range from $150 to $1,100;
Claim limits for surgical implants: $7,000
Annual claim limits: $70,000; and
Lifetime claim limits: $300,000
[Inpatient psychiatric treatment is subject to $100/day, up to 35 days per policy year.]

MediShield also pays for certain expensive outpatient treatments such as chemotherapy and radiotherapy for cancer, and renal dialysis. Please click here for the full list of benefits and claim limits.

There is a list of standard excluded medical treatments and expenses which MediShield does not cover. Please click here for the list. 

As MediShield does not cover the treatment of pre-existing illnesses that were diagnosed before the start of MediShield coverage, additional exclusions may also be imposed on an insured, depending on his health condition at the time of application on a case-to-case basis.

If you are insured under MediShield at the time of your hospitalisation, you may claim part of your hospital bill from MediShield, by informing the hospital staff handling your hospital admission that you wish to make a claim.

The hospital will submit the MediShield claim on your behalf. After processing, any reimbursement will be made by the CPF Board to the hospital directly if there is a claim payout.  The remaining amount can be paid for using Medisave or cash.

You may first check with the hospital whether the treatment can be claimed using MediShield.

Yes, MediShield can be used to cover stays in any ward class. However, for MediShield members who go to private hospitals or Class A/B1 wards, their MediShield payouts will be pro-rated to the equivalent Class B2/C level as MediShield is designed for Class B2/C coverage.  This ensures a more equitable arrangement for all MediShield members and keeps MediShield premiums affordable.  Those who want higher coverage for higher ward class should consider buying Medisave-approved private Integrated Shield plans.  Please contact your financial advisor or insurance agent for more information on Integrated Shield Plans.

No, MediShield only covers hospitalisation expenses and certain approved outpatient treatments. Health screening procedures (for example, screening colonoscopy) are not claimable under MediShield. However, medical treatments that are required in relation to the health screening procedure can be covered under MediShield.

For further details on the MediShield Scheme (including coverage for newborns and youths), you can contact CPF Board at member@cpf.gov.sg  (or at 1800-227 1188) or visit their website here as CPF Board administers MediShield on behalf of MOH.

Each person can only use his/her Medisave to purchase one Medisave-approved private Integrated Shield Plan for himself/herself at any one time.

MediShield is a basic medical insurance plan for all Singaporeans. It is targeted at providing Singaporeans with coverage for large hospital bills at the Class B2/C level.

If you prefer treatment in higher ward classes in public hospitals or in private hospitals, basic MediShield alone is insufficient. You may wish to consider topping-up your insurance coverage with a Medisave-approved private Integrated Shield Plan.

The premiums for Integrated Shield Plans can be paid through Medisave up to a limit of $800 per per year per insured person. For those who are 76-80 years old (age next birthday), the Medisave withdrawal limit is $1,000  per year per insured person. The withdrawal limit is $1,200 per year per insured person for members who are 81-90 years old (age next birthday).

You are encouraged to consider purchasing an insurance plan that is appropriate for your needs and income level.

MediShield is a basic medical insurance plan for all Singaporeans. It is targeted at providing Singaporeans with coverage for large hospital bills at the Class B2/C level. MediShield premiums are priced to cover the expected payouts for Class B2/C ward classes.  MediShield payouts will be pro-rated to the equivalent Class B2/C level as MediShield is designed for Class B2/C coverage.  This ensures a more equitable arrangement for all MediShield members and keeps MediShield premiums affordable.

If you prefer treatment in higher ward classes in public hospitals or in private hospitals, basic MediShield alone is insufficient. You may wish to consider topping-up your insurance coverage with a Medisave-approved private Integrated Shield Plan.

You are encouraged to consider purchasing an insurance plan that is appropriate for your needs.

You may submit an application online now at the CPF website at http://www.cpf.gov.sg . Please go to “my CPF Online Services -> My Requests -> Healthcare Matters -> Apply for MediShield Cover”.

To submit an application online, your NRIC/CPF Account Numbers and SingPass login are required. Please note that the acceptance of your application will be subjected to the eligibility criteria and the member’s health condition at the point of application.

You can use the online application form to enrol your children and other dependants. The form is available at the CPF website at http://www.cpf.gov.sg . Please go to “my CPF Online Services -> My Requests -> Healthcare Matters -> Apply for MediShield Cover”.

Please note that the acceptance of application will be subjected to the eligibility criteria and the member’s health condition at the point of application.

