ElderShield is an affordable severe disability insurance scheme which provides basic financial protection to those who need long-term care, especially during old age. It is estimated that as many as one in 12 elderly persons suffer from disabilities as a result of ageing and illness which render them incapable of doing simple daily activities.
ElderShield provides a monthly cash payout of $300 for a maximum of 60 months (i.e. ElderShield300) or $400 for a maximum of 72 months (i.e. ElderShield400) to help pay the out-of-pocket expenses for the care of the severely disabled person.
CPF Members (Singapore Citizens and Permanent Residents) who reach the age of 40 will be automatically covered under ElderShield. As it is an auto-cover scheme, you do not have to sign up to join ElderShield, or go for medical assessment.
Singapore Citizens and Permanent Residents who are below age 65, and who are not in the auto-coverage group, can apply for ElderShield coverage, subject to medical assessment.
If you join ElderShield early, the premiums payable are affordable. ElderShield premiums are determined at the age of entry and do not increase with age.
By joining the scheme under the auto-coverage arrangement, you do not need to go for any medical assessment unless you have pre-existing disability. This means you will be covered even if you have pre-existing conditions such as diabetes or hypertension. However, if you decide to opt out now and join later, you will need to go through medical assessment to see if you have any medical condition that could lead to severe disability later on. Your application could be rejected because of your medical condition.
Can I join ElderShield if I have pre-existing disability?
Please refer to the section on the “Definition for Disability” for the definition of “pre-existing disability” under ElderShield. As with any insurance plan, a person with pre-existing disability may not be eligible for insurance coverage.
There are 3 ElderShield insurers: Aviva Ltd, Great Eastern Life Assurance Co Ltd and NTUC Income Insurance Cooperative Ltd. All 3 insurers are offering the same premiums and payouts under ElderShield. You will be assigned to any one of the 3 insurers. If you wish to switch to any of the other insurers, you can do so within the 90-day opt-out period with no penalty.
If you change insurer after the 90-day period, you will lose the premiums already paid and will be regarded as a new application by the second insurer. You may then need to undergo medical assessment in order to be accepted by the second insurer.
ElderShield complements your MediShield and other medical insurance plans, by offering added protection and long-term benefits. Both ElderShield and MediShield provide different types of coverage.
ElderShield will pay you monthly cash payouts of $400 for up to 72 months (i.e. ElderShield400) or $300 for up to 60 months (i.e. ElderShield300) if you become severely disabled for any reason.
MediShield helps you pay hospitalisation expenses, if you are admitted to a hospital. It is not designed to give you cash to help pay for the long-term care costs after hospitalisation should you become severely disabled.
What are the benefits of ElderShield?
You will receive a monthly cash payout of $300 or $400 should you become severely disabled. You can draw this sum of money for up to 60 or 72 months (depending on whether you are on ElderShield300 or ElderShield400), and can use the money to help you pay for a type of care that is suitable for your needs (e.g. home nursing services, day rehabilitation, nursing homes, etc). For someone who recovers but becomes severely disabled again, he will still get the cash payout as long as the total payout period is not more than 60 or 72 months.
Why are the premiums for ElderShield differentiated by gender?
Why are the premiums for ElderShield differentiated by gender?
ElderShield is a disability insurance scheme with no savings or investment elements. This helps to keep the premiums affordable.
No one knows for sure whether we would be so unfortunate to be disabled in old age. As we grow older, our chances of suffering from severe disabilities increase sharply. Based on the experience of other advanced countries, such as the UK, men and women have a 35% and 45% chance of being disabled in their lifetime respectively. This high incidence rate of disability makes it necessary to protect ourselves in old age.
One most common cause of disability is stroke. Out of every 10 stroke patients, it is estimated that about 4 can claim for Eldershield payouts. Joining ElderShield will give you the added protection to help cope with the financial burden should you be unable to take care of yourself due to disabilities.
How can I pay the premiums for ElderShield?
You can use your Medisave to pay for your ElderShield premiums. If you do not have enough Medisave savings, you may also use the Medisave Accounts of your spouse, parents, children or grandchildren. You may also pay by cash.
Do I have to continue paying my premiums if I become severely disabled?
If you become severely disabled, your ElderShield payouts will start and your subsequent premiums will be waived.
If you recover from your severe disability, the insurance payouts will stop, and you will have to continue paying the premiums till the end of payment term to be entitled to the remaining payouts.
If you have received the maximum payouts of 60 or 72 months according to the plan you are on (ElderShield300 or ElderShield400), your policy will discontinue. In this situation, of course, no further premium payment is necessary.
How do I make a Claim?
Fill up the claim form and have your condition assessed by an appointed assessor. The assessor will complete the assessment form and return it to your insurer for processing. You will receive your insurance payouts either by cheque or credited into your bank account 90 days after you have been certified to be severely disabled.
You may obtain a copy of the claim form and list of appointed assessors from the insurer's website. You can also contact your Insurer's Customer Service Centre for details and advice.
Why do I need to wait 90 days before getting my payouts if I become severely disabled?.
ElderShield payouts will start 90 days after the certification of severe disability by the appointed assessor. This is known as the “deferment period”. This is to ensure that ElderShield pays out in the event of severe disability for which the person will need long-term nursing care and support.
Without the deferment period, ElderShield premiums will be higher, because Insurers will need to pay the claims for cases of temporary and non-severe disability.
Do I have to bear the cost of assessment?
If your claim is successful, your Insurer will reimburse the assessment fee in full to you. If your claim is unsuccessful, you will have to pay for the cost of the assessment.
