More surgical procedures covered under Medisave, MediShield from 2014

By Sara Grosse, Channel NewsAsia, 16 Oct 2013

More surgical procedures will be covered under Medisave and MediShield from January 2014, following the release of an updated Table of Surgical Procedures (TOSP).

TOSP is a classification of surgical procedures based on their complexity.

The Ministry of Health (MOH) said the changes will help patients reduce their out-of-pocket cash expenses.

About 1,600 surgical procedures listed on TOSP are currently claimable under Medisave and MediShield -- and the number will increase to 2,350 in January.

They will include procedures that are relatively new and have become more common, such as a surgery for abnormal heart rhythm, called Maze surgery.

Other than adding new procedures, MOH has also re-classified existing procedures to better reflect their complexity.

This means patients will not have to pay as much for less complicated surgeries.

Surgeries are categorised into 21 tables, running from Tables 1A, 1B, 1C through to Tables 7A, 7B, 7C, in order of complexity.

For example, total knee replacement is now classified under TOSP as a single procedure on Table 6B, but with the changes, it will be divided into three categories, ranked according to complexity.

The Singapore General Hospital (SGH), which sees about 2,000 knee replacements a year, said the changes will benefit their patients.

Professor Tan Ser Kiat, emeritus consultant at SGH’s Department of Orthopaedic Surgery, said: "The majority of the patients will then pay less compared to what they are paying today, because 70 per cent of the patients fall into the primary simple total knee replacement, which is table 6A.

“Today, all total knee replacements are classified as table 6B, which is one table higher than what is being proposed. The patients probably will pay somewhere in the region of 10 to 15 per cent less than what they would do today."

Professor Tan added that patients which fall under the knee replacement revision category, which is a more complex procedure, will have to pay more than previously.

But he said this is fair, as the surgery requires more time and skill.

The changes were made in consultation with clinicians from various surgical backgrounds in both the public and private sector.

TOSP will be reviewed regularly, in order to keep up with future medical advances.