MediShield is extended to eligible Singapore Citizens and Permanent Residents who are children and youths:

(i) If they are born in Singapore, and their births are registered in Singapore on or after 1 December 2007

(ii) If they are registered in national schools as of May in the years of 2008 to 2013

(iii) If they are under 21 years old as of 30 June 2010

A mailer on MediShield will be sent to one of the parents who has to be a CPF member as the child’s MediShield premium will be paid from the parent's Medisave account.

Parents whose children have yet to be offered a MediShield cover may apply to the Board directly to cover their children any time. The online application form is available at the CPF website at http://www.cpf.gov.sg. Please go to “my CPF Online Services -> My Requests -> Healthcare Matters -> Apply for MediShield Cover”.

Generally, coverage will begin 1 to 2 calendar months after the invitation mailer for MediShield cover has been sent to the parent. For example, if the mailer was sent in February 2013, the cover would commence on 1 March 2013.

However, for Singapore Citizens born on or after 1 March 2013 and whose birth are registered within 42 days from birth, the cover will commence from date of birth and will not be subject to the waiting period.

Coverage of MediShield is often only triggered when an individual makes his first contribution to CPF. Early coverage will benefit youths and their parents, helping them to meet medical expenses in the event of major or prolonged illnesses.  Early MediShield coverage is also beneficial as it would be difficult to obtain subsequent coverage if a person develops an illness in his youth.

The schedule of MediShield premiums can be found at  http://www.moh.gov.sg/content/moh_web/home/costs_and_financing/schemes_subsidies/Medishield/Premiums.html

Participation in MediShield coverage is not compulsory for children. Parents may choose to opt out of MediShield coverage for their children.

However, if the child chooses to take-up MediShield cover in the future, his/her application will be based on his/her health condition then. They will also be offered MediShield coverage again on an opt-out basis after they start work and begin making their own contributions to Medisave.  Those who develop illnesses before the point of application may not be insurable under MediShield. Thus, we strongly encourage parents to retain their children’s MediShield cover.

Parents who choose to cancel their child’s coverage may submit their request online at www.cpf.gov.sg via my cpf Online Services with their CPF Account Number and SingPass. Alternatively, the parent could also write in to CPF via post. The premium paid, if any, will be fully refunded as long as the request is received within two months from the start of the child's cover.

No, MediShield coverage will not be automatically extended to children if their parents had opted them out of the scheme previously on their behalf. However they will be offered MediShield coverage again on an opt-out basis after they start work and begin making their own contributions to Medisave.

Parents have to re-apply to cover their children under MediShield if they wish to insure them under MediShield again before they start making their own contributions to Medisave.

Yes. Parents who wish to more pro-actively insure their children under MediShield may submit an application online now, instead of waiting for the respective mailers. 

Parents can access the CPF website at http://www.cpf.gov.sg and go to “my CPF Online Services -> My Requests -> Healthcare Matters -> Apply for MediShield Cover”.  To submit an application online, NRIC/CPF Account Numbers and SingPass logins are required.

Since 1 July 2005, all Medisave-approved plans have been integrated with MediShield to form Integrated Shield Plans. If your child is already covered under a Medisave-Approved private Integrated Shield Plan, he/she is also covered under MediShield. Thus, he/she will not be extended a MediShield cover again.

If your spouse wishes to take over the premium payment using the savings in his/her Medisave account, he/she may submit the request online at www.cpf.gov.sg via my cpf Online Services with his/her CPF Account Number and SingPass. Alternatively, your spouse may use the form “Application to Change Payer for MediShield Cover”, which can be downloaded from www.cpf.gov.sg > General Information > Forms (View and Print).

If there are insufficient funds in the payer’s (one of the parents) Medisave account, he or she will be notified by CPF Board to top up their Medisave accounts before the child’s MediShield cover commencement date. Alternatively, the other parent may choose to take over the premium payment, and use his/her Medisave savings for the premium payment of the child's policy.

All Singaporeans born on or after 26 August 2013 will have a Medisave account created and receive a $3,000 one-off Medisave grant from the Government over 2 tranches. Parents may also choose to use their child's own Medisave account to pay for the child's insurance premiums.

No. Delivery charges are excluded. MediShield does not cover bills related to pregnancy or childbirth.

Parents may use their Medisave for delivery charges. The Medisave Maternity Package allows parents to use their Medisave for the delivery and pre-delivery medical expenses of their first four children.

All Singapore Citizens born on or after 1 March 2013 will be able to receive full coverage from birth without having to be assessed for pre-existing conditions, as long as they do not opt out. All existing policyholders who were insured before 1 March 2013 will also receive coverage for congenital conditions diagnosed on or after 1 March 2013.

