Hospitalisation coverage is a must-have tool to have in your life due to the ever-rising healthcare costs in the country. According to the Singapore Department of Statistics, the cost of Medical & Dental Treatment has risen nearly 78% in the last 20 years.
In 2015, the MediShield Life Scheme was introduced as a replacement and an enhancement for the older MediShield Plan introduced in 1990. MediShield Life is a basic hospitalisation coverage plan that provides life coverage for all Singaporean Citizens and Permanent Residents, including those with pre-existing conditions. MediShield Life covers most basic hospitalisation fees such as Inpatient/Outpatient Treatment subsidised bills incurred at Class B2/C wards in public hospitals.
IP provides additional benefits such as claiming higher coverage for general medical procedure costs and higher class ward stays and other advantages such as pre-authorisation, higher coverage under panel doctors, and Preferential Health Screening Rates.
Integrated Shield Plan
So what is an Integrated Shield Plan (IP)? An IP is a hospitalisation plan administered by private insurers, as approved by MOH, providing enhanced coverage beyond MediShield Life. Various plan types are available for stays in private hospitals or Class A/B1 wards of public hospitals.
Since it is an extension of MediSheild LIfe, the MediShield Life component of the IP is fully payable by MediSave. In contrast, the private insurance component of the IP is payable by MediSave up to the Additional Withdrawal Limit (AWL), and the remainder is payable by cash. Riders cannot be paid using MediSave. From 1 November 2015, the AWL is set per insured person per policy year, as stated below:
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Unlike MediShield LIfe plans, Coverage for the private insurance component of the IP may be declined or imposed with exclusions or restrictions arising from pre-existing conditions. There is a minimum and maximum entry age limit. However, some insurers would allow those with pre-existing conditions to take on an IP plan with a higher premium price via Risk-Loading.
There are different Tier of IPs depending on how much you can afford and how comprehensive you want your coverage to be (Class B1 Wards for Public Hospitals vs Class A Wards for Public/Private Hospitals).
As of 1 May 2016, all IP insurers must sell the Standard IP regulated by MOH. The benefits of Standard IP are identical across all IP insurers and have claim limits sized to cover nine out of ten Class B1 bills fully. Like other IPs, it also has co-insurance and deductible components. As of 2022, there are 7 Standard IP Providers:
Private Insurers can also provide upgraded and enhanced plans that can cover more aspects of Class B1 plans, Class A plans for public hospitals, and private hospital expenses.
Co-Insurance, Deductibles, and Pro-Ration Factors
As health insurance will not fully pay for your medical expenses as regulated by the government, you should understand three Health Insurance terms before getting a shield plan from your relevant insurer: Deductibles, Co-Insurance, and Pro-Rations.
Deductibles are the flat rate of how much you have to pay for your medical bills before any insurer can pay any benefit payment under the IP policy to ensure that the premiums of the hospitalisation plan remain affordable, as the onus is less on the insurer. Deductibles are usually counted on a per-year basis, meaning that all eligible expenses incurred within a policy year will be used to satisfy the deductible amount. However, some plans have per disability deductibles.
Co-Insurance is a specified percentage (Usually 5-10%, depending on the inclusion of Riders) of the total medical expenses post-deductible payment that you must pay according to your IP Policy states. Co-insurance aims to reduce over-consumption of medical costs, and some riders will provide a reduction in coinsurance and deductibles. Click here to read more about IP Riders.
A Pro-Ration Factor is an additional charge (a percentage expressed as a pro-ration factor in the benefits schedule) that you have to pay if you are admitted to a hospital or ward that is higher than what your current shield plan allows, e.g. if you get an IP that entitles you to B1-Class Ward stays.
However, you are admitted to an A-class ward/ private hospital. The benefit payable by the insurer will be reduced to consider the differences in the government subsidies applicable to the ward type of your current policy. This ensures fairness in payment (those who pay higher premiums for better coverage can enjoy, and those who pay lower premiums should only use what they are entitled to).
Should I Switch my Insurer for IP Plans?
Some people might be tempted to switch their insurers for their IP if they already have an IP Policy prior due to peer pressure from their Financial Advisor peers or a desire to integrate all things insurance with a new financial advisor from a different insurance company. We do not recommend switching your IP Plans for whatever reason.
Integrated Shield Plans by private insurers will subject you to underwriting to check if you are eligible for insurance and if you have any pre-existing conditions that might subject you to risk-loading. You would also have your original coverage terminated and face the possibility of not being able to reapply for your original plan.
If you switch to a new IP, you can have the option to return to the previous insurer within 30 days from the date of notification of termination of the initial IP policy. No re-underwriting is allowed by your previous insurer, as though the first IP policy had never been terminated in the first place. Nonetheless, it is not worth facing the trouble and risk.
With the rise in healthcare costs, having comprehensive coverage for medical expenses has become more crucial. There are some tools from the Ministry of Health (MOH) website that can help you understand and compare different IPs from private insurance companies, as well as allow you to check if you are covered by an existing shield plan.