Sunday 29 December 2019

MediShield Life to offer higher payouts with new claim limits from 1 January 2020; no changes to premiums

January 1 changes will benefit 90,000 a year although premiums will stay the same
By Timothy Goh, The Straits Times, 28 Dec 2019

Patients who need surgery will be able to claim more from their compulsory health insurance from Jan 1, the Ministry of Health (MOH) announced yesterday.

This comes as MediShield Life claim limits are being raised, a move which is expected to benefit around 90,000 patients a year.

MediShield Life is a basic health insurance plan that helps to pay for large hospital bills and selected costly outpatient treatments, such as dialysis and chemotherapy.

All Singaporeans and permanent residents are covered by MediShield Life, which is administered by the Central Provident Fund Board.

Patients undergoing surgical procedures listed in the MOH's Table of Surgical Procedures can claim from MediShield Life and tap their Medisave to pay for their surgical bills subject to claim limits.

There are currently seven tiers of MediShield Life claim limits to cater to surgical procedures of different complexities.

This number will triple to 21 from next year, allowing for more differentiation between procedures of varying complexities.

The new set of limits, offering higher payouts, will take effect for those admitted for surgical procedures from Jan 1.

For instance, Patient A who undergoes a complex uterus operation might currently be able to claim only up to $1,400 - the same amount as Patient B who undergoes a simpler uterus operation.

Under the revised limits, Patient A would be able to claim up to $2,180. Patient B would be able to claim up to $1,800 for the simpler procedure, less than Patient A, but $400 more than the previous limit allowed.

MOH said yesterday that the introduction of the new tiers will provide better coverage for more complex surgical procedures, which tend to be costlier.

There will be no adjustments to premiums at this point, as the Government committed to keeping premiums constant for five years when MediShield Life was launched in November 2015.

The claim limits were adjusted to keep pace with increasing healthcare costs since 2015.

The claim limit revisions were recommended by the MediShield Life Council as part of its review exercise, which started last year and is expected to be completed by the end of next year.

Senior Minister of State for Health Edwin Tong said yesterday that the new claim limits would be implemented first so patients can benefit earlier from the changes.

He added: "The new claim limits will improve MediShield Life coverage for more complex surgical procedures and better protect Singaporeans against large hospital bills... We will continue our efforts to keep healthcare costs sustainable and affordable for all Singaporeans."

Patients do not need to take any steps to benefit from the new limits, which will be automatically applied to their MediShield Life claims.

Dr Lily Neo, deputy chairman of the Government Parliamentary Committee for Health, said: "It is useful to have such revisions... Not all conditions are the same or require the same standardised procedures, so if we can have more tiers, that will better accommodate various conditions that require different types of treatment or better technology."

In its statement, MOH emphasised that the Government provides significant subsidies of up to 80 per cent to keep healthcare costs low, and that there are various forms of financial assistance available for those in need.

It added: "No Singaporean will be denied appropriate healthcare due to an inability to pay."

Higher MediShield Life claim limits a relief for parents of baby due for surgery
MediShield Life revisions will help ease their financial worries over his cleft palate operation
By Timothy Goh, The Straits Times, 28 Dec 2019

One of the first patients to benefit from revisions to MediShield Life may not even remember undergoing his procedure.

One-year-old Bryler Tan is scheduled to have cleft palate repair surgery in January - the same month that claim limits for the insurance plan will be raised and separated into more tiers.

The revisions to MediShield Life, which the Ministry of Health announced yesterday, are expected to benefit some 90,000 patients a year with higher payouts, from Jan 1.

For Bryler's mother, 27-year-old senior patient service associate How Pei Fen, this is a huge relief.

The baby's surgery is currently listed under tier 5C in the Ministry of Health's Table of Surgical Procedures, which means his family would have been able to claim up to $1,400 for it from MediShield Life.

Madam How, who is married to a helper at a food store, said yesterday: "We were worried about the huge cost of the surgery and scared we couldn't pay for it. We also knew Bryler would need to go for a lot of follow-ups and treatments, and we'd need to spend a lot.

"We have financial issues and were worried that we'd have insufficient Medisave to make the payment."

The estimated cost of Bryler's upcoming surgery is around $15,000 before government subsidies. This estimated amount is based on a four-day stay in the hospital.

Following the revision, they can claim up to $2,180 for the procedure. "This will help us to reduce our out-of-pocket payment, and even with the little we can pay out of Medisave, we will still be able to afford high surgery cost," said Madam How.

Higher and more granular claim limits for MediShield Life -27 Dec 2019

Are MediShield Life payouts lower than subsidised fees?

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