All other new members who join MediShield (without coverage from birth) on or after 1 March 2013 will be covered for congenital conditions if the conditions were diagnosed on or after the cover commencement date.

However, MediShield will exclude coverage for any active surgical interventions for the following rare congenital conditions which are severe and fatal by nature: Trisomy 13, Trisomy 18, Bilateral Renal Agenesis, Bart's Hydrops, Alobar Holoprosencephaly, Anecephaly.

From 1 March 2013, MediShield will cover the child from birth if he or she is registered within 42 days from birth and has Singapore citizen or PR status at the time of birth registration.  For such newborns, you will be able to claim from their MediShield policy if he/she is hospitalised soon after the birth.

If your child was insured as your dependant before age 21, and you have been paying for his/her policy, your child will take over the payment of his/her MediShield premium when he/she has:

i) Attained the age of 21
ii) Continuous working CPF contributions made towards his/her CPF account and
iii) Sufficient Medisave balance for at least 3 years of premium deductions.

If he/she has not met the above conditions but wish to take over the payment for his/her own MediShield premium from the next policy year, he/she can apply to do an online change of premium payer using his/her own CPF Account Number and SingPass. Alternatively, he/she can complete the Change of Payer Form and return it to CPF Board for processing.

Once the request is approved, he/she will take over the premium payment from the next policy year.

The following changes will be introduced to MediShield from 1 March 2013: 

a) Increase the coverage age from 85 to 90 years to ensure that our elderly remain insured as they live longer;

b) Extend coverage to inpatient congenital and neonatal treatment for newly diagnosed conditions [1]. This will allow all Singapore Citizens born on or after 1 March 2013 to be covered under MediShield without having to be assessed for pre-existing conditions;

c) Extend coverage to inpatient psychiatric treatment at $100 per day up to 35 days per year for newly diagnosed conditions [1], to encourage timely and appropriate treatment of mental illnesses;

d) Extend coverage to short-stay wards in Emergency Departments;

e) Increase the policy year and lifetime limit from $50,000 to $70,000 and from $200,000 to $300,000 respectively to better cover members who face exceptionally large bills;

f) To maintain the scheme’s focus on large bills, increase the Class B2/C deductibles [2] moderately by $500 from $1,500/$1,000 to $2,000/$1,500 for those aged 80 and below based on their age next birthday [3] ;

g) Increase the Medisave withdrawal limits for MediShield and Medisave-approved Integrated Shield Plans from $800 to $1,000 for those aged 76 to 80 and from $1,150 to $1,200 for those aged above 80 based on their age next birthday;

h) Remove the MediShield maximum entry age of 75 to enable healthy uninsured elderly to obtain coverage; and

i) Update MediShield premiums in line with claims experience and to support the benefit enhancements.

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[1] Conditions that are diagnosed on or after 1 March 2013 or cover commencement date, whichever is latest.

[2] The deductible is the amount one would need to pay for claim(s) made in a policy year, before there is a payout from MediShield. The deductible is only applied once in each policy year.

 

[3] Deductibles for those aged 81 and above based on their age next birthday will not be changed. For this group, the deductible for Class B2 is $3,000 and the deductible for Class C is $2,000. Deductibles for day surgeries will also remain unchanged at $1,500 for those aged 80 and below, and $3,000 for those aged 81 and above, based on their age next birthday.

Neonatal conditions refer to conditions that require newborns to seek treatment soon after birth. An example of a serious neonatal illness is pneumonia.

Parents have expressed their desire for MediShield to cover their children who may require hospitalisation upon, or soon after birth for medical complications or treatment of congenital anomalies.

To help to relieve the financial burden on parents and provide peace of mind, we will be extending MediShield to cover congenital and neonatal conditions. This will enable all Singapore Citizens born on or after 1 March 2013 to receive coverage from birth without having to be assessed for pre-existing conditions.

With the extension of coverage, all Singapore Citizens born on or after 1 March 2013 and whose birth are registered within 42 days from birth will be able to receive full coverage from birth without having to be assessed for pre-existing conditions, as long as they do not opt out. All existing policyholders who were insured before 1 March 2013 will also receive coverage for congenital conditions diagnosed on or after 1 March 2013.

All other new members who join MediShield on or after 1 March 2013, without coverage from birth, will be covered for congenital conditions if the conditions were diagnosed on or after the cover commencement date.

The MediShield changes will take effect on 1 March 2013.

A congenital illness is a condition that exists at birth. Some common examples of congenital anomalies are cleft palate, hole-in-the-heart and Down’s syndrome.

