In a recent article from The Straits Times, the headline caught our attention: ‘More than half of those who opt for Integrated Shield Plans (IPs) for private healthcare choose subsidised wards during hospital stays.‘ This naturally prompts the question: what’s behind this trend?
A common concern shared by many revolves around the lack of clarity when it comes to the out-of-pocket expenses that come with using your Integrated Shield Plan (IP).
Let’s break down the basics to gain a clearer picture.
In Singapore, we contribute a portion of our income to MediSave, a national medical savings scheme that provides us access to subsidised healthcare across hospitals and clinics in the country. In 2015, the government introduced MediShield Life (MSHL), a basic health insurance plan that covers all Singaporeans and PRs. This initiative aims to safeguard all Singapore Citizens and Permanent Residents from substantial hospital expenses throughout their lifetimes, irrespective of their age or health condition.
If we rely solely on MediShield Life (MSHL) insurance for covering medical costs within Singapore’s hospitals, we’re entitled to full subsidies for treatment in Class C/B2 wards. These wards accommodate either 6 or 12 patients sharing a room. Anything beyond this class receives partial subsidies. For details, refer to Table A illustrating the MediShield Life Payout Subsidy.
*MediShield Life Payout Subsidy & Deductible
Hospital Type | Ward Class | Subsidy | +Deductible |
|---|---|---|---|
Public | B2/C | 100% | $1,500 |
B1 | 43% | $2,000 | |
A | 35% | $2,900 | |
Private | – | 25% | $3,800 |
* This is based on an insured person who is below the age of 81 years old, and holds an IP whose ward coverage is pegged to their actual ward stay.
+Deductible: An initial amount to be paid before you can make claims in a policy year from your health insurance (applicable to both MSHL and IP). The specific amount depends on the hospital type and ward class you opt for.
Therefore, most of us purchase an add-on to our MediShield Life policy, known as an Integrated Shield Plan (IP), which allows us to claim higher out-of-pocket expenses for non-subsidised wards and private healthcare, in cases where the medical bills are higher.
To get a clearer picture of the out-of-pocket expenses we might face with MediShield Life or an Integrated Shield Plan, let’s examine the cost of a Heart Bypass Surgery in various hospital and ward classes, with and without an IP.
Without an IP
Class C* | Class B2* | Class B1^ | Class A^ | Private Hospital^ | |
|---|---|---|---|---|---|
Final out-of-pocket cost | $0 | $0 | $21,650 | $25,050 | $69,050 | Hospital Bill | $6,400 | $8,300 | $36,100 | $39,500 | $83,500 |
MSHL Pays | $4,400 | $5,800 | $6,900 | $6,900 | $6,900 |
Your Co-payment (includes deductibles and co-insurance | $2,000 | $2,500 | $29,200 | $32,600 | $76,600 |
Claimable by MediSave (up to a limit of $7,550) | $2,000 | $2,500 | $7,550 | $7,550 | $7,550 |
* Subsidised: Class C, B2
^Non-subsidised: Class B1, A, and Private Hospital
With IP and Rider
Class C* | Class B2* | Class B1^ | Class A^ | Private Hospital^ | |
|---|---|---|---|---|---|
Final out-of-pocket cost | $0 | $0 | $0 | $0 | $0 | Hospital Bill | $6,400 | $8,300 | $36,100 | $39,500 | $83,500 |
MSHL Pays | $4,400 | $5,800 | $6,900 | $6,900 | $6,900 |
Insurer Pays
(IP & Rider) | $1,700 | $2,100 | $27,400 | $30,600 | $73,600 |
Your Co-payment (includes includes deductibles and co-insurance) | $300 | $400 | $1,800+ | $2,000+ | $3,000+ |
Claimable by MediSave (up to a limit of $7,550) | $2,000 | $2,500 | $3,000 | $3,000 | $3,000 |
* Subsidised: Class C, B2
^ Non-subsidised: Class B1, A, and Private Hospital
+ Pre-authorisation is required with your insurer prior to your surgery with a specialist on the insurer’s panel
- 10% co-insurance: Generally, a co-insurance percentage that comes into effect once you have met your deductible.
- The co-payment can be paid by MediSave, subject to the MediSave withdrawal limits.
- Computations assume treatment falls under Table 7C, which allows a MediSave withdrawal limit of $7,550
- Non-subsidised bills are generally larger than subsidised bills, and MSHL covers a much smaller proportion of non-subsidised bills compared to subsidised bills.
- Hospital bill and MSHL/IP payout figures are rounded to the nearest 100
- Computations assume treatment at panel specialist in private hospital with 5% co-payment capped at $3,000
- Computations assume the insured is a Singapore Citizen aged 80 and below.
To put it simply, the table above highlights the variation costs across the different ward classes. It provides us with a clearer picture of potential medical expenses we could encounter, the portion covered by our MediSave, and the amount we’ll need to pay directly in cash.
Our suggestion is to evaluate if your coverage matches the ward class you’d select during a medical emergency. If your budget allows and your health is a top priority, having access to private and highly specialised medical professionals and healthcare facilities may be worth considering.
To estimate the out-of-pocket expenses for treatments in private hospitals, you can use Mount Elizabeth’s hospital bill estimator. This tool provides information on your IP and riders and gives you an approximate idea of your out-of-pocket medical expenses.
Being well-prepared for unexpected health scenarios is absolutely crucial.