It costs $50 for each assessment if you visit an appointed assessor at the clinic. For those who prefer to have the assessment done at their homes, they can arrange for any of the appointed assessors to go to their homes to do the assessment. For such cases, the assessment will cost $150 per visit.
(Note: The fees quoted above are subject to future revisions.)
Can I see my own doctor or specialist to be assessed?
Yes, you can see your own doctor or specialist for assessment if he or she is in the panel appointed by the Insurers. The purpose of having an appointed panel of doctors to conduct the assessments is to minimise inappropriate claims and to ensure consistency in the claims assessment. You are encouraged to bring along your medical records (if any) for your severe disability assessment.
What can I do if I disagree with the claims assessment of the insurer?
If you disagree with the assessment of the assessor, you can request to be assessed by a specialist. However, you will need to bear the costs of the assessment fees ($75 for assessment done at the specialist’s clinic or $150 for house visit). If you are assessed by the specialist to be eligible for claims, your assessment fee will be reimbursed in full by your Insurer.
If the specialist assesses that you are not eligible for claims and you still disagree with the assessment, you could submit an appeal to the ElderShield Arbitration Panel set up by the Ministry of Health. The ElderShield Arbitration Panel may appoint a geriatrician or any other qualified medical practitioner to do a reassessment. The decision of the Arbitration Panel shall be final and binding on both you and your Insurer. Costs incurred for this assessment shall be borne by your insurer if the ElderShield Arbitration Panel decides that you are disabled. Otherwise, the assessment fee shall be borne by you if the ElderShield Arbitration Panel decides that you are not disabled.
You can also contact your Insurer's Customer Service Centre for details and advice.
When ElderShield300 was first launched in 2002, there was very little Singapore-based data on severe disability claims. MOH had to rely on overseas data to help guide the initial design and pricing of the ElderShield300 scheme. In view of this, MOH then made a specific provision in its ElderShield contract with the insurers to return 50% of any accumulated surplus to existing policyholders, if the actual claims experience during each five-year period turn out to be different from what was projected in 2002. In the first 5 years of the scheme, ElderShield claims have been lower than those projected in 2002. Hence, for the existing policyholders who have participated in ElderShield in 2002-2007 and whose policies are still in force then, they were entitled to premium rebates in 2007/8.
In the 2007 reform, a similar provision was also made for the ElderShield400 contract with the insurers.
This year (2012) marks the second rebate exercise with the insurers, for both ElderShield300 and ElderShield400. MOH has assessed the claims experience of the past 5 years (2007-2012) with the insurers, and found that ElderShield claims made from 2007-2012 were lower than those projected in the pricing basis for ElderShield300 and ElderShield400. Hence, existing ElderShield policyholders will be entitled to premium rebates in this round of ElderShield Rebate exercise in 2012.
The rebate will be distributed in the form of premium discounts to offset part of your premiums. Depending on the timing of your policy renewal, it will take place between October 2012 and September 2013.
If you have finished paying your ElderShield premiums, the rebate will be returned to you via the latest stipulated premium payment method. The rebate will be credited into your Medisave account if you have paid your premiums via Medisave, or a cheque will be sent to you if you have paid your premiums using cash.
You may obtain more information from your insurer.
The rebate is a contractual requirement stipulated by MOH that the ElderShield insurers have to fulfil. As ElderShield is a long-term insurance policy, the remaining portion of the accumulated claims surplus is being set aside as reserves by the insurers to meet their obligations to pay out claims many years in the future. This is necessary as ElderShield policyholders cease paying premiums at age 65, but can claim the benefits anytime during their lifetime until their 80s and even later. In fact, most severe disability claims occur well after age 65. Hence, we need to ensure that the scheme is able to pay for future claims when more policyholders experience severe disability but have already stopped contributing premiums to the scheme.
ElderShield insurers abide by MAS’s risk-based capital framework to hold sufficient reserves in order to absorb the impact of adverse claims experience and other risk factors and continue to support payouts from ElderShield over the long-term.
Although we have accumulated 10 years of claims experience, we cannot yet draw definitive conclusions about future claims experience. Our local experience in severe disability claims is still evolving, and we need to have an appropriate allowance for the claims experience over time. While we have experienced good claims experience so far, it would not be advisable to reduce the current ElderShield premiums, given that it is a long-term insurance product where policyholders cease paying premiums at age 65, but can claim the benefits anytime during their lifetime until their 80s and even later. In fact, most severe disability claims occur well after age 65. Hence, we need to ensure that the scheme is able to pay for future claims when more policyholders experience severe disability but have already stopped contributing premiums to the scheme.
MOH will continue to monitor the claims experience of insurers, and consider the need for adjustments in premiums and rebates in future.
Premium rebates are calculated by comparing the pricing parameters and the actual claims made by ElderShield300 and ElderShield400 policyholders in the past five years (2007-2012) respectively.
As the profile of policyholders and the pricing parameters used in ElderShield300 and ElderShield400 are different, the rebates are calculated as two separate groups so as to be fair to both ElderShield300 and ElderShield400 policyholders.
The rebates for ElderShield300 and ElderShield400 are calculated separately due to the different pricing parameters and claim experience for each scheme.
When ElderShield400 was introduced, policyholders were able to enjoy more competitively priced premiums vis-a-vis the benefits, compared to ElderShield300. It would thus not be fair to compare the rebate amounts received by ElderShield300 and ElderShield400 policyholders
For example, for those who upgraded from ElderShield300 to ElderShield400 in 2007, their coverage increased by 60% via the upgrade, while their premiums increased by less than 40%. This meant that those who upgraded had reaped the benefits of getting value-for-money premiums when they upgraded to ElderShield400.