This is aligned with the principle that insurance should help members pool their risks against unknown health conditions. If your condition was diagnosed prior to the extension in cover (and hence considered pre-existing) on 1 March 2013, the condition will not be covered under MediShield. Needy patients can continue to approach the Medical Social Workers at the public hospitals for assistance through other avenues.

The government will introduce Medifund Junior from 1 March 2013, and provide an additional $10 million over 5 years, to help needy families with children who require medical treatment, including those who are unable to be covered by MediShield for their pre-existing congenital and neonatal conditions (diagnosed before 1 March 2013).

As an insurance scheme funded through riskpooled premiums paid by policyholders, all MediShield enhancements and changes have to take place on the same date. CPF Board has to give policyholders sufficient notice of the enhanced benefits and premium adjustments, before they are effected. Bearing this in mind, MOH and CPF Board have worked towards an implementation date of 1 March 2013 to allow time for individual notifications, as well as the system changes to support the processing of claims.
 
Significant Government subsidies of up to 80% will continue to be available to all who require treatment for their congenital and neonatal conditions in public hospitals, even if insurance coverage is not available. Parents can also use their Medisave for their children’s healthcare bills. Needy families who face difficulties with their healthcare bills can continue to approach the Medical Social Workers at the public hospitals for assistance through other avenues, such as Medifund Junior. MOH has introduced Medifund Junior to provide more targeted financial assistance for healthcare bills incurred by sick children from needy families.  This will include those who were unable to obtain insurance coverage due to pre-existing conditions, e.g., those with congenital conditions diagnosed before 1 March 2013.

Congenital and neonatal conditions will be covered as per other medical conditions under the prevailing MediShield claim limits subject to the deductible and co-insurance.

However, MediShield will exclude coverage for any active surgical interventions for the following rare congenital conditions which are severe and fatal by nature: Trisomy 13, Trisomy 18, Bilateral Renal Agenesis, Bart’s Hydrops, Alobar Holoprosencephaly, Anecephaly.

No action is required on the part of parents if either parent is a CPF member.

All Singapore Citizens born on or after 1 March 2013, and whose births are registered within 42 days from birth, will be automatically extended a cover under MediShield from birth without having to be assessed for pre-existing conditions, if parents do not opt their children out. For these newborns, hospitalisations for congenital and neonatal conditions will be covered under MediShield from their date of birth, subject to the prevailing claim limits.

Existing policyholders, such as insured children, will also automatically receive coverage for any congenital condition diagnosed on or after 1 March 2013.
 
Parents will be notified of the extension of MediShield coverage for their newborns by CPF Board. Premiums for a child’s MediShield cover can be paid for using either parent’s Medisave account or the child’s Medisave account.

If your child’s birth is not registered within 42 days, he/she will not be extended a MediShield cover from his/her date of birth. However, he/she will still be automatically extended a cover which will start 1 calendar month after the MediShield invitational mailer has been sent to you/your spouse. The cover extended to your child will be subject to CPF Board’s assessment for any pre-existing conditions.

Parents are therefore encouraged to register their child’s birth early, within 14 days of birth. You may wish to refer to ICA’s website for more information on birth registration: http://www.ica.gov.sg/page.aspx?pageid=144

Currently, the private insurers providing the Medisave-approved Integrated Shield Plans do not provide coverage from birth.

You do not need to terminate your child’s MediShield cover before applying for an Integrated Shield Plan for him/her. As the Integrated Shield plan consists of an enhanced portion provided by the private insurer as well as a MediShield component provided by CPF Board, your child’s Integrated Shield Plan will be integrated seamlessly with his/her initial MediShield cover upon the commencement of the Integrated Shield Plan.

If your child’s MediShield cover commences from his/her date of birth, we encourage you not to opt your child out from MediShield as the MediShield cover extended to your child will not have exclusions imposed due to pre-existing conditions.

Policyholders aged 65 and below (or 9 out of 10 policyholders) will face premium increases of less than $10 per month while those aged above 65 will face premium increases of up to $21 per month.  

To help offset the premium increases, the Government will be providing a one-off Medisave top-up of up to $400, for all insured Singapore Citizens. This is sufficient to offset part of or the full premium increases for up to two years i.e. until 2015. The elderly will also receive additional annual Medisave top-ups of up to $450 under the permanent GST Voucher Scheme to help with their healthcare expenses.

For younger Singaporeans aged 65 and below, the impact of the premium increase will be no more than $5 per month in the next two years due to additional Government support given as part of Budget 2012. For the elderly, their premiums will be largely offset by the annual Medisave top-up under the GST Voucher Scheme and the one-off Medisave top-up. They will see a decrease in premiums payable. Overall, MediShield premiums will continue to remain affordable even for the lower-income.

In addition, elderly policyholders aged 71 and above will also receive premiums rebates if they had joined the scheme before 60 years old and remained continuously insured.

The new premiums will apply from 1 March 2013 to all MediShield and Integrated Shield Plan policyholders. All CPF members paying for MediShield and Integrated Shield Plan policies will receive a notification letter from CPF Board in February 2013 notifying them of the premiums payable.

All MediShield and Integrated Shield Plan policyholders who are Singapore Citizens will be eligible for the one-off Medisave top-up, which helps to offset part of or the full premium increase for up to two years. The top-up will be automatically credited to the Medisave account of the policy payer from March 2013.

If your next policy renewal date is …	Premium Collection
In March 2013	You will pay the revised MediShield premium in March 2013.
Between 1 April 2013 and 1 February 2014	You will have to pay a pro-rated increase in MediShield premium for the period from 1 March 2013 until your next policy renewal date. This amount will be deducted from the payer’s Medisave account by CPF Board in March 2013.   From your next policy renewal date, you will pay the revised MediShield premium.

The pro-rated premium you will have to pay is based on the difference between the existing and new MediShield premiums for the remaining policy year until your next policy renewal date. Please refer to the notification letter which will be sent in February 2013 for the exact pro-rated premium amount payable. The notification letter will be sent either to you if you are paying for your own policy, or the person who is currently paying for your policy.

You may check your pro-rated premium amount based on your age and policy renewal date here .

Worked Example for the Computation of the Pro-rated Premium
For a member aged 62 (as at next birthday), whose policy will be renewed on 1 June 2013:  

Current MediShield premium	$332
Revised MediShield premium	$455
Number of months between 1 March 2013 until policy renewal on 1 June 2013	3
Pro-rated premiums to be collected	($455-$332)*3/12 = $30.75

The pro-rated premium will be deducted from the payer’s Medisave account in March 2013. Please ensure that you have sufficient funds in your Medisave account for the deduction.

MediShield premiums can be paid by Medisave up to the prevailing Medisave withdrawal limit for premiums.

As a not-for-profit self-financing insurance scheme, MediShield premiums have to be adjusted from time to time in line with the claims experience. This ensures that the scheme remains solvent and can continue to fund payouts to policyholders in future. Since the last premium revision in 2008, the average claim per policyholder had increased by about 12% per year from 2009 to 2011.

The increase in claims experience was due to:

• Growing number of claims paid: Since the last revision of the deductibles in 2005, MediShield has been covering more hospital bills than its previous intent. Together with the rising utilisation of healthcare, the number of claims per policyholder has increased by 9% per annum.

• Rising cost of treatment as Singaporeans are receiving higher quality of treatment due to medical advances, which contributes towards improving patient outcomes.

• Overall medical inflation at about 3% per annum.  

In addition, premiums will also need to be adjusted to support the MediShield benefit enhancements that will take effect on 1 March 2013.

The GST Voucher Scheme is a permanent transfer scheme introduced in 2012 to help lower- and middle-income Singaporean households with their expenses. It includes annual Medisave top-ups of up to $450 to help elderly Singapore Citizens aged 65 and above with their medical expenses.

Top-ups to the Medisave account can also be used to pay for MediShield premiums.

Age	AV £ $13,000	$13,000 >AV ³ $20,000
65 – 74	$250	$150
75 – 84	$350	$250
³ 85	$450	$350

The one-off Medisave top-up of up to $400 is provided for all Singapore Citizens who are insured under MediShield or a Medisave-approved Integrated Shield Plan to offset part of or the full premium increases for up to two years.

The top-up will be automatically credited to your account in March 2013 if you are the payer of your or your dependants’ MediShield or Medisave-approved Integrated Shield Plan. No action is required on your part.

MediShield provides a single basic tier of benefits for all Singaporeans, with affordable premiums. Allowing some to retain reduced benefits will fragment the pool of policyholders and reduce the cost-effectiveness of the risk-sharing across the national risk pool.

In addition, premiums will have to be adjusted from time to time to support the rising claims experience, even if there was no change in the benefit schedule.

With increasing awareness and the growing burden of mental illnesses, the extension of MediShield coverage to inpatient psychiatric treatment is intended to help relieve part of the financial burden faced by patients and their families and encourage timely and appropriate treatment of mental illnesses.

The claim limits for inpatient psychiatric care are set in line with current bill sizes and duration of stay for inpatient psychiatric treatment, and are adequate to cover the majority of patients who require such care. Similar to other bills, MediShield will continue to cover 80-90% of the claimable amount after the deductible.

For inpatient treatment of psychiatric conditions, we will compare the daily ward and treatment charges against the computed claim limits of ($100 x length of inpatient stay up to 35 days per policy year). Please see example for an illustration.

Example

Patient’s citizenship: Singapore Citizen
Patient’s age: 50 years old
Ward Class: C
Length of stay: 30 Days

	Hospital Bill 1	MediShield Claim Computation
Daily Ward & Treatment Charges (for 30 days of inpatient psychiatric treatment in normal ward)	$3,500	$3,0002
Total	$3,500	$3,000
Less Deductible3	-	($1,500)
Claimable Amount (less Deductible)	-	$1,500
Less Co-insurance	-	($300)4
MediShield pays	-	$1,200
Medisave and/or Cash	-	$2,300

¹ As the insured member is a Singapore Citizen who stayed in Class C ward, the MediShield claim is computed based on 100% of the bill.

² Lower of the claim limit for Daily Ward & Treatment Charges for Psychiatric treatment, ($100 x 30 days) = $3,000, or 100% of charges incurred of $3,500 . Therefore, the claimable amount is $3,000 .

³ The insured member is below age 80, subject to Deductible of $1,500 for Class C Ward.

⁴ Co-insurance = ($1,500 x 20%) = $300.

This approach is aligned with the principle of insurance of helping members pool their risks against unknown health conditions. If your condition was diagnosed prior to the extension in cover (and hence considered pre-existing) on 1 March 2013, the condition will not be covered under MediShield. Needy patients can continue to approach the Medical Social Workers at public hospitals for assistance through other avenues.

The deductible is the amount a patient would need to pay for claim(s) made in a policy year, before there is a payout from MediShield. The deductible preserves MediShield’s intent as a basic insurance scheme designed for large bills by sieving out small bills, keeping MediShield premiums affordable. 

The deductible portion can be paid for using Medisave.

The deductible is applicable only once per policy year (and not on a per admission basis), regardless of the number of admissions made in the year. Patients who incur multiple bills will receive coverage for subsequent bills after the deductible is crossed. Smaller bills can be paid for using Medisave.

There will be moderate adjustments to the Class B2/C deductibles for those aged 80 and below, based on their age next birthday. There are no changes to the deductibles for policyholders aged above 80 based on their age next birthday, and no changes to the day surgery deductibles.

Deductibles preserve MediShield’s intent as a basic insurance scheme designed for large bills by sieving out small bills. By not covering smaller bills that can be adequately covered by Medisave, MediShield premiums can be kept affordable.

Since the last adjustment of the deductibles in 2005, MediShield’s coverage has slipped to covering close to 1 in 2 bills. This is not in line with MediShield’s intent to risk-pool against large bills. With more bills qualifying for MediShield payouts, claims would be higher and there would be an impact on premiums. To maintain MediShield’s focus on large bills and manage premium affordability, moderate adjustments to the deductibles for Class B2 and C are necessary.

The deductible can continue to be paid through Medisave. Medisave is sufficient to help cover the increased deductible, with average Medisave balances having risen from $12,000 to $18,000 from 2005 to 2011.

The deductible amount can continue to be paid using Medisave, up to the current withdrawal limits. The Medisave withdrawal limits will be reviewed from time to time to ensure that they are adequate for Class B2/C hospitalisations.

The Ministry regularly reviews the maximum coverage age in line with the ageing population. As numbers are small, it is not possible to retain a sufficient risk-pool and the premiums for ages above 90 will certainly be high. 

Those above age 90 can tap on their Medisave and Medifund Silver to pay for their bills. Government has also provided annual Medisave top-ups of up to $450 under the permanent GST Voucher Scheme to help them with their healthcare bills.

All policyholders whose MediShield covers were terminated when they reached the maximum coverage age of 85 years old will be invited to re-join the scheme when the coverage age is extended till age 90. Conditions that were previously covered before the termination of cover will continue to be covered under the extension in coverage. These policyholders will also be eligible for the one-off Medisave top-up, which will be automatically credited to the Medisave account of the policy payer from March 2013.

All eligible members will be notified of the extension in cover in writing from CPF Board at a later date.

In response to public feedback, the MediShield maximum entry age of 75 has been removed to enable healthy uninsured elderly to obtain coverage. Hence, you will be able to apply to join the scheme. Similar to all applicants, entry into the scheme will be subject to your good health.

For members whose MediShield cover expired due to the maximum age limit, MediShield will only cover treatment that takes place after the extension of cover from 1 March 2013.

A Medisave-approved private Integrated Shield Plan provides additional insurance coverage above MediShield, for treatment in Class A/B1 in public hospitals or in private hospitals. An Integrated Shield Plan is made up of MediShield, and a Medisave-approved enhancement plan offered by a private insurer. There are currently five private insurers offering such plans – AIA, Aviva, Great Eastern, Prudential and NTUC Income.

Premiums for Integrated Shield Plan can be paid by Medisave up to the prevailing Medisave withdrawal limit for premiums.

Medisave is meant to help Singaporeans prepare financially for their basic hospitalisation expenses, especially after retirement, and Medisave contribution rates are set accordingly.  For this reason, Medisave withdrawal limits for healthcare-related expenses are in place to prevent the premature depletion of an individual's Medisave account. 

In line with these considerations, the Medisave withdrawal limits are set to be more than sufficient to cover the basic MediShield premiums for all policyholders.  However, if you wish to purchase higher coverage above basic MediShield, such as coverage for Class A/B1 wards, you will have to consider if it is suitable for your situation and may have to co-pay some out-of-pocket cash in line with your decision.

As Medisave-approved Integrated Shield Plans (IP) are made up of MediShield, and a Medisave-approved enhancement plan offered by a private insurer, the MediShield premium increases will also affect IP policyholders. Your IP insurer will inform you of the revised premium rates if there is any change.

If you are a Singapore Citizen insured under MediShield or IP, you will be eligible for the one-off Medisave top-up. This will be automatically credited to the Medisave account of the policy payer from March 2013.

If your next policy renewal date is …	Premium Collection
In March 2013	Your private insurer will inform you of any changes to the IP premium payable.
Between 1 April 2013 and 1 February 2014	You will have to pay a pro-rated increase in MediShield premium for the period from 1 March 2013 until your next policy renewal date. This amount will be deducted from the payer’s Medisave account by CPF Board in March 2013.   Your private insurer will inform you of any changes to the IP premium payable from your next policy renewal date.

Medisave-approved Integrated Shield Plans (IP) are made up of MediShield, and a Medisave-approved enhancement plan offered by a private insurer. Singapore Citizens and Permanent Residents who choose to be covered under an Integrated Shield Plan enjoy supplementary benefits offered by the private enhancement plan, on top of the basic coverage offered by MediShield. At the same time, they are still part of the national MediShield riskpool which helps to keep the basic coverage component more affordable for all Singaporeans.

For the convenience of policyholders, the private insurer will collect a combined annual premium and make a combined claims payout from both the MediShield scheme and the Medisave-approved enhancement plan to your hospital. The annual premium and claims for your Integrated Shield Plan is then distributed backend.

From 1 March 2013, MediShield benefits will be enhanced immediately for all policyholders, including IP policyholders. MediShield premiums will also be adjusted at the same time to support the enhanced benefits and to be in line with the latest claims experience.  As the MediShield enhancements and premiums take effect for all policyholders from 1 March 2013, a one-off pro-rated amount on the increase in premiums will be collected from all policyholders to support the enhanced coverage provided under MediShield for the remaining policy year.

Private insurers are also enhancing the IP benefits and adjusting their premiums accordingly. Unlike the MediShield changes, these enhanced IP benefits and revised premiums will only take effect for each IP policyholder upon his or her next policy renewal date on or after 1 March 2013. Hence, no pro-rated premium will be collected for the IP portion.

The pro-rated premium you will have to pay is based on the difference between the existing and new MediShield premiums for the remaining policy year until your next policy renewal date.

If your next policy renewal date is …	Premium Collection
In March 2013	You will not have to pay any additional pro-rated MediShield premium to CPF Board. Your private insurer will inform you of any changes to the IP premium payable.
Between 1 April 2013 and 1 February 2014	You will have to pay a pro-rated increase in MediShield premium for the remaining period from 1 March 2013 until your next policy renewal date. This amount will be deducted from the payer’s Medisave account by CPF Board in March 2013. Please refer to the worked example below for more details.   From your next policy renewal date, your private insurer will inform you of any changes to the IP premium payable.

Please refer to the notification letter which will be sent in February 2013 for the exact pro-rated premium amount payable. The notification letter will be sent either to you if you are paying for your own policy, or the person who is currently paying for your policy.

You may check your pro-rated premium amount based on your age and policy renewal date here .

Worked Example for the Computation of the Pro-rated Premium
For a member aged 62 (as at next birthday), whose policy will be renewed on 1 June 2013:

Insured’s current IP premium	$600
Current MediShield premium	$332
Revised MediShield premium	$455
Number of months between 1 March 2013 until policy renewal on 1 June 2013	3
Pro-rated premiums to be collected	($455-$332)*3/12 = $30.75

 

The pro-rated premium will be deducted from the payer’s Medisave account in March 2013. Please ensure that the payer has sufficient funds in the Medisave account for the deduction.

As Medisave-approved Integrated Shield Plans (IP) are made up of MediShield, and a Medisave-approved enhancement plan offered by a private insurer, members who are covered under Integrated Shield Plans are also insured under MediShield and hence will be affected by the increase in MediShield premiums.

The Government will be providing a one-off Medisave top-up of up to $400 to all who are paying for a Singapore Citizen’s Integrated Shield Plan or basic MediShield cover to help to offset the increase in MediShield premiums for up to two years.
 
The amount will be credited into the payer’s Medisave account automatically in March 2013.  No application is required.

Yes, a Medisave deduction will be attempted for policyholders even if they currently pay their premiums by cash. Payment of the pro-rated premium for MediShield will only be via Medisave. To help with the MediShield premium increase, the Government will provide a one-off Medisave top-up of up to $400 in March 2013 to all who are paying for a Singapore Citizen’s Integrated Shield Plan. The amount will be credited into the payer’s Medisave account automatically in March 2013.

You may contact your IP insurer, i.e. AIA, Aviva, Great Eastern, Prudential, NTUC Income, for clarifications.

As Medisave-approved Integrated Shield Plans (IP) are made up of MediShield, and a Medisave-approved enhancement plan offered by a private insurer, Singapore Citizens and Permanent Residents who choose to be covered under Integrated Shield Plans enjoy supplementary benefits offered by the private enhancement plan, on top of the basic coverage offered by MediShield, and will obtain the higher of the benefits offered by the private enhancement plan and MediShield.

For the convenience of policyholders, the private insurer will make a combined claims payout from both the MediShield scheme and the Medisave-approved enhancement plan to your hospital. The annual claims for your Integrated Shield Plan is then distributed backend. You will enjoy all benefits offered by MediShield, such as coverage for congenital conditions diagnosed after 1 March 2013 without a waiting period, regardless of whether your private insurer of the enhancement plan currently provides such coverage.

An Integrated Shield Plan is made up of MediShield, and a Medisave-approved enhancement plan offered by a private insurer. 

Once you reach MediShield’s maximum coverage age, your Integrated Shield Plan will cease to be integrated with MediShield. With the extension in MediShield’s maximum coverage age, your Integrated Shield Plan will remain integrated with MediShield until age 90, instead of age 85. This allows Integrated Shield Plan policyholders to continue to enjoy the higher of benefits offered by MediShield and the private Integrated Shield Plan until a later age.

The deductible is the amount a patient would need to pay for claim(s) made in a policy year, before there is a payout from Integrated Shield Plan. The deductible preserves the Integrated Shield Plan’s intent to cover large bills.  The deductible portion can be paid for using Medisave and/or cash.

The deductible is applicable only once per policy year (and not on a per admission basis), regardless of the number of admissions made in the year. Patients who incur multiple bills will receive coverage for subsequent bills after the deductible is crossed. Smaller bills can be paid for using Medisave and/or cash.

MOH specifies the minimum level of deductibles of Integrated Shield Plans.  Private insurers are free to set their deductibles at or above the minimum level.

The minimum level of deductibles for Integrated Shield Plans will be adjusted upwards by $500 for each plan type/ward class. There are no changes to the day surgery deductibles.


For day surgeries and short-stay wards, the minimum deductible is $2,000 for non-subsidised treatment, and $1,500 for subsidised treatment.

Integrated Shield Plans (IPs) offered by private insurers were established to help Singapore Citizens who desire higher coverage risk-pool their premiums for protection against large hospitalisation bills incurred in ward classes above Class B2 and C in public hospitals or private hospitalisations.  To ensure that IPs remain focussed on large hospitalisation bills, MOH mandates a minimum level of deductibles for IPs.

Similar to MediShield, more bills have been qualifying for IP payouts since the last adjustment in minimum deductibles.  To restore the focus of IP plans, the required minimum IP deductibles will be adjusted upwards by $500 from 1 March 2013, similar to the adjustment in MediShield deductibles.